| 摘要: |
| 目的：观察补肺健脾方联合常规疗法治疗慢性阻塞性肺疾病急性加重（AECOPD） 的临床疗效。方法：选取60 例肺脾气虚型AECOPD 患者，随机分为对照组和观察组各30 例。2 组均采用常规疗法治疗，观察组加用补肺健脾方治疗，2 组疗程均为7 d。治疗前后评定2 组患者的慢性阻塞性肺疾病患者自我评估测试（CAT） 评分、改良版英国医学研究委员会呼吸问卷（mMRC） 等级以及中医证候评分，检测感染性炎症指标［降钙素原（PCT）、C-反应蛋白（CRP）］、血气分析指标［动脉血氧分压（PaO2）、二氧化碳分压（PaCO2） 和血氧饱和度（SaO2）］。比较2 组的临床疗效。结果：治疗后，观察组临床疗效优于对照组（P＜0.05）。2 组CAT 各项评分及总分均较同组治疗前降低（P＜0.01），观察组各项评分及总分均低于对照组（P＜0.05）。2 组引起呼吸困难的活动强度均较治疗前提高（P＜0.05），观察组引起呼吸困难的活动强度高于对照组（P＜0.05）。2 组外周血PCT、CRP 水平均较同组治疗前降低（P＜0.01），观察组PCT、CRP 水平均低于对照组（P＜0.05）。2 组PaO2、SaO2 均较同组治疗前升高（P＜0.01），PaCO2 均较同组治疗前降低（P＜0.01）。观察组PaO2、SaO2 均高于对照组（P＜0.01），PaCO2 低于对照组（P＜0.01）。观察组肺脾气虚证各项证候评分及总分均较治疗前降低（P＜0.01）。对照组咳嗽、咯痰、喘息、胸闷、气短评分及总分均较治疗前降低（P＜0.01），纳呆、自汗、腹胀评分与治疗前比较无统计学差异（P＞0.05）。观察组各项证候评分及总分均低于对照组（P＜0.05）。结论：补肺健脾方联合常规疗法治疗AECOPD，能够在更有效控制感染性炎症的同时，显著改善气流受限和缺氧情况，进一步缓解患者的临床症状，提高生活质量，对AECOPD 病情的控制具有十分积极的作用。 |
| 关键词: 慢性阻塞性肺疾病急性加重 肺脾气虚证 补肺健脾方 炎症指标 血气分析 |
| DOI： |
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| 基金项目: |
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| Clinical Study on Bufei Jianpi Prescription Combined with Routine Therapy for AcuteExacerbation of Chronic Obstructive Pulmonary Disease |
| ZHUANG Jianbin,WU Huijun,LIN Ruida,LYU Zhiwei,WU Xiaodan |
| (单篇PDF全文查阅请上中国知网下载阅读（中国知网电子版刊出时间：纸刊刊出日期一个月左右）) |
| Abstract: |
| Abstract：Objective：To observe the clinical effect of Bushen Jianpi prescription combined with routine therapy for acute
exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods：A total of 60 cases of patients with AECOPD of
lung- spleen qi deficiency type were randomly divided into the control group and the observation group， 30 cases in each
group. Both groups were treated with routine therapy，and the observation group was additionally treated with Bufei Jianpi
prescription. Both groups were treated for seven days. Before and after treatment， the scores of COPD Assessment Test
(CAT)， Breathlessness measurement using the modified British Medical Research Council(mMRC)， infective inflammation
indexes including procalcitonin(PCT) and C-reactive protein(CRP)，the indexes of blood gas analysis including partial pressure
of oxygen(PaO2)， partial pressure of carbon dioxide(PaCO2) and oxygen saturation(SaO2)， and the Chinese medicine
syndrome scores were evaluated and detected in the two groups. The clinical effect was compared between the two groups.
Results：After treatment，the clinical effect in the observation group was superior to that in the control group(P＜0.05). The
total score and each score of CAT in the two groups were decreased when compared with those before treatment(P＜0.01)，
and the above scores in the observation group were all lower than those in the control group(P＜0.05). The activity intensity
causing dyspnea in the two groups were increased when compared with that in the same group before treatment(P＜0.05)；
the activity intensity in the observation group was higher than that in the control group(P＜0.05). The levels of PCT and CRP in
peripheral blood in the two groups were decreased when compared with those before treatment(P＜0.01)，and the levels in
the observation group were lower than those in the control group(P＜0.05). The levels of PaO2 and SaO2 in the two groups
were increased when compared with those before treatment(P＜0.01)， and the levels of PaCO2 were decreased when
compared with those before treatment(P＜0.01). The levels of PaO2 and SaO2 in the observation group were higher than those
in the control group(P＜0.01)，and the level of PaCO2 in the observation group was lower than that in the control group(P＜
0.01). Each syndrome score of lung- spleen qi deficiency syndrome and the total score in the observation group were
decreased when compared with those before treatment(P＜0.01). The scores of cough， expectoration， dyspnea， chest
distress and short breath as well as the total score in the control group were decreased when compared with those before
treatment(P＜0.01)；when compared the scores of torpid intake，spontaneous sweating and abdominal distention before and
after treatment in the control group，there was no significance in the difference(P＞0.05). Each syndrome score and the total
score in the observation group were lower than those in the control group(P＜0.05). Conclusion：The therapy of Bushen Jianpi
prescription combined with routine therapy for AECOPD can more effectively control infective inflammation，and meanwhile，
significantly improve airflow obstruction and hypoxia，further relieve clinical symptoms，and enhance the quality of life，with
very positive effect on the control of AECOPD. |
| Key words: Keywords ： Acute exacerbation of chronic obstructive pulmonary disease Lung-spleen qi deficiency syndrome Bushen Jianpi prescription Inflammatory indexes Blood gas analysis |
