中西医结合治疗慢性阻塞性肺疾病急性加重期的疗效观察

摘要

Objective To observe the clinical therapeutic effect of integrated traditional Chinese medicine (TCM ) and western medicine (integrative medicine) for treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECGPD) - Methods Sixty-two patients with AECOPD were enrolled in this prospective study. They were randomly divided into two groups ; control group (31 cases! and experimental group (31 cases). Both groups were treated with conventional western medicine, and additionally, according to syndrome differentiation principle. TCM was applied once a day for 14 days, constituting a course of treatment in the experimental group. Blood pH, arterial blood partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCCO, the changes of clinical efficacy and the occurrence of adverse reactions were compared between ihe iwo groups. Results There were no significani differences in the pH, PaO2, PaCO2 before treatment in the two groups. The pH and PaO3 were significantly increased and PaCO3 was significantly reduced after treatment, and the degree of improvement in pH. PaO2 (mm Hg.l mm Hg = 0.133 kPa) and PaCO2 (mm Hg) in experimental group was better than those in the control group (pH : 7.38±0.19 vs. 7.34±0.21. PaO2 : 83.72±4.57 vs. 72.79±3.66, PaCO2 ; 43.27±3.86 vs. 53.78±3.69, all P＜0.05). The total effective rate in experimental group was obviously higher than that in the control group [93.55% (29/31) vs. 67.74% (21/31). P＜0.05]. Any significant adverse events were not found in iwo groups, but one patient was infected by fungus in the control group. Conclusion The efficacy of integrative medicine is better than thai of western medicine alone in treating patients wiih AECOPD.%目的 观察中西医结合治疗慢性阻塞性肺疾病急性加重期(AECOPD )的临床疗效.方法 用前瞻性研究方法将符合诊断标准的62 例患者按随机原则分为两组,对照组(31 例)给予常规西医综合治疗采措施;治疗组(31 例)在常规西医综合治疗基础上针对患者证候的不同加用中药治疗,每日1 剂,14 d 为1 个疗程,共1 个疗程.比较两组患者治疗前后血液pH 值,动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、临床疗效的变化和不良反应的发生情况.结果 两组治疗前pH 值、PaO2、PaCO2 比较差异无统计学意义,治疗后pH 、PaO2 明显升高,PaCO2 明显降低,且治疗组pH 值、PaO2(mm Hg,1 mm Hg = 0.133 kPa )及PaCO2(mm Hg )改善程度明显优于对照组(pH 值:7.38±0.19 比7.34±0.21,PaO2:83.72±4.57 比72.79±3.66,PaCO2:43.27±3.86 比53.78±3.69,均P<0.05).治疗组总有效率明显高于对照组[93.55%(29/31 )比67.74%(21/31)P＜0.05 ].对照组和治疗组均未见明显不良反应发生,对照组真菌感染1 例.结论 中西医结合治疗AECOPD 效,果显著.