Efficacy Of Qingfei Tongfu Decoction In The Treatment Of Elderly Phlegm-heat Obstructing Pulmonary AECOPD With Constipation

Objective:Based on the theory of"lung and large intestine inside and outside",the clinical effect of qingfei tongfu decoction in the treatment of elderly phlegm-heat obstructing pulmonary chronic obstructive pulmonary disease（AECOPD）with constipation was observed by using the tongfu method,providing clinical ideas and references for the treatment of these diseases.Methods:From September 2017 to may 2019,96 elderly patients with AECOPD and constipation of phlegm heat damming lung type were selected from the pulmonary department and thoracic surgery of the Affiliated Hospital of Jiangxi University of traditional Chinese medicine.According to the method of random number table,the patients were divided into two groups,48 in each group.The basic data study showed that the difference was statistically insignificant and comparable.The control group was treated with conventional western medicine.The experimental group was treated with Qingfei Tongfu Decoction on the basis of the control group for 10 days.The clinical data were recorded on the first and the tenth day of treatment respectively.The TCM symptom score,serum inflammatory factors（IL-6,IL-8,TNF-α,CRP）,lung function（FEV1,FEV1/FVC value）and blood gas analysis（Pa O₂,Pa CO₂）were performed between the two groups The length of stay and safety of medication were compared between the two groups.Spss22.0 software was used for statistical analysis of the two groups of clinical research data,to objectively evaluate the clinical efficacy of the two groups,and compare the difference between the two groups,whether there is statistical significance.Results:1.After 10 days of treatment,the total effective rate of the experimental group was 83.33%and that of the control group was72.92%.The total curative effect of the experimental group was better than that of the control group,the difference was significant（P<0.05）;and in the score of TCM symptoms,the symptoms of the experimental group were less than that before treatment,the improvement of the scores of cough,expectoration,panting,chest tightness,body heat and constipation in the experimental group was significantly better than that in the control group,and the constipation was greatly improved（P<0.01）.2.The levels of serum inflammatory factors IL-6,IL-8,TNF-αand CRP in the two groups were all decreased after treatment,the CRP in the experimental group decreased from 64.43±23.21mg/l before treatment to 2.10±2.44mg/l after treatment,and the CRP in the control group decreased from 65.25±17.43mg/l before treatment to 3.57±2.33mg/l after treatment,and the overall inflammatory level in the experimental group was significantly lower than that in the control group（P<0.05）.3.The difference of FEV1 and FEV1/FVC between the experimental group and the control group was statistically significant（P<0.05）.FEV1/FVC（48.24±5.10%）in the experimental group increased to（66.32±6.47%）after treatment;FEV1/FVC（49.08±6.41%）in the control group increased to（62.65±5.36%）after treatment,and FEV1 and FEV1/FVC in the experimental group increased significantly.4.Comparison of blood gas analysis after treatment showed statistically significant differences in Pa O₂and Pa CO₂between the experimental group and the control group after treatment（P<0.05）.Before treatment,Pa O₂（66.56±8.34）mm Hg in the experimental group increased to（87.77±4.54）mm Hg after treatment,while before Pa CO₂ treatment（56.32±6.31）mm Hg decreased to（40.24±4.54）mm Hg after treatment.5.The length of stay was 12.83±1.05 days in the experimental group.The length of stay in the control group was 16.32±1.43 days,and the length of stay in the experimental group was 3.49 days less than that in the control group（P<0.05）.In terms of safety evaluation,it mainly monitored the patients’general vital signs,electrocardiogram,three routine procedures and liver and kidney functions,etc.,and there was no significant difference between the two groups（P>0.05）.Conclusion:1.Qingfei tongfu decoction assisted in the treatment of elderly phlegm-heat obstructing pulmonary AECOPD with constipation,with an effective rate higher than that of western medicine control group.2.Qingfei tongfu decoction assisted in the treatment of elderly phlegm-heat obstructing pulmonary AECOPD with constipation can significantly improve the patients’symptoms of acute clinical discomfort and reduce the damage of inflammatory response.3.Qingfei tongfu decoction can assist in the treatment of elderly phlegm-heat obstructing pulmonary AECOPD with constipation,which can reduce the length of stay in hospital,play a safe and effective role,and can effectively relieve the patients’lung and systemic inflammatory response,improve the pulmonary ventilation function and improve the level of lung function.