慢阻肺急性加重期中西医结合治疗：现状与展望
Integrated Traditional Chinese and Western Medicine for Acute Exacerbation of COPD: Current Status and Future Perspectives
DOI: 10.12677/tcm.2025.1410621, PDF,   
作者: 杨梅婕：成都中医药大学临床医学院，四川 成都；高培阳*：成都中医药大学附属医院重症医学科，四川 成都
关键词: 慢性阻塞性肺疾病；急性加重期；中西医结合治疗；未来方向；Chronic Obstructive Pulmonary Disease (COPD)； Acute Exacerbation； Integrated Traditional Chinese and Western Medicine Therapy； Future Directions
摘要: 慢阻肺(COPD)是一种全球普遍存在的呼吸系统疾病，其急性加重期的管理对于改善患者的生活质量和预后具有重要意义。近年来，随着对其病理机制的深入研究，中西医结合治疗策略逐渐引起了临床和研究者的关注。中西医结合治疗的方法不仅融合了现代医学的先进技术，也借鉴了传统中医的整体观念和个性化治疗。然而，目前仍面临中西医结合诊疗体系科学化、规范化不足的困境，为实现慢阻肺急性加重期中西医规范化管理未来我们还需做很多努力。本文论述内容涵盖了中西医结合治疗慢阻肺急性加重期的现状、困境以及未来的研究方向与挑战等多个维度，希望能为临床实践提供有益的参考和指导。
Abstract: Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory disorder worldwide, and the management of its acute exacerbations plays a crucial role in improving patients’ quality of life and prognosis. In recent years, with in-depth research into its pathological mechanisms, integrated traditional Chinese and Western medicine (TCM-WM) therapy has garnered increasing attention from clinicians and researchers. This approach combines advanced modern medical techniques with the holistic and individualized treatment principles of traditional Chinese medicine. However, challenges remain, particularly in standardizing and scientifically validating the integrated TCM-WM diagnostic and therapeutic framework. Further efforts are needed to establish evidence-based guidelines for COPD exacerbation management. This article comprehensively reviews the current status, challenges, and future research directions of integrated TCM-WM therapy for acute COPD exacerbations, aiming to provide valuable insights for clinical practice.
文章引用：杨梅婕, 高培阳. 慢阻肺急性加重期中西医结合治疗：现状与展望[J]. 中医学, 2025, 14(10): 4286-4291. https://doi.org/10.12677/tcm.2025.1410621

参考文献

[1] Celli, B.R., Fabbri, L.M., Aaron, S.D., Agusti, A., Brook, R., Criner, G.J., et al. (2021) An Updated Definition and Severity Classification of Chronic Obstructive Pulmonary Disease Exacerbations: The Rome Proposal. American Journal of Respiratory and Critical Care Medicine, 204, 1251-1258. [Google Scholar] [CrossRef] [PubMed]
[2] Erhabor, G.E., Adeniyi, B., Arawomo, A.O., Akinwalere, O., Adetona, G., Fagbohun, F.T., et al. (2021) Acute Exacerbation of COPD: Clinical Perspectives and Literature Review. West Africa Journal of Medicine, 38, 1129-1142. [Google Scholar] [CrossRef] 
[3] Kyriakopoulos, C., Gogali, A., Kostikas, K. and Konstantinidis, A. (2021) Hypercoagulable State in COPD—A Comprehensive Literature Review. Diagnostics (Basel), 11, Article No. 1447. [Google Scholar] [CrossRef] [PubMed]
[4] Global Strategy for Prevention, Diagnosis and Management of COPD: 2025 Report.
https://goldcopd.org/2025-gold-report/
[5] Sun, T., Li, X., Cheng, W., et al. (2020) The Relationship between Morning Symptoms and the Risk of Future Exacerbations in COPD. International Journal of Chronic Obstructive Pulmonary Disease, 15, 1899-1907.
[6] Casadevall, C., Sancho-Muñoz, A., Vicente, I., Pascual-Guardia, S., Admetlló, M. and Gea, J. (2022) Influence of COPD Systemic Environment on the Myogenic Function of Muscle Precursor Cells in Vitro. Respiratory Research, 23, Article No. 282. [Google Scholar] [CrossRef] [PubMed]
[7] Barnes, P.J. (2016) Inflammatory Mechanisms in Patients with Chronic Obstructive Pulmonary Disease. Journal of Allergy and Clinical Immunology, 138, 16-27. [Google Scholar] [CrossRef] [PubMed]
[8] Torrelles, J.B., Restrepo, B.I., Bai, Y., Ross, C., Schlesinger, L.S. and Turner, J. (2022) The Impact of Aging on the Lung Alveolar Environment, Predetermining Susceptibility to Respiratory Infections. Frontiers in Aging, 3, Article ID: 818700. [Google Scholar] [CrossRef] [PubMed]
[9] Kayongo, A., Robertson, N.M., Siddharthan, T., Ntayi, M.L., Ndawula, J.C., Sande, O.J., et al. (2023) Airway Microbiome-Immune Crosstalk in Chronic Obstructive Pulmonary Disease. Frontiers in Immunology, 13, Article ID: 1085551. [Google Scholar] [CrossRef] [PubMed]
[10] Rabe, K.F., Martinez, F.J., Ferguson, G.T., Wang, C., Singh, D., Wedzicha, J.A., et al. (2020) Triple Inhaled Therapy at Two Glucocorticoid Doses in Moderate-to-Very-Severe COPD. New England Journal of Medicine, 383, 35-48. [Google Scholar] [CrossRef] [PubMed]
[11] Martinez, F.J., Rabe, K.F., Ferguson, G.T., Wedzicha, J.A., Singh, D., Wang, C., et al. (2021) Reduced All-Cause Mortality in the ETHOS Trial of Budesonide/Glycopyrrolate/Formoterol for Chronic Obstructive Pulmonary Disease. A Randomized, Double-Blind, Multicenter, Parallel-Group Study. American Journal of Respiratory and Critical Care Medicine, 203, 553-564. [Google Scholar] [CrossRef] [PubMed]
[12] Lea, S., Higham, A., Beech, A. and Singh, D. (2023) How Inhaled Corticosteroids Target Inflammation in COPD. European Respiratory Review, 32, Article ID: 230084. [Google Scholar] [CrossRef] [PubMed]
[13] Upadhyay, J., Trivedi, N. and Lal, A. (2020) Risk of Future Type 2 Diabetes Mellitus in Patients Developing Steroid-Induced Hyperglycemia during Hospitalization for Chronic Obstructive Pulmonary Disease Exacerbation. Lung, 198, 525-533. [Google Scholar] [CrossRef] [PubMed]
[14] Papadopoulou, E., Bin Safar, S., Khalil, A., Hansel, J., Wang, R., Corlateanu, A., et al. (2024) Inhaled versus Systemic Corticosteroids for Acute Exacerbations of COPD: A Systematic Review and Meta-Analysis. European Respiratory Review, 33, Article ID: 230151. [Google Scholar] [CrossRef] [PubMed]
[15] Leitao Filho, F.S., Takiguchi, H., Akata, K., Ra, S.W., Moon, J., Kim, H.K., et al. (2021) Effects of Inhaled Corticosteroid/Long-Acting Β2-Agonist Combination on the Airway Microbiome of Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Clinical Trial (DISARM). American Journal of Respiratory and Critical Care Medicine, 204, 1143-1152. [Google Scholar] [CrossRef] [PubMed]
[16] Mir, T., Uddin, M., Khalil, A., Lohia, P., Porter, L., Regmi, N., et al. (2022) Mortality Outcomes Associated with Invasive Aspergillosis among Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patient Population. Respiratory Medicine, 191, Article ID: 106720. [Google Scholar] [CrossRef] [PubMed]
[17] Suissa, S., Dell’Aniello, S., Gonzalez, A.V. and Ernst, P. (2019) Inhaled Corticosteroid Use and the Incidence of Lung Cancer in COPD. European Respiratory Journal, 55, Article ID: 1901720. [Google Scholar] [CrossRef] [PubMed]
[18] Stolz, D., Mkorombindo, T., Schumann, D.M., Agusti, A., Ash, S.Y., Bafadhel, M., et al. (2022) Towards the Elimination of Chronic Obstructive Pulmonary Disease: A Lancet Commission. The Lancet, 400, 921-972. [Google Scholar] [CrossRef] [PubMed]
[19] 陈科伶, 付正丰, 黄青松, 等. 小青龙汤化学成分分析及其对慢性阻塞性肺疾病急性发作期小鼠的作用[J]. 中成药, 2022, 44(12): 4037-4040.
[20] Zhu, H., Li, C., Liu, L., Tong, J., Lan, Z., Tian, S., et al. (2024) Efficacy and Safety of Qingfei Huatan Formula in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Multi-Centre, Randomised, Double-Blind, Placebo-Controlled Trial. Journal of Integrative Medicine, 22, 561-569. [Google Scholar] [CrossRef] [PubMed]
[21] Wang, Y., Li, N., Li, Q., Liu, Z., Li, Y., Kong, J., et al. (2021) Xuanbai Chengqi Decoction Ameliorates Pulmonary Inflammation via Reshaping Gut Microbiota and Rectifying Th17/Treg Imbalance in a Murine Model of Chronic Obstructive Pulmonary Disease. International Journal of Chronic Obstructive Pulmonary Disease, 16, 3317-3335. [Google Scholar] [CrossRef] [PubMed]
[22] 张莲花, 高向坤, 马新峰, 等. 越婢加半夏汤对急性加重期慢阻肺(痰热郁肺证)患者的应用效果[J]. 黑龙江医药科学, 2025, 48(3): 74-77.
[23] 陈文. 清肺固元汤治疗肾虚痰热证慢性阻塞性肺疾病急性加重期(AECOPD)临床效果观察[D]: [硕士学位论文]. 武汉: 湖北中医药大学, 2023.
[24] 马强, 陈荣. 西药联合小青龙汤加减治疗慢性阻塞性肺疾病急性加重期外寒内饮证的临床效果[J]. 临床医学研究与实践, 2022, 7(9): 131-134.
[25] Jawitz, N.G., Gellad, Z.F., Lin, L., Wood, R.K. and Leiman, D.A. (2020) Patient, Physician, and Procedure Characteristics Are Independently Predictive of Polyp Detection Rates in Clinical Practice. Digestive Diseases and Sciences, 66, 2570-2577. [Google Scholar] [CrossRef] [PubMed]
[26] Yang, H.M., Ryu, M.H., Carey, V.J., et al. (2024) Chronic Obstructive Pulmonary Disease Exacerbations Increase the Risk of Sub-Sequent Cardiovascular Events: A Longitudinal Analysis of the COPD Gene Study. Journal of the American Heart Association, 13, e033882.
[27] Wu, R., Fengjie, Z., Li, Y., Yan, S., Miao, L., Tan, W., et al. (2013) Modified Dachengqi Decoction Combined with Conventional Treatment for Treating Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review Based on Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine, 2013, Article ID: 323715. [Google Scholar] [CrossRef] [PubMed]
[28] Liu, S., Shergis, J., Chen, X., Yu, X., Guo, X., Zhang, A.L., et al. (2014) Chinese Herbal Medicine (Weijing Decoction) Combined with Pharmacotherapy for the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Evidence-Based Complementary and Alternative Medicine, 2014, Article ID: 257012. [Google Scholar] [CrossRef] [PubMed]
[29] Gao, Z., Jing, J. and Liu, Y. (2020) Xiaoqinglong Decoction (a Traditional Chinese Medicine) Combined Conventional Treatment for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. Medicine, 99, e19571. [Google Scholar] [CrossRef] [PubMed]
[30] Hung, J.H., Chen, W.C., Lin, M., Chuang, H., Wang, J., Fu, P., et al. (2022) Associations of Chinese Herbal Medicine Use with the Risks of Acute Exacerbation and Mortality in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study. Journal of Integrative and Complementary Medicine, 28, 77-86. [Google Scholar] [CrossRef] [PubMed]
[31] 赵智慧, 秦睿, 李炜弘, 等. 基于多级任务的“视觉脉诊”方法研究[J]. 成都中医药大学学报, 2024, 47(5): 60-66.
[32] 陈韵岱. 智能可穿戴设备在房颤综合防治的研究进展[J]. 中华保健医学杂志, 2021, 23(5): 429-430.
[33] 叶晓滨. 麻黄常用药对化学成分与药理作用的研究进展[J]. 中医研究, 2021, 34(3): 57-62.
[34] 谢又佳, 梁虹艺, 林伟斌, 等. 中西医结合治疗新型冠状病毒肺炎中潜在药物相互作用途径[J]. 实用医学杂志, 2020, 36(7): 842-848.
[35] 杨乐乐, 龙海, 姚克宇, 等. 基于本体推理和语义网检索的中西药相互作用知识发现研究[J]. 中华中医药学刊, 2024, 42(9): 13-17.