| Chronic obstructive pulmonary disease(COPD) is a disease state characterized by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. The Patients of chronic bronchitis, pulmonary emphysema whose spirometry show airflow limitation not fully reversible can be diagnosed as COPD. These patients of COPD usually have chronic cough, sputum production, air hunger or dyspnea, asthma and chest distress. The medicine workers pay more and more attention to COPD which owe to a great deal of COPD patients, high case fatality rate and weighty economy burden. This article summarize the recordation about COPD in the archaic Chinese medicine literature, the progress of modern Chinese medicine in the study on COPD, the canonical prevention and cure for COPD .progress of modern medicine in the study on COPD, the connection between TNF-alpha and COPD, and so on. On the basis of the above summarization, we probe into the curative effect on AECOPD of clearing away heat—evil and resolving phlegm in this antitheses, prospective study so as to provide scientific evidence for treating COPD with the management of clearing away heat—evil and resolving phlegm.ObjectiveTo observe the curative effect on AECOPD with the management of clearing away heat—evil and resolving phlegm by analyzing the symptom, sign, blood gas analysis, spirometry , the level of TNF- alpha in theperipheral blood.MethodSixty hospitalized AECOPD patients (stage I-II) with retention of phlegm and heat syndrome in the lung in TCM are randomly divided into two groups, the trial group and the control group. The patients of trial group take the Chinese medicine decoctions which have the efficacy of clearing away heat —evil and resolving phlegm (qianjin weijing decoction plus others) , and simultaneously accept conventional therapy of the western medicine same as the control group (controllability oxygen treatment, bronchodilators, antibiotic, expectorants). The period of treatment is 10 days. To compare the result of two groups by analyzing clinical symptom and sign, blood gas analysis, spirometry, the level of TNF-alpha in peripheral blood.ResultClinical symptom and sign: After the treatment, melioration of clinical symptom and sign in both groups have significant difference. Compared with the control group, melioration of the trial group, such as colour of sputum, chest distress, fever, appetite, consciousness, rhonchi and moist rale is greater, showing significant difference. The above result show that therapy of two groups both can help COPD, and the trial group is better than the control group.Blood gas analysis: The melioration of PaO2, PaC02 have significant difference in both groups. Compared with the control group, melioration of the trial group is greater and has significant difference. So we can see that the therapy of both groups can help to improve the indexs of blood gas analysis, and the trial group is superior to the control group.Spirometry: After the treatment, melioration of FEV1, FEV1%, FEV1/ FVC in both groups have significant difference. The melioration of spirometry has no significant difference between the two groups. This show that the therapy of the trial group is the same as the one of the control group.TNF-alpha in the peripheral blood: TNF-aphla in the peripheral blood of both groups reduce, showing significant difference. And TNF-aphla reduce more greatly in the trial group. So we can see that the effect of the trial group on reducing TNF- aphla in the peripheral blood is moresignifiant than the one of the control group.ConclusionThe management of clearing away heat—evil and resolving phlegm can help AECOPD. It can improve clinical symptom and sign, remedy the stateof anoxia and carbon dioxide retention, reduce inflammatory factor----TNF-aphla in the peripheral blood so as to accelerate rehabilitation of COPD patients.
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