【作者】 徐正莉；

【导师】 胡天成；

【作者基本信息】 成都中医药大学 ， 中医内科， 2004， 博士

【摘要】 目的 探讨润肺饮对慢性阻塞性肺疾病急性发作期燥热咳嗽患者的临床疗效和部分作用机理。 方法 选择符合慢性阻塞性肺疾病诊断标准患者，随机分2组，治疗组采用中药润肺饮汤剂口服，盐酸左氧氟沙星（0.2g）静滴，每日两次，舒氟美0.1g口服，每日两次，必嗽平16mg口服，每日三次；对照组采用盐酸左氧氟沙星（0.2g）静滴，每日两次，舒氟美0.1g口服，每日两次，必嗽平16mg口服，每日三次。两组疗程均为14天，每日进行症状、体征评分记录，治疗前后进行相关项目检查。 结果 治疗组显控率为70％，明显优于对照组（P＜0.05）。其改善咳嗽、咳痰、喘息症状和改善舌质、舌苔明显优于对照组；显著降低白细胞总数、血清内毒素、C反应蛋白、白介素-8、肿瘤坏死因子-α含量；明显降低全血黏度值、血浆黏度值；明显提高FVC、FEV₁、FEV₁％和PaO₂数值，降低PaCO₂水平。 结论 润肺饮有润燥清热，化痰祛瘀，止咳平喘功效，可能是通过抑制COPD急性加重期患者的炎症介质和细胞因子释放，减轻气道及全身炎症反应，舒张支气管平滑肌，改善血液流变学，改善肺功能之故，从而具有较好的临床疗效，有利于COPD患者病情的恢复。更多还原

【Abstract】 Objective: The object of this study was to assess the clinical effectiveness and part therapeutic mechanism of Run Fei Yin decoction in treating chronic obstructive pulmonary disease (COPD).Methods: The study was randomly determined in 60 patients with COPD in acute stage including 30 treating group and 30 in comparing group. The case in treatment group were treated with Run Fei Yin decoction, assisted with western medicine. The case in control group were treated with western medicine simply. Symptom and signs were measured and recorded every day. The related items were measured before and after treatment.Results: The results showed that Run Fei Yin decoction was proved to be efficacious in improving clinical symptom and signs such as cough, asthma, expectoration . The proper and coating were improved. The clinical controlled and remarkably effective rate in treatment group is higher than that in control group (P<0.05). Furthermore, White blood cell(WBC), Endotoxin(ET), Interleuin-6(IL-6), Interleuin-8(IL-8), Tumor necrosis factor alpha(TNF- a ) , C reactive protein (CRP) in treatment group were decreased significantly. The whole blood viscosity and blood plasma viscosity were obviously reduced. Pulmonary ventilator function such as FVC, FEV1 FEV1% were increased obviously. The level of PaO2 were increased.Conclusion: Run Fei Yin decoction has the effect of resolving phlegm and relieving cough. The clinical observation suggested that it may reduced inflammation of respiratory tract by inhibiting the inflammation medium and cell factor released. It also could improve pulmonary ventilatory functions.更多还原