加味升陷苓桂术甘汤治疗慢性阻塞性肺疾病急性加重期35例临床观察

陈必勤　余茂强　祁向荣等

摘要：目的观察加味升陷苓桂术甘汤治疗慢性阻塞性肺疾病急性加重期的临床疗效。方法将70例慢性阻塞性肺疾病急性加重期患者随机分为对照组与治疗组，每组35例。对照组给予抗感染、化痰止咳平喘、氧疗等治疗；治疗组在对照组用药基础上加服加味升陷苓桂术甘汤，14 d/疗程。观察2组患者治疗前后的临床症状、肺功能、血气情况。结果对照组、治疗组总有效率分别为85.71%、94.29%，2组比较差异有统计学意义（P<0.05）；2组在治疗1个疗程后肺功能均有明显改善，PaO2明显升高，PaCO2明显降低，且治疗组在改善肺功能和动脉血气方面优于对照组，差异有有统计学意义（P<0.05）。结论加味升陷苓桂术甘汤治疗慢性阻塞性肺疾病急性加重期具有较好疗效。

关键词：加味升陷苓桂术甘汤；慢性阻塞性肺疾病；急性加重期；临床观察

中图分类号：R256.1文献标志码：B文章编号：1007-2349（2015）05-0052-02

【Abstract】Objective： To observe the clinical effect of Jiaweishengxian Linggui Zhugan Decoction on the treatment of chronic obstructive pulmonary patients. Methods： 70 patients were randomly divided into a control group and a treatment group， 35 cases per group. The control group was treated with antibiotics， antitussive and antiasthmatic prescriptions and oxygen therapy while the treatment group was added with Jiaweishengxian Linggui Zhugan Decoction besides the treatment of the control group. 14 days was a course of treatment. The patients clinical symptoms， pulmonary function and blood gas of the two groups were observed before and after the treatment. Result： The total effective rate of the control group and the treatment group was 85.71% and 94.29% respectively. The comparison of the two groups was statistically significant difference （P<0.05）. The pulmonary function of the two groups after a course of treatment showed significant improvement， PaO2 increased significantly and PaCO2 decreased significantly. The treatment group improved better than the control group in the pulmonary function and arterial blood gas and the difference was statistically significant （P<0.05）. Conclusion： Jiaweishengxian Linggui Zhugan Decoction has a good effect on the treatment of chronic obstructive pulmonary patients with acute exacerbation.

【Key words】Jiaweishengxian Linggui Zhugan Decoction， chronic obstructive pulmonary， acute exacerbation， clinical observation

慢性阻塞性肺疾病是一种可以治疗和预防的以气流受限为特征的临床常见肺部疾患，其气流受限多呈进行性发展，严重危害患者的身心健康。慢性阻塞性肺疾病急性加重是指在疾病过程中，短期内咳嗽、咳痰、气短等症状加重，超出日常变异的范围，是该病患者肺功能下降甚至死亡的主要原因。目前，单用西药治疗本病往往容易出现菌群失调及肠道功能紊乱等多种并发症，而中医药恰能减少西药使用的毒副作用，有效促使痰液排除，达到缩短病程，提高疗效的作用。加味升陷苓桂术甘汤是李绍鸿教授在长期临床实践中拟定的经验方，由黄芪、柴胡、升麻、桂枝、茯苓、丹参、白术等药组成，具有补气化饮、温阳通脉的功效。笔者继承李绍鸿教授的经验，采用随机对照的方法，对加味升陷苓桂术甘汤治疗慢性阻塞性肺疾病急性加重期的临床疗效进行观察，获得良好疗效，现报道如下。……