| Research purpose:Using retrospective research methods to analyze the clinical efficacy of Qing Jin Hua Zhuo Prescription combined with conventional Western medicine treatment on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with phlegm-heat accumulating lung syndrome,and to explore the clinical effects of this combination of prescriptions,which is the clinical application Provide basis for promotion.Research method:Adopting retrospective research methods and according to the inclusion and exclusion criteria of this study,we selected AECOPD(phlegm-heat accumulating lung syndrome)patients who were hospitalized in the Department of Respiratory Medicine,Wangjing Hospital,China Academy of Chinese Medical Sciences from January 1,2017 to December 31,2020 as the research objects.The patients were divided into exposure group(82 cases)and non-exposure group(105 cases)according to whether they received traditional Chinese medicine(Qing Jin Hua Zhuo Prescription).The two groups of study subjects were paired using propensity score matching nearest neighbor matching method.Comparing the matched two groups of patients before treatment,10 days after treatment(±3 days)TCM syndrome score,modified version of British Medical Research Council Dyspnea Rating Scale(mMRC),the first second forced expiratory volume as a percentage of the expected value(FEVi%pred),forced expiratory volume in the first second/forced vital capacity(FEVi/FVC),white blood cell count(WBC),neutrophil percentage(NEUT%),C-reactive protein(CRP),liver and kidney function(Alanine aminotransferase ALT,aspartate aminotransferase AST,urea nitrogen(BUN,creatinine CRE)index changes and the difference in the length of hospital stay between the two groups.Results of the study:Use propensity score matching to match the two groups of patients,the matching ratio is 1:1,and the caliper value is 0.02.Before matching,the baseline levels of NEUT%,FEV1%pred,and FEV1/FVC of the two groups were compared,and the difference was statistically significant(P<0.05),and the data between the two groups were not comparable.After pairing,a total of 108 patients were matched,54 cases in each group.After statistical analysis,there was no statistically significant difference in the clinical characteristics of the two groups of patients at baseline(P>0.05),and the data between the groups were comparable.1.TCM syndrome score and clinical symptom curative effect comparison After treatment,the total effective rate of TCM syndromes in the exposed group was 98.15%,and that in the non-exposed group was 94.44%.According to statistical analysis,the difference in the total effective rate of TCM syndromes between the two groups was not statistically significant(P>0.05).The comparison of the curative effect grades of TCM syndromes between the latter two groups was statistically significant(P<0.01).Comparing the symptoms of the two groups before and after treatment,the differences in cough,expectoration,sputum color,shortness of breath,fever,thirst,and constipation were statistically significant(P<0.01).After treatment,the clinical symptoms of the two groups of patients were compared,the differences between the groups of cough and constipation were statistically significant(P<0.05),and the differences between the groups of expectoration,sputum color,shortness of breath,and thirst were statistically significant(P<0.01),there was no statistically significant difference between the fever groups(P>0.05).The results showed that the curative effect of TCM syndromes in the exposed group after treatment was significantly higher than that in the non-exposed group.After treatment,the two groups of patients can improve the symptoms of cough,expectoration,sputum,shortness of breath,fever,thirst,and constipation.Compared with the non-exposed group,the exposed group can significantly improve cough,expectoration,sputum,shortness of breath,and the symptoms of thirst and constipation did not differ significantly between the two groups in improving fever symptoms.2.Comparison of the severity of dyspnea After statistical analysis,the difference in the severity of dyspnea between the two groups before and after treatment was statistically significant(P<0.01),and the difference between the groups after treatment was statistically significant(P<0.05).The results suggest that the severity of dyspnea after treatment in the two groups of patients has been significantly improved,and the improvement of the exposed group is better than that of the non-exposed group.3.Lung function comparison After statistical analysis,the difference between the two groups of FEV1%pred before and after treatment was statistically significant(P<0.01),and the difference between the two groups of FEV1%pred before and after treatment was statistically significant(P<0.05).The difference between the two groups of FEVi/FVC before and after treatment was statistically significant(P<0.01),and the difference between the two groups of patients before and after the FEV1/FVC treatment was statistically significant(P<0.05).The results showed that the lung function(FEV1%pred,FEV1/FVC)of the two groups of patients after treatment were significantly improved,and the lung function of the exposed group was better than that of the non-exposed group.4.Comparison of inflammation indicators After statistical analysis,the two groups of inflammatory indicators were compared before and after treatment.The differences in WBC,NEUT%,and CRP between the exposed group and the non-exposed group were statistically significant(P<0.01);the difference between the two groups of inflammatory indicators before and after treatment In comparison between groups,the difference in WBC and NEUT%was statistically significant(P<0.05),while the difference in CRP was not statistically significant(P>0.05).It showed that the inflammatory indexes of the two groups of patients were reduced after treatment,and the degree of reduction of WBC and NEUT%in the exposed group was better than that of the non-exposed group.The two groups had the same effect in reducing CRP levels.5.Comparison of length of hospital stay After statistical analysis,the difference in the length of hospital stay between the two groups was statistically significant(P<0.05).From the numerical point of view,the length of stay in the exposed group was shorter than that of the non-exposed group.It shows that the combined application of Qing Jin Hua Zhuo Prescription has positive significance in shortening the length of stay in AECOPD patients.6.Comparison of safety indicators After statistical analysis,there was no statistically significant difference between the two groups of patients’ liver and kidney functions(ALT,AST,BUN,CRE)before and after treatment(P>0.05).The results suggest that Qing Jin Hua Zhuo Prescription has good clinical safety and does not increase the burden of liver and kidney.Research conclusion:Qing Jin Hua Zhuo Prescription combined with Western medicine in the treatment of AECOPD patients with phlegm-heat accumulating lung syndrome,compared with Western medicine alone,can significantly improve the efficacy of TCM syndromes,improve patients’ cough,expectoration,phlegm color,shortness of breath,thirst,and constipation The clinical symptoms of the drug,reduce the severity of dyspnea,improve lung function,reduce the level of inflammatory indicators,shorten the length of hospitalization,and do not increase the burden of liver and kidney after treatment,suggesting that the drug is safe and worthy of further promotion and application in clinical treatment. |
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