| ObjectiveThis paper explored and analyzed the theory of Xin-Kai-Ku-jiang,and preliminarily summarized the theoretical basis of applying Xin-kai-Ku-Jiang method in the treatment of pulmonary diseases.The modified Xiaoqinglong decoction was used to observe the clinical effect and safety of the treatment of AECOPD patients with the theory of Xin-Kai Ku-Jiang,so as to provide reference for the treatment of clinical AECOPD.Method1.Theoretical research:referring to the related literature of Xin-Kai-Ku-jiang theory,combing the source and development,exploring the connotation,revealing the relationship between Xin-kai-Ku-Jiang theory and the movement and entry of qi machine,as well as the relationship between the movement and entry of qi machine and lung physiological characteristics,providing theoretical support for the treatment of AECOPD with Xin-kaiKu-Jiang modified Xiaoqinglong decoction.2.Clinical study:A retrospective study was conducted to select AECOPD patients who were up to the notch and were hospitalized in the Pulmonary Department of Shandong Hospital of Traditional Chinese Medicine from October 1,2019 to October 1,2021 by searching the electronic medical record system.Pick up information such as recording gender,recording age and BMI,collecting smoking history and lung function,inquirying underlying diseases,gathering admission and discharge time and so on.Inflammatory indicators such as white blood cell count(WBC),neutrophil percentage(NEUT%),Creactive protein(CRP),and safety indicators such as alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),creatinine(CRE)were also analyzed.According to whether the patients were treated with oral Jiawei Xiaoqinglong Decoction(>7 days),they were segmented into the treatment group and the matched group.According to the propensity score matching of the two groups,the matching ratio was 1:1,and the caliper value was 0.02.The two groups of subjects who were successfully matched were statistically analyzed to test the clinical efficacy of Jiawei Xiaoqinglong decoction in patients with AECOPD.ResultsPropensity score matching was used to pair the two groups of patients.Before matching,the baseline WBC levels of the two groups were compared,and the difference was statistically obvious,and the two groups were not comparable.After propensity score matching,a total of 62 patients were finally matched,with 31 cases in each group.Statistical analysis of the baseline levels of clinical characteristics between the two groups showed that there was no obvious difference between the two groups,and the data between the two groups could be compared.1.Comparison of efficacy and scores of TCM syndromesAfter treatment,the total effective rate of TCM syndrome in the experimental group was 96.8%,and the total effective rate of TCM syndrome in the control group was 87.1%,and the experimental group was higher than the control group.After statistical analysis,the difference in the efficacy level of TCM syndromes between the two groups after therapy was statistically remarkable(P<0.001).After statistical analysis,the symptoms of cough,expectoration,sputum color,wheezing and shortness of breath in the two groups before and after therapy were compared,the differences were statistically obvious(P<0.05).After treatment,there were statistically clear differences in cough,expectoration,sputum color,wheezing,thirst and constipation between the two groups(P<0.05),but there was no statistically clear difference in fever(P>0.05).The results showed that the symptoms of cough,expectoration,sputum color and wheezing were improved in both groups after treatment,and the effect of the experimental group was more obvious.The symptoms of thirst and constipation in the control group were not relieved after treatment,while the symptoms in the experimental group were evident improved after cure.There was no clear distinction in fever symptoms between the two groups after cure(P>0.05).2.Comparison of CAT scoresAfter statistical analysis,the CAT scores of the two groups before and after treatment were compared,the difference was statistically significant(P<0.05).The CAT scores of the two groups were compared after treatment,and the difference was statistically distinct(P<0.05).The promotion of CAT score in the experimental group was significantly better than that in the control group.3.Comparison of inflammatory markersAfter statistical analysis,the comparison of WBC,NEUT%and CRP in the two groups before and after treatment indicated that the distinctions were mathematically significant(P<0.05),that is,the two treatment methods can effectively reduce the level of inflammatory indicators.After treatment,there were statistically evident distinctions in WBC and NEUT%between the two groups(P<0.05),but there was no statistically obvious difference in CRP(P>0.05).From the perspective of numerical changes,the reduction of WBC and NEUT%in the experimental group was better than that in the control group,indicating that the combined treatment with traditional Chinese medicine has a better effect on the promotion of inflammation.4.Safety indicatorsThere were no obvious adverse reactions in the experimental group and the control group after therapy,and there were no significant discrepancy in ALT,AST,CRE and BUN before and after therapy(P>0.05).There are no obvious problems in the safety of the two treatment methods.5.Length of stayAfter statistical analysis,there was no statistically significant disparity in the length of hospital stay between the two groups(P>0.05)ConclusionCompared with conventional treatment of Western medicine alone,Xiaoqinglong decoction combined with Xiaoqinglong Decoction can effectively relieve symptoms,improve status and improve quality of life of patients based on conventional treatment of Western medicine.The theory of Xinkaikuanjian should be valued in clinical COPD treatment. |
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