Clinical Reaserch Of The Efficacy Of Qin Jin Hua Zhuo Prescription For Phlegm Heat Obstructing The Lung Syndrome In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Reaserch objectiveObservation of the Qing Jin Hua Zhuo prescription combined with conventional western medicine treatment for phlegm heat obstructing the lung syndrome in Acute exacerbation of Chronic obstructive pulmonary disease(AECOPD),on the clinical efficacy,inflammatory markers, arterial blood gas analysis, TCM syndrome score and dyspnea severity degree changes before and after treatment, a comprehensive evaluation method for AECOPD the Qing Jin Hua Zhuo prescription increase the clinical effect and improve the degree of dyspnea severity, control the inflammation effect, to provide the basis for clinical use of the prescription.Research methodMethods a randomized, parallel group, from October 2015 to December 2016 AECOPD (class II) in the Department of respiration of Wangjing Hospital affiliated to Chinese Academy of traditional Chinese Medicine, acute exacerbation of disease course less than or equal to 7 days, is the dialectical phlegm heat obstructing the lung were randomly divided into two groups. the observation group of 34 cases, 32 cases in the control group.The control group was treated with standard treatment programme,the observation group combined with Qing Jin Hua Zhuo decoction on this basis,the course of treatment is 10 days. The changes of clinical symptoms, signs, white blood cell count (WBC), Fractional exhaled nitric oxide (FeNO), partial pressure of oxygen in artery(PaO2),partial pressure of carbon dioxide in artery(PaCO2) were observed before and after treatment.Research results(1) The clinical efficacy The TCM syndrome total effective rate of the observation group was 91.18%, that of the control group was 81.25%, by statistical analysis, the difference of the TCM syndrome total effective rate in the two groups has statistically significant(P<0.01).Comparison of between before and after treatment in each group,the difference of the main symptoms and signs in cough, sputum,wheezing and chest tightnes,fever in each group has highly statistically significant(P<0.01); comparison of between groups, the difference of the TCM syndromes in cough, wheezing and chest tightnes has statistically significant(P<0.01).The results showed that the two groups can improve clinical symptoms, Each treatment was effective,and the observation group was significantly better than the control group.(2) The inflammatory indexes By statistical analysis, comparison of between before and after treatment in each group, the difference of WBC, FeNO in the observation group has highly statistically significant(P<0.01), that of the control group has statistically significant(P<0.05); comparison of between groups, the difference of WBC has statistically significant(P<0.05),the difference of FeNO has no statistically significant(P>0.05). The results showed that the two groups can reduce White blood cells count and Fractional exhaled nitrie oxid,observation group increased the the count of white blood cells is better than the control group, the effect of the observation group on Fractional exhaled nitrie oxid was comparable with that of the control group.(3) The index of blood gas By statistical analysis, comparison of between before and after treatment in each group, the difference of PaO2 in the observation group has statistically significant(P<0.05), there was no significant difference of PaCO2(P>0.05),the difference of PaO2, PaCO2 in the control group has highly statistically significant(P<0.01); comparison of between groups, there was no significant difference of PaO2(P>0.05), the difference of PaCO2 has statistically significant(P<0.05). The results showed that the two groups were beneficial to increase the oxygen partial pressure, while the effect of the observation group on Oxygen partial pressure was comparable with that of the control group, the observation group to prevent the increase of Carbon dioxide partial pressure is better than the control group.(4) The severity of dyspnea By statistical analysis, comparison of between before and after treatment in each group, the difference of mMRC score in each group has statistically significant(P<0.01); comparison of between groups, with statistically significant differences in mMRC scores(P<0.01). The results showed that the two groups could improve the degree of dyspnea severity, the observation group in the improvement of dyspnea severity degree is superior the control group.(5) Safety indicators Before and after the clinical treatment of two groups of patients in safety index include red blood cell count(RBC),hemoglobin(HGB),urinaly--sis,alanine aminotransferase(ALT),serum creatinine(CRE) were no clinical significa--nce, and no obvious adverse reactions after treatment. It shows that the method has good safety, no obvious toxic and side effects, and the patient is easy to accept.research conclusionIn the treatment of AECOPD,Qing Jin Hua Zhuo prescription can effectively reduce white blood cell count, control of inflammation; prevent carbon dioxide retention, improve patients with cough, wheezing and chest tightness, dyspnea severity of symptoms improve pulmonary ventilation function;improve clinical efficiency, and the prescription has good safety, is worthy of clinical application and promotion.