苗药紫金牛、铁扫帚对肺胀痰热壅肺型患者的临床疗效观察

Observation on the Clinical Effect of Miao National Herbs Ardisia and Lespedeza cuneata in Patients with Lung Distension and Phlegm Heat Obstructing Lung

摘要: 目的：观察苗药紫金牛、铁扫帚治疗慢性阻塞性肺疾病急性加重期痰热壅肺型患者的临床疗效。方法：将符合纳入标准及排除标准的60例慢性阻塞性肺疾病急性加重期(AECOPD)、肺胀痰热壅肺型患者采用随机、开放、对照试验，应用随机数值表法，按就诊先后顺序将患者随机分为西医常规治疗加苗药紫金牛、铁扫帚治疗组(以下简称苗药组)、西医常规治疗组(以下简称对照组)。对照组采用常规抗炎、止咳、平喘等对该药物无影响的西医常规综合治疗，苗药组在此基础上加用苗药紫金牛、铁扫帚煎剂口服，2次/日，疗程14天，观察两组患者治疗前后的中医证候积分、血气分析PaO2、PaCO2、肺功能中FEV1/FVC、FEV1/预计值、6分钟行走试验的变化，综合评估其治疗效果。结果：治疗后苗药组对慢性阻塞性肺疾病急性发作期痰热壅肺型患者中医证候均有明显改善，差异有显著意义(P < 0.05)；对照组对咳嗽、咳痰、痰色及啰音方面有改善，差异有显著意义(P < 0.05)，其余指标均无明显变化，差异无显著意义(P > 0.05)；苗药组在临床控制、显效、有效的例数及总有效率明显高于对照组，差异有显著意义(P < 0.05)。治疗后苗药组与对照组组内比较患者肺功能指标FEV1/FVC、FEV1/预计值均有改善，差异有显著意义(P < 0.05)；苗药组与对照组组间比较患者肺功能指标FEV1/FVC、FEV1/预计值均有改善，差异有显著意义(P < 0.05)。治疗后苗药组与对照组组内比较患者血气分析指标PO2、PCO2值均有改善，差异有显著意义(P < 0.05)；苗药组与对照组组间比较患者血气分析指标PO2、PCO2值均有改善，差异有显著意义(P < 0.05)。治疗后苗药组与对照组组内比较患者6分钟行走试验有改善，差异有显著意义(P < 0.05)；苗药组与对照组组间比较患者6分钟行走试验结果无显著差异(P > 0.05)。结论：苗药紫金牛、铁扫帚联合西医常规治疗能有效改善慢性阻塞性肺疾病急性加重期痰热壅肺证患者的临床症状，提高患者活动耐量，改善肺功能及血气等疗效。其效果优于西医常规治疗。

Abstract: Objective: To observe Miao national herbs Ardisia and Lespedeza cuneata in the treatment of chronic obstructive pulmonary disease with acute exacerbation of phlegm heat obstructing lung type patients. Methods: 60 cases of phlegm heat obstructing lung type chronic obstructive pulmo-nary disease with acute exacerbation patients (AECOPD) which would meet the inclusion criteria and exclusion criteria were randomly divided into routine treatment of western medicine plus Miao national herbs Ardisia and Lespedeza cuneata treatment group (hereinafter referred to as the Miao national herbs group), conventional treatment of western medicine group (hereinafter referred to as the control group) by random, open, controlled trials, and the random number table method, according to the sequence of treatment. Control group was treated with conventional an-ti-inflammatory, relieving cough and asthma of the drug which had no effect of conventional western medicine comprehensive treatment, Miao national herbs group was based on the same treatment plus Miao national herbs Ardisia and Lespedeza cuneata decoction, 2 times/day, with a course of 14 days. The changes of patients were observed with TCM syndromes, blood gas analysis of PaO2, PaCO2, lung function of FEV1/FVC, FEV1/expected value, the six minutes’ walk test before and after treatment in two groups, and the therapeutic effect was evaluated comprehensively. Results: The TCM symptom of phlegm heat obstructing lung type chronic obstructive pulmonary disease with acute exacerbation patients was obviously improved, the differences are significant (P < 0.05); the cough, sputum, sputum color and rales of control group were improved, the difference is significant (P < 0.05); the other indicators showed no significant changes, the difference was not significant (P > 0.05); Miao national herbs group in clinical control, excellence, effective number of cases and the total efficiency was significantly higher than that of the contrast group, the difference is significant (P < 0.05). After treatment, the expected value of FEV1/FVC, FEV1 of lung function index within the Miao national herbs group and the control group was increased, the difference is significant (P < 0.05); the expected value of FEV1/FVC, FEV1 of lung function index between the Miao national herbs group and the control group was increased, the difference is significant (P < 0.05). After treatment, the blood gas analysis index PO2 and PCO2 values within the Miao national herbs group and the control group was increased, the difference is significant (P < 0.05); the blood gas analysis index PO2 and PCO2 values between the Miao national herbs group and the control group was increased, the difference is significant (P < 0.05). After treatment, the 6 minutes’ walk test within the Miao national herbs group and the control group was increased, the difference is significant (P < 0.05); the 6 minutes’ walk test between the Miao national herbs group and the control group showed no significant changes, the difference was not significant (P > 0.05). Conclusion: Miao national herbs Ardisia and Lespedeza cuneata combined with conventional western medicine therapy could effectively improve the clinical symptoms of phlegm heat ob-structing lung type chronic obstructive pulmonary disease with acute exacerbation patients, im-prove patient activity tolerance, improve lung function and blood gas effect. Its effect is superior to conventional western medicine treatment.