作者：任红伟，曹国芸，李梦云，周亮亮，孙伟晴，张立南，何菲

单位：

073000河北省保定市，河北省第七人民医院呼吸内科 通信作者：任红伟，E-mail：rhw1122330@163.com

Units：

Department of Respiratory Medicine, Hebei Province Seventh People's Hospital, Baoding 073000, China Corresponding author: REN Hongwei, E-mail: rhw1122330@163.com

关键词：

支气管扩张; 感染; 痰热壅肺证; 清肺化痰解毒汤; 西医治疗; 治疗结果;

Keywords：

Bronchiectasis; Infection; Phlegm heat blocking lung syndrome; Qingfei Huatan Jiedu decoction; Westernmedicine treatment; Treatment outcome

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.083

Funds：

河北省中医药管理局中医药类科研指令性课题（2022134）

摘要：

目的 观察清肺化痰解毒汤联合西医治疗支气管扩张伴感染（痰热壅肺证）患者的临床疗效。方法 选取2020年7月至2021年11月河北省第七人民医院收治的支气管扩张伴感染（痰热壅肺证）患者80例为研究对象，采用随机数字表法将其分为对照组和治疗组，各40例。对照组患者给予常规西医治疗，治疗组患者给予自拟清肺化痰解毒汤联合常规西医治疗，治疗2周后评价临床疗效。比较两组患者临床症状消失时间，临床疗效，治疗前后肺功能指标[第1秒用力呼气容积（FEV1）、FEV1/用力肺活量（FVC）]、炎症因子[C反应蛋白（CRP）、白介素6（IL-6）、肿瘤坏死因子α（TNF-α）、降钙素原（PCT）]水平、症状及体征积分，治疗期间不良反应发生情况。结果 治疗组患者体温恢复正常时间、咳嗽咳痰消失时间、肺部啰音消失时间均短于对照组（P<0.05）。治疗组患者临床疗效优于对照组（P<0.05）。治疗后，两组患者FEV1大于本组治疗前，FEV1/FVC高于本组治疗前（P<0.05）；治疗后，治疗组患者FEV1大于对照组，FEV1/FVC高于对照组（P<0.05）。治疗后，两组患者血清CRP、IL-6、TNF-α、PCT水平分别低于本组治疗前，且治疗组患者低于对照组（P<0.05）。治疗后，两组患者咳嗽、黄痰、胸痛、口干、便秘、湿啰音积分分别低于本组治疗前，且治疗组患者低于对照组（P<0.05）。对照组患者不良反应发生率为12.5%（5/40），与治疗组患者的17.5%（7/25）比较，差异无统计学意义（P>0.05）。结论 清肺化痰解毒汤联合西医治疗支气管扩张伴感染（痰热壅肺证）患者的临床疗效较好，可有效缓解患者的临床症状及体征，改善患者肺功能，抑制炎症反应，且未增加药物不良反应。

Abstract：

【Abstract】　Objective To observe the clinical efficacy of Qingfei Huatan Jiedu decoction combined with westernmedicine in the treatment of patients with bronchiectasis and infection (phlegm heat blocking lung syndrome) . Methods A totalof 80 patients with bronchiectasis and infection (phlegm heat blocking lung syndrome) admitted to the Hebei Province SeventhPeople's Hospital from July 2020 to November 2021 were selected as the study subjects. They were divided into treatment groupand control group by random number table method, with 40 cases in each group. The patients in the control group were treatedwith conventional western medicine, and the patients in the treatment group were treated with self-made Qingfei Huatan Jiedudecoction combined with conventional western medicine. The clinical efficacy was evaluated after 2 weeks of treatment. Thedisappearance time of clinical symptoms, clinical efficacy, pulmonary function indexes [forced expiratory volume in one second(FEV1) , FEV1/forced vital capacity (FVC) ] , level of inflammatory factors [C-reactive protein (CRP) , interleukin-6 (IL-6) , tumornecrosis factorα (TNF-α) and procalcitonin (PCT) ] and score of symptoms and signs before and after treatment, and occurrenceof adverse reactions during treatment were compared between the two groups. Results The recovery time of body temperature,the disappearance time of cough and expectoration, pulmonary rales in the treatment group were shorter than those in the controlgroup (P <0.05) . The clinical efficacy of treatment group was better than that of control group (P <0.05) . After treatment, FEV1of the two groups was bigger than that before treatment, and FEV1/FVC was higher than that before treatment, respectively (P <0.05) ; after treatment, FEV1 in the treatment group was bigger than that in the control group, and FEV1/FVC was higher than thatin the control group (P <0.05) . After treatment, the serum levels of CRP, IL-6, TNF-α and PCT in the two groups were lowerthan those before treatment, respectively, and those in the treatment group were lower than those in the control group (P <0.05) .After treatment, scores of cough, yellow phlegm, chest pain, dry mouth, constipation and wet rales in the two groups were lowerthan those before treatment, respectively, and those in the treatment group were lower than those in the control group (P <0.05) .There was no significant difference in the incidence of adverse reactions between control group and treatment group [12.5% (5/40)vs 17.5% (7/25) , P > 0.05] .Conclusion Qingfei Huatan Jiedu decoction combined with western medicine has a good clinicaleffect in the treatment of patients with bronchiectasis and infection (phlegm heat blocking lung syndrome) . It can effectivelyalleviate the clinical symptoms and signs of patients, improve the pulmonary function, inhibit inflammatory reaction, and does notincrease adverse drug reactions.

ReferenceList：