Clinical Observation Of Modified Lianggesan Power On Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

ObjectiveTo observe the clinical effect of Jiawei Liangge Powder on acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.By Using scientific research methods,through observing the curative effect of modified Liangge Powder in the treatment of AECOPD,In order to improve the clinical symptoms of AECOPD patients,reduce the rate of deterioration,mortality and hospitalization costs,improve patient survival rate,improve patient infection,inflammatory reaction and immune function.MethodsThere were 80 cases of AECOPD in the Intensive Care Unit and Respiratory Department of the Tianjin University of Traditional Chinese Medicine affiliated Wuqing Chinese Medicine Hospital from September 2019 to March 2021.Referring to the random number table method,80 patients were randomly divided into two groups,40 patients（27 males and13 females）in the study group of modified Liangge Powder,the average age was 60.28±7.32years,and the course of disease ranged from 1 to 30 years,7.90±5.21 years on average.The course of acute exacerbation was 1-5 days,with an average of 2.85±1.25 days.And 40 cases（24 males and 16 females）in control group treated by routine Western medicine,the average age ranged from 43 to 75 years,the average age was 61.28±7.44 years,the course of disease ranged from 1 to 30 years,the mean age was 8.15±7.95 years,and the duration was 0.5～5days,the mean was 2.90±1.26 days.According to whether or not to use traditional Chinese medicine,The study group was treated with modified Liangge Powder on the basis of standardized treatment of Western medicine,while the control group was treated with conventional treatment of western medicine,the specific prescription of Jiawei liangge powder is as follows:Forsythia 20g,Scutellaria 9g,gardenia 9g,rhubarb 9g（lower）,mirabilite9g,peppermint leaves 6g（lower）,bamboo leaves 12g,licorice 6g,hunberg fritillary bulb9g,whiteflower hogfennel root 9g,bitter apricot kernel 9g,platycodon 6g,immature bitter orange 6g,Fructus Trichosanthis 9g,honeysuckle 15,Houttuynia 9g,which mirabilite another packaging,hand in the hands of patients with a good soup preparation.By the hospital pharmacy on behalf of decoction to 2 bags/dosaget,200m L each bag,30-45minutes after meals to take medicine,one dose a day,morning and evening each time,two groups were treated for7days.The patients in the control group were given 1-2 L/min continuous low flow oxygen inhalation and nebulizer inhalation on the basis of standardized treatment of primary diseases.The specific drugs were:The patients in the control group were given 1-2 l/min continuous low flow oxygen inhalation and nebulizer inhalation on the basis of standardized treatment of primary diseases,the specific medicines are:30 mg ambroxol hydrochloride injection（produced by Tianjin Pharmaceutical Research Institute Pharmaceutical Co.,Ltd.,Sinopharm H20051604）,0.005 mg salbutamol sulfate aerosol inhalation solution（produced by Shenzhen Dafo Pharmaceutical Co.,Ltd.,Sinopharm H2000348）,0.5 mg Ipratropium bromide solution for inhalation（Boehringer Ingelheim Pharma Gmb H&Co.KG,import drug registration number H20150159）,atomization inhalation,three times a day.Patients with severe infection were treated with the third generation cephalosporin antibiotics[cefoperazone sodium and tazobactam sodium]（produced by for Liaoning Haisike2011Pharmaceutical Co.,Ltd.,1.0 g:Standard Chinese Medicine H20113313 2.0 g:H20113314）].The clinical symptoms of TCM were observed in the two groups,white blood cell（WBC）,neutrophil percentage（NEUT%）,C-reactive protein（CRP）,calcitonin（PCT）,blood gas analysis[arterial partial pressure of oxygen（Pa O₂）and arterial partial pressure of carbon dioxide（PaCO₂）],pulmonary function[ratio of forced expiratory volume to forced vital capacity in the first second（FEV1/FVC）,forced expiratory volume in the first second（Fev1%pred）,etc].After treatment,the outcome and laboratory safety observation indexes（eosinophils,serum transaminase and serum creatinine）were examined.The clinical symptom scores of TCM the two groups before and after treatment were recorded to evaluate the curative effect of TCM.The clinical data were observed and analyzed by SPSS23.0software,and whether the data difference between the two groups was statistically significant was compared.Results1.Baseline information:There were 80 patients in this study,40 in the study group and40 in the control group.The basic data（gender,age,course of disease and acute aggravation period）P>0.05 showed no significant difference between the two groups.2.TCM clinical symptom grading score:After treatment,the symptom score and total score of the two groups were significantly lower than those before treatment,and the difference between the two groups was statistically significant（P<0.05）.3.The total effective rate of traditional Chinese medicine:After treatment,the total effective rate of the study group and the control group was 90%and 72.5%,respectively,and the difference between the two groups was statistically significant（P<0.05）.4.Comparison of the efficacy indexes of Western medicine test before and after treatment in the two groups:The levels of WBC,NEUT%,CRP,PCT and PaCO₂in the two groups were significantly lower than those before treatment,and the levels of Pa O₂,FEV1/FVC and FEV1%pred were significantly higher than those before treatment.The comparison between the two groups was statistically significant（P<0.05）.5.Safety analysis:The safety test indexes of the two groups were within the safety range,and no obvious adverse reactions occurred.6.To the end of the observation,two groups did not appear shedding cases and exit cases.Conclusion1.Modified Liangge Powder combined with conventional western medicine in the treatment of AECOPD can reduce the levels of WBC,NEUT%,CRP and PCT,inhibit the release of inflammatory factors,and effectively control the body infection.2.Modified Liangge Powder combined with conventional western medicine treatment can reduce PaCO₂and increase Pa O₂,improve lung function and hypoxia in AECOPD patients,and thus effectively alleviate the clinical symptoms of dyspnea and wheezing.3.Modified Liangge Powder group can improve the TCM clinical syndromes of AECOPD patients with phlegm-heat stagnation of lung type,enhance the body immunity,and improve the quality of life of patients.4.Modified Liangge Powder in the treatment of AECOPD curative effect,low price,no side effects,has good clinical and social benefits,worthy of clinical promotion.