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目的:观察用中药汤剂辨证内服联合布地奈德、盐酸氨溴索治疗慢性阻塞性肺病急性加重期的临床效果。方法:选取2012年2月~2014年11月就诊于我院的94例慢性阻塞性肺病急性加重期患者,按照随机数字表法分为对照组和治疗组患者各47例。两组患者均给予控制感染、解痉、吸氧、平喘等西医常规治疗,对照组患者在常规治疗基础上给予布地奈德混悬液联合盐酸氨溴索注射液雾化吸入治疗;治疗组患者则在对照组基础上给予中药汤剂辨证内服治疗,1剂/日,连续治疗7日。治疗后观察患者临床症状的改善情况,计算有效率;对咳嗽、喘鸣的消失时间及住院总时间进行统计;检测治疗前后患者肺功能、血气分析指标、血液流变的改善情况。结果:治疗组有效率为89.3%,明显高于对照组的70.2%,差异有统计学意义(P<0.05);治疗组患者经治疗后咳嗽、喘鸣的消失时间及住院总时间较对照组明显缩短,差异有统计学意义(P<0.05);患者经治疗后肺功能及血气指标有所改善,与肺功能密切相关的1秒用力呼气容积/用力肺活量(FEV1/FVC)、FEV1%均明显高于对照组患者,血气分析指标Pa CO2水平有所下降,Pa O2水平有所提高,以治疗组的改善程度尤其明显,差异有统计学意义(P<0.05);患者经治疗后血液流变有所改善,全血低切粘度、全血高切粘度、红细胞聚集、血浆粘度均有所降低,以治疗组降低更为突出,差异有统计学意义(P<0.05)。结论:中药汤剂辨证内服联合布地奈德、盐酸氨溴索能有效缓解慢性阻塞性肺病急性加重期患者的临床症状,加快症状消退,缩短病程,提高肺功能,改善血气分析和血液流变,是中西医结合论治的有效方式,疗效确切,值得临床深入推广运用。
Objective: To observe the clinical efficacy of Chinese medicine decoction combined with oral administration of budesonide and ambroxol hydrochloride in the treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods: A total of 94 patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) treated in our hospital from February 2012 to November 2014 were selected and divided into control group and treatment group according to random number table. Both groups were given routine treatment of Western medicine such as infection control, antispasmodic therapy, oxygen inhalation and antiasthmatic treatment. The patients in the control group were given budesonide suspension combined with ambroxol hydrochloride injections on the basis of routine treatment. The treatment group Patients in the control group on the basis of traditional Chinese medicine decoction dialectical treatment, 1 / day, continuous treatment for 7 days. The patients were observed after treatment to improve the clinical symptoms, calculate the efficiency; the disappearance of cough, wheezing and the total time of hospitalization statistics; test patients before and after treatment of lung function, blood gas analysis indicators, the improvement of blood rheology. Results: The effective rate of the treatment group was 89.3%, which was significantly higher than that of the control group (70.2%) (P <0.05). The cough, the disappearance of wheezing and the total length of hospital stay after treatment in the treatment group were significantly lower than those in the control group (P <0.05). The pulmonary function and blood gas index were improved after treatment in patients with FEV1 / FVC and FEV1%, which were closely related to pulmonary function, Were significantly higher than the control group patients, blood gas analysis indicators Pa CO2 levels decreased, Pa O2 levels have been increased to the extent of improvement in the treatment group was particularly significant difference was statistically significant (P <0.05); patients after treatment of blood Rheology improved, whole blood low shear viscosity, whole blood high shear viscosity, erythrocyte aggregation, plasma viscosity decreased, with the treatment group decreased more prominent, the difference was statistically significant (P <0.05). Conclusion: The Chinese medicine decoction combined with budesonide and ambroxol can effectively relieve the clinical symptoms of patients with acute exacerbation of chronic obstructive pulmonary disease, accelerate the regression of symptoms, shorten the course of disease, improve lung function, improve blood gas analysis and blood rheology, Integrative Medicine is an effective way to rule, the exact effect, it is worth further clinical application.