Observation On The Curative Effect Of Huatan Qingre Huoxue Recipe Paste And Rubbing In Adjuvant Treatment Of AECOPD With Phlegm Heat Stasis Lung Syndrome

Background:As one of the main chronic respiratory disease,chronic obstructive pulmonary disease(COPD)is characterized by persistent respiratory symptoms and airflow limitation.In recent years,the prevalence and mortality of COPD have been on the rise,which has seriously affected the quality of life of patients and brought a severe economic burden to the society.Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is a process of chronic respiratory symptoms getting worse,which requires additional treatment.It also leads to decreased lung function,worse long-term prognosis,and more frequent acute exacerbations.That's the reason why it is considered to be an important part of the management of COPD.Therefore,it's essential to prevent acute exacerbations of COPD,to relieve the severity of acute exacerbations and to shorten the course of treatment for exacerbations.Traditional Chinese medicine(TCM)believes that COPD can belong to the categories of "lung distension","cough",and "asthmatic syndrome".According to the large-sample cross-sectional syndrome studies and real-world studies find that common syndrome types of AECOPD include phlegm-heat congesting the lung,phlegm-stasis obstructing the lung,phlegm-damp obstructing lung,external cold and internal rheum,among which the three pattern elements of phlegm,heat,and stasis are the most common.As an important branch of external treatment of TCM ointment therapy has not received much attention in the treatment of chronic obstructive pulmonary disease and has not been reported in the literature.Ointment therapy refers to the application of an ointment made of TCM herbs on the surface of the human body to combine the effects of the manipulation and the medicine.Based on the mechanism of ointment therapy and other clinical trials of the ointment treatment of respiratory diseases,the presupposition that ointment therapy can make a difference in treating COPD can hopefully come true.Based on the above background,this clinical trial is going to confirm that ointment made of Huatan Qingre Huoxue Decoction have the clinical efficacy for AECOPD patients with pattern of phlegm-heat and blood stasis obstructing lung.At the same time,safety of this therapy is going to be proved as well.It's hoped that the therapy has a certain clinical value.Objective:To observe the clinical efficacy and safety of adding ointment therapy on the basis of conventional medical treatment on AECOPD,aim to provide patients with new TCM treatment to shorten the course of acute exacerbations and improve symptoms such as cough phlegm and shortness of breath.Methods:The study is a randomized controlled trial.Patients in this study must fit both AECOPD diagnosis and phlegm-heat and blood stasis obstructing lung diagnosis as well as sign informed consent.To randomly divide 46 patients into two groups,22 of which were in the treatment group,23 were in the control group,and 1 was dropped off midway.The control group was treated with conventional medicine such as controlled oxygen therapy,anti-infection,and bronchodilator.The treatment group was treated with Huatan Qingre Huoxue ointment once a day on the basis of the treatment plan of the control group.The course of observation was 7 days.The efficacy evaluation based on scales such as TCM syndrome score,CAT score,mMRC grading and serological indicators such as WBC,NE%,NLR,EO#,RDW,CRP,FIB et.Results:? Baseline comparison:There was no statistical difference between the treatment group and the control group in gender,age,course of disease,COPD classification,COPD grouping,and AECOPD degree classification at the time of entry(P>0.05).There was no statistical difference in the evaluation of the TCM syndrome and physical signs scale,CAT score and mMRC grading scale(P>0.05).There was no statistical difference in serological indicators such as WBC,NE%,NLR,EO#,RDW,CRP and FIB(P>0.05).With all this being said,the baselines of the two groups are level and the comparability is good.?Clinical related scales and overall effective rate evaluation analysis:The two groups of TCM syndrome scores,mMRC scores,and CAT scores all decreased significantly after treatment,indicating that the two groups of treatments are generally effective in improving symptoms.Among them,the scores of TCM syndromes and CAT scores on the 4th and 7th day of the comparison between the groups were significantly different from the day of enrollment(P<0.01).The mMRC scale is except for the control group on the 4th day There are also significant differences within the group(P<0.01).The comparison between the two groups found that only the CAT score on day 7 showed a statistical difference(P<0.05).In terms of overall efficacy evaluation,the effective rate of the treatment group on the 4th day was 36.4%,and the effective rate of the control group was 8.7%.There was a statistical difference(P<0.05).On the 7th day,the effective rate of the treatment group was 90.9%,and the effective rate of the control group was 90.9%.It was 73.9%.The total effective rate of the treatment group was higher,but there was no statistical difference(P>0.05).?Serological index analysis:The comparison between the two groups before and after treatment showed that there was a significant difference in WBC(P<0.01),NE%only appeared in the treatment group(P<0.05),and CRP only appeared in the control group.Difference(P<0.05),there was no difference between groups in the three indicators(P>0.05).The treatment group has more advantages in improving RDW and FIB than pure Western medicine treatment.The specific manifestation is that FIB has an inter-group difference on the 7th day(P<0.05),and RDW has an intra-group difference in the treatment group(P<0.05)but not in the control group.There was no significant difference between the two groups in NLR and EO#(P>0.05).Conclusion:?Ointment combined with Western medicine treatment can improve the clinical symptoms of COPD faster than pure Western medicine treatment,and the overall effective rate is higher;?The ointment treatment is more effective in improving the CAT score,and has a prominent advantage in the improvement of chest tightness symptom;?The addition of ointment treatment is better than simple western medicine treatment in improving FIB,indicating that ointment can have the effect of promoting blood circulation and removing blood stasis;?Ointment with Huatan Qingre Huoxue Decoction has no skin,liver and kidney side effects,which prove the safety of this therapy.