Effects Of The Qing Jin Hua Zhuo Prescription Infectious Acute Exacerbation Of Chronic Obstructive Pulmonary Disease And Airway Mucus Hypersecretion

Objective:In this study,the patients with infectious Acute Exacerbation of Chronic Obstructive Pulmonary Disease(AECOPD)with syndrome of phlegm heat and accumulation of lung were treated with the Qing Jin Hua Zhuo Prescription combined with western medicine standard treatment to proved that the Qing Jin Hua Zhuo Prescription could improve the clinical efficacy of infectious AECOPD,reduce the MUC5AC content of sputum,inhibit the airway mucus hypersecretion,to provide basis for clinical application and promotion of the prescription.Method:Adopting a randomized parallel control method,the patients of infectious AECOPD(grade Ⅰ-Ⅱ)and TCM syndrome differentiation of phlegm heat accumulation lung syndrome were treated in the Department of respiration of Wangjing Hospital Of CACMS on October 2018-December 2019.The patients were randomly divided into the observation group and the control group according to the time sequence of treatment,including 31 cases in the observation group and 31 cases in the control group.The control group adopted the western medicine standard treatment,and the observation group,on this basis,was treated with the Qing Jin Hua Zhuo Prescription of 7 days.During the study period,two groups of patients were forbidden to take western medicine or Chinese medicine/proprietary Chinese medicine with the expectorant and antitussive effects.The TCM symptom score,sputum characteristics score,dyspnea severity,infection index and sputum MUC5AC contentof two groups before and after treatment were observed.Result:1.TCM symptom score comparison The total effective rate of TCM symptoms after treatment was 93.54%in the observation group and 83.87%in the control group.After statistical analysis,the difference of curative effect of TCM symptoms between the two groups was highly statistically significant(P<0.01).After treatment,the TCM symptom score in the two groups were compared before and after treatment,and the differences in cough,cough sputum,wheeze and fever were highly significant(P<0.01).The difference in thirst in the observation group was highly statistically significant(P<0.01),while the difference in thirst in the control group was not statistically significant(P>0.05).The difference in constipation in the observation group was highly statistically significant(P<0.01),while that in the control group was statistically significant(P<0.05).Comparing of TCM symptoms between two groups after treatmen,The differences in cough,cough sputum,wheeze,thirst and constipation were highly significant(P<0.01),while the difference in fever was not statistically significant(P>0.05).It indicated that the two groups could improve the symptoms of cough,cough sputum,wheeze,fever and constipation.The observation group was significantly better than the control group in improving cough,cough sputum,wheeze,thirst and constipation symptoms,and the efficacy of the observation group in improving the symptoms of fever was similar to that in the control group.2.Comparison of sputum trait scores After statistical analysis,intra-group comparison of the sputum trait scores between the two groups after treatment,there were significant differences in sputum volume,color and quality between the two groups(P<0.01).Comparing of sputum trait scores between two groups after treatmen,the difference in sputum volume and quality was highly significant(P<0.01),and the difference in sputum color was statistically significant(P<0.05),indicating that the two groups could improve the sputum trait of patients,and the observation group was better than the control group in improving sputum volume and sputum quality.3.Comparison of the severity of dyspnea After statistical analysis,intra-group comparison of the severity of dyspnea between the two groups after treatment,there was a statistically significant difference after treatment in the severity of dyspnea between the two groups(P<0.01).Comparing of the severity of dyspnea between two groups after treatment,the difference of severity of dyspnea between the two groups after treatment was statistically significant(P<0.05).It indicated that the two groups could improve the severity of dyspnea in patients with infectious AECOPD.The efficacy of the observation group in improving the severity of dyspnea was better than that in the control group.4.Comparison of infection indicators After statistical analysis,the infection indexes of the two groups before and after treatment were compared,and the difference of WBC and NEUT%in the observation group was highly significant(P<0.01);in the control group,the difference of WBC was statistically significant(p<0.05),and the difference of NEUT%was highly statistically significant(p<0.01).After treatment,the difference between the two groups of WBC and NEUT%was statistically significant(P<0.05).The results showed that the white blood cell count and the percentage of neutrophils in the two groups were decreased,and the white blood cell count and neutrophil percentage in the observation group were better than those in the control group.5.Comparison of sputum MUC5AC content After statistical analysis,intra-gro--up comparison of the MUC5AC contents in sputum between the two groups after treatment,the difference of MUC5AC content in sputum of the observation group was highly statistically significant(p<0.01);the difference of MUC5AC content in the sputum of the control group was statistically significant(p<0.05).Comparing of MUC5AC in sputum between two groups after treatment,the difference of sputum MUC5AC content was statistically significant(p<0.05),indicating that the two groups could reduce the content of sputum MUC5AC,and the observation group was better than the control group in reducing the MUC5AC content of sputum.6.Safety indicators Safety index two groups before and after treatment blood routine,liver function(ALT,AST),renal function(BUN,CRE),urine routine and other safety indicators were not statistically significant differences,and there were no obvious adverse reactions after treatment.Conclusion:Qing Jin Hua Zhuo Prescription for infectious AECOPD of phlegm-heat accumulation lung syndrome can significantly improve the symptoms of cough,cough sputum,wheeze,fever,thirst,constipation,sputum trait and the severity of dyspnea,reduce the infection index,improve the clinical efficacy;reduce the content of MUC5AC to inhibit airway mucus hypersecretion,improve the efficacy of anti infection.Good safety is worthy of clinical application and promotion.