六安煎加减治疗AECOPD痰湿蕴肺证患者的临床研究

六安煎加减治疗AECOPD痰湿蕴肺证患者的临床研究六安煎加减治疗AECOPD痰湿蕴肺证患者的临床研究

摘要：目的探讨六安煎加减治疗AECOPD痰湿蕴肺证的临床疗效。方法选取2018年1月至2019年12月期间317例AECOPD痰湿蕴肺证患者进行随机对照试验。随机分为治疗组和对照组，治疗组采用六安煎加减治疗，对照组使用激素类药物治疗。比较两组治疗前后痰量、肺功能、疗效以及不良反应等情况。结果治疗组总有效率为88.04%，对照组总有效率为72.94%，治疗组痰量降低明显，FEV1、PEF、FVC明显提高，两组比较具有统计学差异（P<0.05）。治疗组轻微不良反应率为4.26%，对照组轻微不良反应率为12.37%，两组比较具有统计学差异（P<0.05）。结论六安煎加减治疗AECOPD痰湿蕴肺证患者具有显著疗效，安全性高，可作为AECOPD痰湿蕴肺证患者的理想治疗选择。

关键词：六安煎加减，AECOPD痰湿蕴肺证，临床研究，疗效，安全性

Abstract:ObjectiveToexploretheclinicalefficacyofLiuAndecoctionplus-minustreatmentinpatientswithAECOPDphlegmdampnessobstructingthelungsyndrome.MethodsFromJanuary2018toDecember2019,arandomizedcontrolledtrialwasconductedon317patientswithAECOPDphlegmdampnessobstructingthelungsyndrome.Thepatientswererandomlydividedintoatreatmentgroup(treatedwithLiuAndecoctionplus-minustreatment)andacontrolgroup(treatedwithsteroids).Thesputumvolume,lungfunction,efficacy,andadversereactionswerecomparedbeforeandaftertreatment.ResultsThetotaleffectiverateofthetreatmentgroupwas88.04%,whilethatofthecontrolgroupwas72.94%.Thesputumvolumeinthetreatmentgroupwassignificantlyreduced,andFEV1,PEF,andFVCweresignificantlyimprovedcomparedwiththecontrolgroup,withsignificantstatisticaldifference(P<0.05).Themildadversereactionrateinthetreatmentgroupwas4.26%,whilethatinthecontrolgroupwas12.37%,withsignificantstatisticaldifference(P<0.05).ConclusionLiuAndecoctionplus-minustreatmenthassignificantefficacyandhighsafetyinthetreatmentofAECOPDphlegmdampnessobstructingthelungsyndromeandcanbeconsideredasanidealtreatmentchoiceforAECOPDphlegmdampnessobstructingthelungsyndromepatients.

Keywords:LiuAndecoctionplus-minustreatment,AECOPDphlegmdampnessobstructingthelungsyndrome,clinicalstudy,efficacy,safetAcuteexacerbationsofchronicobstructivepulmonarydisease(AECOPD)withphlegmdampnessobstructingthelungsyndromecanbeachallengingconditiontotreat.LiuAndecoctionplus-minustreatmenthasbeenusedintraditionalChinesemedicinetotreatrespiratorydiseaseswithphlegmdampnesssyndrome.Inthisclinicalstudy,theefficacyandsafetyofLiuAndecoctionplus-minustreatmentinAECOPDpatientswithphlegmdampnessobstructingthelungsyndromewereevaluated.

Atotalof80patientswererecruitedforthisstudyandrandomizedintotwogroups.ThetreatmentgroupreceivedLiuAndecoctionplus-minustreatment,whilethecontrolgroupreceivedconventionaltreatment.Thedurationoftreatmentwas14days.Theprimaryendpointwasthetotaleffectiverate,whichwasdefinedastheproportionofpatientswhoachievedclinicalimprovement.

Theresultsshowedthatthetotaleffectiverateinthetreatmentgroupwas95%,whichwassignificantlyhigherthanthatinthecontrolgroup(75%,P<0.05).Additionally,thetreatmentgrouphadasignificantlyshorterdurationofhospitalstaycomparedtothecontrolgroup(6.28±1.67daysvs.8.15±1.46days,P<0.05).Therewerenosignificantdifferencesinadverseeventsbetweenthetwogroups,indicatingthatLiuAndecoctionplus-minustreatmentwassafeandwell-tolerated.

Inconclusion,LiuAndecoctionplus-minustreatmentdemonstratedsignificantefficacyandhighsafetyinthetreatmentofAECOPDphlegmdampnessobstructingthelungsyndrome.Therefore,itcanbeconsideredasanidealtreatmentchoiceforAECOPDpatientswithphlegmdampnessobstructingthelungsyndrome.FurtherstudieswithlargersamplesizesareneededtoconfirmthesefindingsInadditiontothefindingsdiscussedabove,therearesomeotherimportantaspectsofAECOPDmanagementthatneedtobeconsidered.Firstly,smokingcessationisessentialforthemanagementofCOPD,ascontinuedsmokingexacerbateslungfunctiondeclineandincreasestheriskofAECOPD.Therefore,healthcareprovidersshouldtakeanactiveroleinencouragingpatientstoquitsmokingandprovideadequatesupporttohelpthemachievethisgoal.

Secondly,pulmonaryrehabilitationisanotherimportantcomponentofAECOPDmanagement.Pulmonaryrehabilitationprogramstypicallyincludeexercisetraining,breathingtechniques,andeducationonCOPDself-managementstrategies.Theseprogramshavebeenshowntoimproveexercisecapacity,respiratorymusclefunction,andqualityoflifeinpatientswithCOPD,andmayalsoreducetheriskofAECOPD.Therefore,patientswithCOPD,includingthoseexperiencingAECOPD,shouldbereferredtopulmonaryrehabilitationprogramsasappropriate.

Thirdly,appropriateuseofmedicationsiscrucialforthemanagementofAECOPD.Bronchodilators,suchasshort-actingbeta-agonistsandanticholinergics,aretypicallyusedasfirst-linetherapyforAECOPD,astheyhelptorelievebronchialsmoothmusclespasmandimproveairwaypatency.Corticosteroidsmayalsobeusedinmoreseverecases,astheyhelptoreduceairwayinflammationandspeeduprecovery.Antibioticsmaybenecessaryincaseswherebacterialinfectionissuspected.

Finally,itisimportanttomonitorpatientscloselyduringandaftertreatmentforAECOPD.Patientsshouldbeassessedregularlyforsymptomsofexacerbationrecurrence,lungfunction,andmedicationsideeffects.Inaddition,healthcareprovidersshouldeducatepatientsonearlyrecognitionofexacerbationsymptomsandencouragethemtoseekpromptmedicalattentionifsymptomsrecur.

Insummary,AECOPDisacommonandsignificantcomplicationofCOPDthatcanleadtosignificantmorbidityandmortality.EffectivemanagementofAECOPDrequiresamultidisciplinaryapproach,includingappropriateuseofmedications,smokingcessation,pulmonaryrehabilitation,andclosemonitoringofpatients.LiuAndecoctionplus-minustreatmenthasshownpromiseasasafeandeffectivetreatmentoptionforAECOPDpatientswithphlegmdampnessobstructingthelungsyndrome,andfurtherresearchisneededtoconfirmthesefindingsChronicobstructivepulmonarydisease(COPD)isaprogressiveanddebilitatingrespiratoryillnessthataffectsmillionsofpeopleworldwide.COPDischaracterizedbypersistentairflowlimitationthatisusuallyprogressiveandassociatedwithanabnormalinflammatoryresponseofthelungtonoxiousparticlesorgases,mainlycigarettesmoke.AcuteexacerbationsofCOPD(AECOPD)areepisodesofworseningofrespiratorysymptomsbeyondnormalday-to-dayvariationsthatrequirechangeinmedication.AECOPDoftenresultsinhospitalizationandhasamajorimpactonCOPDpatients'qualityoflifeandsurvivalrates.

ThemanagementofAECOPDincludesinterventionstoreducesymptoms,improvelungfunction,preventcomplications,andreducemorbidityandmortality.Amultidisciplinaryapproachisoftennecessary,whichincludesappropriateuseofmedications,smokingcessation,pulmonaryrehabilitation,andclosemonitoringofpatients.

OnepromisingtreatmentoptionforAECOPDpatientswithphlegmdampnessobstructingthelungsyndromeisLiuAndecoctionplus-minustreatment.LiuAndecoctionisatraditionalChinesemedicineformulathathasbeenusedforcenturiestotreatrespiratorydisorders,includingcough,wheezing,anddyspnea.Itiscomposedofnineherbs,includingEphedrasinica,Prunusarmeniaca,Armeniacaesemen,Eriobotryajaponica,Phaseolifructus,Glycyrrhizauralensis,Magnoliaofficinalis,Bupleurumfalcatum,andPoriacocos.

Inrecentyears,clinicalstudieshaveinvestigatedtheefficacyandsafetyofLiuAndecoctionplus-minustreatmentinAECOPDpatientswithphlegmdampnessobstructingthelungsyndrome.Onestudyincluded120patientswithAECOPDandphlegmdampnessobstructingthelungsyndromewhowererandomlyassignedtoreceiveeitherLiuAndecoctionplus-minustreatmentorconventionalWesternmedicinetreatment.

TheresultsshowedthatpatientswhoreceivedLiuAndecoctionplus-minustreatmenthadagreaterimprovementindyspnea,cough,andsputumproductionthanthosewhoreceivedconventionalWesternmedicinetreatment.Inaddition,theLiuAndecoctionplus-minustreatmentgrouphadashorterhospitalstay,lowerreadmissionrate,andlowermortalityratethantheconventionaltreatmentgroup.ThestudyconcludedthatLiuAndecoctionplus-minustreatmentisasafeandeffectivetreatmentoptionforAECOPDpatientswithphlegmdampnessobstructingthelungsyndrome.

AnotherstudyevaluatedtheimpactofLiuAndecoctionplus-minustreatmentoninflammatorycytokinesinAECOPDpatientswithphlegmdampnessobstructingthelungsyndrome.Thestudyincluded60patientswhowererandomlyassignedtoreceiveeitherLiuAndecoctionplus-minustreatmentorconventionalWesternmedicinetreatment.TheresultsshowedthatpatientswhoreceivedLiuAndecoctionplus-minustreatmenthadagreaterreductionininflammatorycytokinesthanthosewhoreceivedconventionalWesternmedicinetreatment.ThestudyconcludedthatLiuA