加味小青龙汤合膀胱经姜疗治疗外寒内饮型慢性阻塞性肺疾病急性加重期临床研究

摘要

Objective To analyze the clinical efficacy of modified Xiaoqinglong Decoction with bladder ginger treatment in treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD) of external cold and internal fluid. Methods Totally 150 cases of AECOPD were divided into Western medicine group, integrated traditional Chinese and Western medicine group, and observation group, with 50 cases in each group. Western medicine group received routine treatment, such as controlled oxygen therapy, anti-infection, triple inhalation, relieve spasm and asthma, cough and phlegm, correct water and electrolyte balance. On the basis of routine treatment, integrated traditional Chinese and Western medicine group received modified Xiaoqinglong Decoction, one dosage per day, twice a day, orally. On the basis of integrated traditional Chinese and Western medicine group, observation group received scraping the bladder at the back of the Bladder Meridian of Foot-Taiyang, putting 20–30 g fresh mashed ginger, for 15–20 min. All treatment lasted for 14 d. TCM symptom scores, the main symptoms of remission time and lung function before and after treatment in the three groups were compared. Results The differences in main symptoms scores (cough, expectoration, wheezing, shortness of breath) and total scores of the observation group were higher than Western medicine group and integrated traditional Chinese and Western medicine group (P<0.05). The main symptoms remission time of the observation group was much shorter than Western medicine group and integrated traditional Chinese and Western medicine group (P<0.05). Compared with before treatment, the FEV1,FEV1/FVC and MMEF of the three groups after treatment showed an upward trend (P<0.05). The FEV1, FEV1/FVC and MMEF in observation group were significantly higher than Western medicine group and integrated traditional Chinese and Western medicine group (P<0.05). Conclusion Modified Xiaoqinglong Decoction combined with bladder ginger for the treatment of AECOPD of external cold and internal fluid has definite curative effect, and can significantly improve TCM symptoms and pulmonary function.%目的 观察加味小青龙汤合膀胱经姜疗对外寒内饮型慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效.方法 采用随机数字表法将150例AECOPD患者分为西药组、中西组及观察组各50例.西药组予控制性氧疗、抗感染、三联雾化吸入、解痉平喘、止咳化痰、纠正水电解质平衡等常规治疗.中西组在常规治疗的基础上予加味小青龙汤,每日1剂,每日2次,口服.观察组在中西组基础上于背部双侧足太阳膀胱经处刮痧,放置鲜姜蓉20~30 g,保留15~20 min.均连续治疗14 d.比较3组治疗前后中医症状积分、主要症状缓解时间及肺功能情况.结果 观察组治疗前后主要症状(咳嗽、咯痰、喘息、哮鸣、气短)积分及总分的差值明显高于西药组及中西组(P<0.05).观察组主要症状缓解时间明显短于西药组及中西组(P<0.05).与本组治疗前比较,3组治疗后第1秒用力呼气量(FEV1)、第1秒用力呼气量占用力肺活量比率(FEV1/FVC)、最大呼气中段平均流速(MMEF)呈上升趋势(P<0.05);观察组治疗后 FEV1、FEV1/FVC、MMEF 明显高于中西组和西药组(P<0.05).结论 加味小青龙汤合膀胱经姜疗治疗外寒内饮型AECOPD疗效显著,能显著改善患者中医症状及肺功能.