A Retrospective Study Of The Whole Course Treatment Of Chronic Obstructive Pulmonary Disease With Syndrome Of Phlegm-heat Obstructing Lung By Traditional Chinese Medicine

Chronic obstructive pulmonary disease,referred to as COPD,it’s character is not-completely reversible airflow limitation and persistent respiratory symptoms.Because it is easy to acute exacerbate by infection,it is a repeated stimulation to airways and lung tissues,and eventually cause irreparable lung damage.Patients with acute exacerbation has dyspnea,cough and expectoration,and even need adjuvant ventilation in severe cases.Long-term medication is needed after stable transition.And we need to be careful to avoid the acute exacerbation.And because the course is long,with many complications,it brings a lot of pain and inconvenience to patients and their families.The mainly treatments of COPD in modern medicine is bronchodilators and glucocorticoid.Anti-infection treatment with antibiotics in AECOPD,dispelling phlegm if it’s needed.Oxygen therapy and lung rehabilitation are the main rehabilitation methods when it is stable.It’s a period of rapid change in AECOPD,with complex pathogenic bacteria.Most of clinical treatments is using experienced antibiotics or broad-spectrum antibiotics.Recently,the whole course of treatment with traditional Chinese medicine is giving full play to the traditional treatment of COPD,combined with Western Medicine,to be the focus of clinical treatment in the furture.It is also a future treatment for COPD that is more worthy of further study.Purpose:To analyse the effect of the whole course treatment of chronic obstructive pulmonary disease by traditional Chinese medical decoction retrospectively.To observe the curative effect of traditional Chinese medicine decoction combined with conventional therapy in western medicine and only-using the conventional therapy in western medicine in the whole course.Furthermore,the value of the whole course of traditional Chinese medicine treatment in chronic obstructive pulmonary disease in many ways and faces.To provide a new reference for the treatment of the whole course of chronic obstructive pulmonary disease.Method:This is a single-center retrospective cohort study.AECOPD patients with syndrome of phlegm-heat obstructing lung were diagnosed and treated in the Department Two of Respiratory in the Second of Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,from May 2019 to September 2020,will be collected.Cases are screened according to inclusion and discharge criteria.The symptoms and inflammatory indexes of patients in acute stage will be recorded,and follow the patients by outpatient medical records.To record the information and CCQ,and CAT,and m MRC questionnaire record score with patients in stable period.And then check-up every 4 weeks to make a judgement to the withdrawal of traditional Chinese medicine and exacerbation until 12 weeks.And then enter the qualified case information into an Excel spreadsheet to form a database.According to whether the patients used traditional Chinese medicine decoction,dividing paients into observation group and control group.The control group only took conventional western medicine treatment.Besides,the observation group took it combined with traditional Chinese medicine decoction.And to evaluate the efficacy and feasibility of the whole course of treatment combined with traditional Chinese medicine decoction on the basis of western medicine treatment by comparing the differences between the two groups.Results:1.All 210 patients were included in this study,125 persons in observation group and 85 persons in control group.There were no significant differences in age,gender,and smoking status between them(P>0.05).2.Patients treated with traditional Chinese medicine decoction,the main symptoms of cough,expectoration,the secondary symptoms of chest tightness,fever,stool dry knot and the improvement of traditional Chinese medicine syndrome score were more significant,but the improvement degree of wheezing and dry thirst was significant in acute exacerbation,the difference was statistically significant(P<0.05).3.In acute exacerbation,the clinical efficacy of conventional western medicine treatment was more worse than combined treatment,the difference is statistically significant(P<0.05).4.The white blood cell count,neutrophil percentage and C reactive protein of the patients treated with traditional Chinese medicine decoction were better than those treated with conventional western medicine in acute exacerbation(P<0.05).5.The average length of hospitalization of patients in acute exacerbation treated with traditional Chinese medicine decoction was about 1 day shorter than that of control patients treated with conventional western medicine alone in acute exacerbation.And the average length of hospitalization in the observation group was shortened by about 0.5days,however,the average length hospitalization of the control group was about 0.5 days longer than the average.The difference was statistically significant(P<0.05).6.The CCQ questionnaire score and m MRC rating of the patients after 12 weeks of treatment with traditional Chinese medicine decoction were significantly improved compared with those with simple western medicine treatment in stable(P<0.05).Conclusion:1.On clearing heat and resolving phlegm,the traditional Chinese medicine decoction could significantly improve the improvement rate of traditional Chinese medicine syndrome integral and the total clinical therapeutic efficiency in patients which is AECOPD,and it could effectively relieve the main symptoms of cough,expectoration,and wheezing,and the secondary symptoms of dry stool,chest tightness,fever,and thirst.2.The traditional Chinese medicine decoction of clearing heat and resolving phlegm can effectively reduce the WBC,the NEUT% and the CRP.Besides,it could relieve the inflammatory response in patients which is AECOPD.Otherwise,it could shorten the length of days in hospital slightly,which means saving some medical resources and reducing the financial burden of patients to some extent.3.The traditional Chinese medicine decoction of invigorating the lung,spleen and kidney can effectively reduce the grades of CCQ and m MRC.Then,it could have significant improvements in the symptoms of cough,expectoration,wheezing,sleeping condition,strength condition,and psychologic condition.4.The whole course of treatment of spleen,on the basis of western medicine treatment,combined with traditional Chinese medicine decoction,could improve the clinical symptoms of patients in COPD effectively,and it could optimize the prognosis of COPD.