Abstract:

Objective　To observe the effect of Qingjin Zhike Jieji Decoction in the treatment of phlegm-dampness accumulation of lung during acute attack of chronic bronchitis in the elderly. Methods　A total of 118 elderly patients with phlegm-dampness accumulation of lung during acute attack of chronic bronchitis admitted to Xi'an Hospital of Traditional Chinese Medicine from June 2021 to March 2023 were selected as the study objects, and were divided into an observation group (59 cases) and a control group (59 cases) by the random number table method. In the observation group, there were 33 males and 26 females, with an age of (68.71±5.49) years old and a disease course of (9.24±1.58) years. In the control group, there were 35 males and 24 females, with an age of (69.57±5.35) years old and a disease course of (9.64±1.62) years. The control group was treated with conventional western medicine, and the observation group was treated with Qingjin Zhike Jieji Decoction (take 300 ml of decoction, and warm and oral take it in the morning and evening respectively) on the basis of the control group for 2 weeks. The traditional Chinese medicine (TCM) syndrome score, clinical efficacy, remission time of clinical symptoms, blood gas indexes, levels of inflammatory factors, and safety were compared between the two groups. t test and χ² test were used. Results　After treatment, the scores of TCM syndromes in the observation group were lower than those in the control group (all P<0.05). After treatment, the total effective rate of the observation group was higher than that of the control group [91.53% (54/59) vs. 71.19% (42/59)] (χ²=8.045, P=0.005). After treatment, the remission time of cough, sputum, chest tightness, and asthma in the observation group were shorter than those in the control group [(6.24±2.73) d vs. (9.75±2.94) d, (5.31±2.67) d vs. (8.86±3.15) d, (4.65±3.43) d vs. (7.41±2.98) d, (3.73±1.17) d vs. (6.23±2.56) d] (all P<0.05). After treatment, the arterial partial pressure of carbon dioxide (PaCO₂) level in the observation group was lower than that in the control group [(41.65±2.14) mmHg (1 mmHg = 0.133 kPa) vs. (45.27±3.31) mmHg] (P<0.05), but the arterial partial pressure of oxygen (PaO₂) level was higher than that in the control group [(95.82±9.36) mmHg vs. (91.47±9.24) mmHg] (P<0.05). After treatment, the levels of C-reactive protein (CRP), neuron-specific enolase (NSE), and anti-neutrophil cytoplasmic antibodies (ANCA) in the observation group were lower than those in the control group (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion　Qingjin Zhike Jieji Decoction can effectively improve the TCM syndromes in elderly patients with phlegm-dampness accumulation of lung during acute attack of chronic bronchitis, improve the clinical efficacy, shorten the remission time of clinical symptoms, improve the blood gas indexes, and reduce the levels of inflammatory factors, which is worthy of promotion.

Key words:

Chronic bronchitis, Acute attack, Syndrome of phlegm-dampness accumulation of lung, Qingjin Zhike Jieji Decoction, Clinical effect, Safety

摘要：

目的　探讨清金止咳解肌汤辅助治疗老年慢性支气管炎急性发作痰湿蕴肺证的效果。方法　选择2021年6月至2023年3月西安市中医医院收治的118例老年慢性支气管炎急性发作痰湿蕴肺证患者为研究对象，采用随机数字表法将研究对象分为观察组59例和对照组59例。观察组中男33例，女26例，年龄（68.71±5.49）岁，病程（9.24±1.58）年。对照组中男35例，女24例，年龄（69.57±5.35）岁，病程（9.64±1.62）年。对照组采用常规西医治疗，观察组在对照组的基础上采用清金止咳解肌汤治疗（取汁300 ml，分早晚2次温服）。连续治疗2周。比较两组患者的中医证候评分、临床疗效、临床症状缓解时间、血气指标、炎症因子水平、安全性。采用t检验、χ²检验、Fisher确切概率法。结果　治疗后，观察组中医证候评分均低于对照组（均P<0.05）。治疗后，观察组总有效率高于对照组［91.53%（54/59）比71.19%（42/59）］（χ²=8.045，P=0.005）。治疗后，观察组咳嗽、咳痰、胸闷、气喘缓解时间均短于对照组［（6.24±2.73）d比（9.75±2.94）d、（5.31±2.67）d比（8.86±3.15）d、（4.65±3.43）d比（7.41±2.98）d、（3.73±1.17）d比（6.23±2.56）d］（均P<0.05）。治疗后，观察组动脉血二氧化碳分压（PaCO₂）水平低于对照组［（41.65±2.14）mmHg（1 mmHg=0.133 kPa）比（45.27±3.31）mmHg］（P<0.05），动脉血氧分压（PaO₂）水平高于对照组［（95.82±9.36）mmHg比（91.47±9.24）mmHg］（P<0.05）。治疗后，观察组C-反应蛋白（CRP）、神经元特异性烯醇化酶（NSE）、抗中性粒细胞胞浆抗体（ANCA）水平均低于对照组（均P<0.05）。两组患者不良反应发生率差异无统计学意义（P>0.05）。结论　清金止咳解肌汤能够有效改善老年慢性支气管炎急性发作痰湿蕴肺证患者的中医证候，提高临床疗效，缩短临床症状缓解时间，改善血气指标，降低炎症因子水平，值得推广。

关键词:

慢性支气管炎, 急性发作, 痰湿蕴肺证, 清金止咳解肌汤, 临床疗效, 安全性