Evaluation Of Therapeutic Efficiency Of Clearing Heat And Resolving Phlegm For AE COPD With Syndrome Of Phlegm-heat Obstructing Lung In Real World On Propensity Score Matching

Objective To evaluate the clinical therapeutic efficiency of clearing heat and resolving phlegm for AECOPD with syndrome of phlegm-heat obstructing lung in real world by observing the improvements of inflammatory indicators,the duration of fever in febrile patients,and hospitalization days,using propensity score matching.Methods A total of 488 patients who were admitted to the respiratory department of Zhejiang Province Traditional Chinese Medicine Hospital on January 1,2015 to December 31,2017 were enrolled.All of them were diagnosed as AECOPD with syndrome of phlegm-heat obstructing lung.The patients were divided into two groups according to whether they received oral TCM treatment of Clearing Heat and Resolving Phlegm: 88 cases in the TCM group and 400 cases in the control group.After pairing two groups by propensity score matching,the improvement of inflammatory indicators,the duration of fever in febrile patients,hospitalization days and the influence on hematopoietic system and liver and kidney function before and after treatments were compared between two groups.Results Before the match,there are some statistical differences in age,? type respiratory failure,fever,pulmonary embolism,serum urea nitrogen level on admission,and the use of glucocorticoid between two groups.A total of 82 pairs and 164 patients were finally matched by using 1:1 nearest neighbor matching method.After matching,there was no significant difference in clinical characteristics between two groups.(1)Therapeutic effect evaluation:the percentage of neutrophils and CRP after treatment in both groups were lower than before treatment(P < 0.05),and the TCM group was better than the control group(P < 0.05).The duration of fever in febrile patients of TCM group was shorter than that of control group(P <0.05).The white blood cell counts after treatment of the two groups showed no significant change compared with that before treatment(P > 0.05).There was no significant difference in the length of hospitalization days between the two groups(P > 0.05).(2)Safety evaluation:there was no significant difference at discharge in hemoglobin,platelet count,serum creatinine,blood urea nitrogen,ALT,AST,total bilirubin between the two groups(P > 0.05).Conclusion The therapy of clearing heat and resolving phlegm can effectively control the inflammatory reaction of AECOPD patients with syndrome of phlegm-heat obstructing lung,especially for fever patients,increasing the clinical efficacy,while it possess good security,which can be widely used.