| 摘要: |
| 目的：观察凉膈散加减联合常规西药治疗痰热郁肺型慢性阻塞性肺疾病急性加重期（AECOPD） 合并急性胃肠损伤（AGI） 的疗效。方法：选择64 例痰热郁肺兼腑气不通型AECOPD 合并AGI 患者，根据随机数字表法分为治疗组和对照组，每组32 例。对照组给予常规西药治疗，治疗组在对照组基础上加用凉膈散加减治疗，每天1 剂，共治疗7 d。比较2 组治疗前后的慢性阻塞性肺疾病（COPD） 中医证候积分、AGI 中医证候积分、每分钟肠鸣音次数、外周血白细胞计数（WBC）、C-反应蛋白（CRP）、动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、血清瓜氨酸、肠型脂肪酸结合蛋白（IFABP）。结果：治疗后，2 组COPD、AGI 证候积分均较治疗前降低（P＜0.05），治疗组COPD、AGI 证候积分均低于对照组（P＜0.05）；2 组WBC、CRP、PaCO2、IL-6、TNF-α、IFABP 水平均较治疗前降低（P＜0.05），治疗组WBC、CRP、PaCO2、IL-6、TNF-α、IFABP 水平均低于对照组（P＜0.05）；2 组每分钟肠鸣音次数、PaO2、瓜氨酸水平均较治疗前升高（P＜0.05）；每分钟肠鸣音次数、PaO2、瓜氨酸水平均高于对照组（P＜0.05）。结论：凉膈散加减联合常规西药治疗能改善痰热郁肺兼腑气不通型AECOPD 合并AGI 患者的临床症状及体征，改善其炎症反应、胃肠损伤及血气分析指标。 |
| 关键词: 慢性阻塞性肺疾病 急性加重期 急性胃肠损伤 凉膈散加减 血气分析 炎症因子 瓜氨酸 肠型脂肪酸结合蛋白 |
| DOI： |
|
| 基金项目:东莞市社会科技发展一般项目（2018507150021335）；广东省名中医传承工作室建设项目（粤中医办函［2018］5号）；广东省中医药局科
研项目（20181267） |
|
| Clinical Study on Modified Liangge Powder Combined with Routine Western Medicinefor Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated withAcute Gastrointestinal Injury |
| LIAN Leshen,LAI Haifeng,YE Xiaohan,JIANG Ziyun,HUANG Jiacheng,ZHU Biyuan |
| (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 curative effect of modified Liangge powder combined with routine western
medicine for acute exacerbation of chronic obstructive pulmonary disease(AECOPD) of phlegm-heat obstructing the lung type
complicated with acute gastrointestinal injury(AGI). Methods：A total of 64 cases of patients with AECOPD of phlegm- heat
obstructing the lung and inhibited bowel qi type complicated with AGI were divided into the treatment group and the control
group according to the random number table method，32 cases in each group. The control group was given routine western
medicine，and the treatment group was additionally given the oral administration of decoction of modified Liangge powder for
one dose per day based on the treatment of the control group. Both groups were treated for seven days. Before and after
treatment， the syndrome scores of chronic obstructive pulmonary disease(COPD) and AGI， the times of bowel sound per
minute，as well as the levels of peripheral white blood cell count(WBC)，C-reactive protein(CRP)，partial pressure of oxygen
(PaO2)， partial pressure of carbon dioxide(PaCO2)， interleukin- 6(IL- 6)， tumor necrosis factor- α(TNF- α)， citrulline in
serum，and intestinal fatty acid binding protein(IFABP) were compared between the two groups. Results：After treatment，
the syndrome scores of COPD and AGI in the two groups were decreased when compared with those before treatment(P＜
0.05)； after treatment， the two scores in the treatment group were lower than those in the control group(P＜0.05). The
levels of WBC， CRP， PaCO2， IL- 6， TNF- α， and IFABP in the two groups were decreased when compared with those before treatment(P＜0.05)；after treatment，the six levels in the observation group were lower than those in the control group
(P＜0.05). In the two groups， the times of bowel sound per minute， and the levels of PaO2 and citrulline were increased
when compared with those before treatment(P＜0.05)； after treatment， the three indexes in the treatment group were
higher than those in the control group(P＜0.05). Conclusion：The therapy of modified Liangge powder combined with routine
western medicine can improve clinical symptoms and signs of patients with AECOPD of phlegm- heat obstructing the lung
and inhibited bowel qi type complicated with AGI，relieve their inflammatory response，gastrointestinal injury，and the index
of blood gas analysis. |
| Key words: Keywords：Chronic obstructive pulmonary disease Acute exacerbation stage Acute gastrointestinal injury Modified
Liangge powder Blood gas analysis Inflammatory factors Citrulline Intestinal fatty acid binding protein |
