Clinical Observation Of Zhike Pingchuan Decoction For Treating Phlegm-drinking Heat Syndrome In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:To study the clinical efficacy of Zhike Pingchuan Decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease（acute exacerbation of chronic obstructive pulmonary disease,AECOPD）with phlegm-drinking and heat-dissipating syndrome and the improvement of serological inflammatory indexes,and to explore its mechanism,so as to provide theoretical basis for the promotion and application of AECOPD in clinical practice.Method:In this study,70 patients with acute exacerbation of chronic obstructive pulmonary disease with phlegm and heat syndrome were from the Department of Respiratory and Critical Care Medicine of Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine,According to the random number table method,they were divided into control group（conventional western medicine group）and treatment group（conventional western medicine treatment+Zhike Pingchuan decoction group）,35 cases in the control group were given western medicine treatment according to the requirements of 2020 GOLD report（using oxygen therapy,bronchodilators,empirical antibiotics,phlegm and other symptomatic treatment）,and 35 cases in the treatment group were treated with Zhike Pingchuan decoction on this basis.The course of treatment was 12 days.The clinical efficacy,TCM syndrome score,COPD assessment test（CAT）,white blood cell count（WBC）,neutrophil percentage（NEUT%）,C-reactive protein（CRP）,serum amyloid A（SAA）,interleukin 6（IL-6）,blood gas analysis[arterial partial pressure of oxygen（Pa O₂）and arterial partial pressure of carbon dioxide（Pa CO₂）]were observed before and after treatment in the control group and the treatment group.Data collation,and through statistical analysis and comparison.Results:1.There was no significant difference in gender,age,course of disease and pulmonary function grading between the two groups before treatment（P>0.05）;There was no significant difference in total score and single score of TCM syndrome,total score and single score of CAT（P>0.05）;There was no statistical difference in the levels of WBC,NEUT%,CRP,IL-6 and SAA in serum indexes（P>0.05）;There was no statistical difference in arterial blood gas indexes（Pa O₂,Pa CO₂）（P>0.05）.2.Comparison of clinical syndrome score:After treatment,the total score of TCM syndrome,cough,expectoration,asthma,chest tightness,dry mouth but not much drink,and single score of stool rot in the two groups were significantly lower than those before treatment,and the difference was statistically significant（P<0.05）.And the total score of TCM syndrome and cough,expectoration,asthma,chest tightness,dry mouth but drink less single integral in the treatment group were significantly lower than those in the control group,the difference was statistically significant（P<0.05）.After treatment,the scores of stool rot in the two groups were not significant,and the difference was not statistically significant（P>0.05）.3.Comparison of the total effective rates of the two groups:after treatment,the total effective rate of the treatment group was 90.63%,and that of the control group was 75.76%.The clinical efficacy of the treatment group was significantly better than that of the control group,and the difference was statistically significant（P<0.05）.4.Comparison of CAT scores between the two groups:After treatment,the total CAT scores and individual CAT scores of the two groups were significantly lower than those before treatment,and the difference was statistically significant（P<0.05）.And the treatment group was significantly lower than the control group,the difference was statistically significant（P<0.05）.5.The levels of WBC,NEUT%,CRP,IL-6 and SAA in the two groups after treatment were significantly lower than those before treatment,and the difference was statistically significant（P<0.05）.The levels of WBC,NEUT%,CRP,IL-6 and SAA in the treatment group were lower than those in the control group,and the differences were statistically significant（P<0.05）.6.Comparison of arterial blood gas indexes:Pa O₂and Pa CO₂in the two groups were significantly improved after treatment,and the difference was statistically significant（P<0.05）.And the treatment group than the control group improved more significantly,the difference was statistically significant（P<0.05）.Conclusion:1.Zhike Pingchuan Decoction combined with western medicine can improve TCM syndrome,reduce CAT score and improve clinical curative effect of AECOPD patients with phlegm-fluid heat syndrome.2.Zhike Pingchuan decoction combined with western medicine was superior to western medicine alone in improving WBC,NEUT%,CRP,IL-6 and SAA levels in AECOPD patients with phlegm-fluid heat syndrome.3.Zhike Pingchuan Decoction combined with Western medicine can improve the hypoxia status of patients by increasing the value of Pa O₂and reducing the value of Pa CO₂.