目的 觀察清咳平喘顆粒治療慢性阻塞性肺疾?。–OPD）急性加重期患者的臨床療效。方法 回顧性選取2019年11月—2021年5月在上海市（復旦大學附屬）公共衛(wèi)生臨床中心呼吸內(nèi)科住院的COPD急性加重期患者70例為研究對象，根據(jù)藥物治療方法分為試驗組和對照組，每組各35例。對照組根據(jù)病情常規(guī)給予低流量氧療、抗感染、解痙平喘化痰等綜合治療，試驗組在對照組治療基礎上加用清咳平喘顆粒，開水沖服，每次10 g，每日3次。兩組均治療10 d。觀察兩組患者治療前后中醫(yī)證候療效，慢性阻塞性肺疾病癥狀評估測試（CAT）評分，肺功能、動脈血氣、炎癥指標及不良反應。結(jié)果 試驗組中醫(yī)證候療效總有效率（88.6%）明顯高于對照組（68.6%）（P＜0.05）。試驗組及對照組患者治療前CAT評分、動脈血氣、肺功能指標比較差異均無統(tǒng)計學意義（P＞0.05），治療后兩組患者CAT評分和動脈二氧化碳分壓（pCO₂）均較治療前顯著降低（P＜0.05），治療后兩組患者動脈血氧分壓（pO₂）、第1秒用力呼氣容積（FEV1）和第1秒用力呼氣容積/用力肺活量（FEV1/FVC）均較治療前顯著升高（P＜0.05）；治療后試驗組患者CAT評分、動脈血氣及肺功能指標較對照組改善均更明顯，差異均有統(tǒng)計學意義（P＜0.05）。治療前，兩組患者外周血白細胞（WBC）計數(shù)、C反應蛋白（CRP）、血清降鈣素原（PCT）水平比較均無統(tǒng)計學差異（P＞0.05），治療后兩組患者WBC、CRP、PCT水平均較本組治療前顯著降低（P＜0.05），且治療后試驗組WBC、CRP、PCT水平較顯著低于對照組（P＜0.05）。試驗組不良反應發(fā)生率14.3%與對照組（8.6%）比較，差異無統(tǒng)計學意義（P＞0.05）。結(jié)論 清咳平喘顆粒治療COPD急性加重期患者有協(xié)同作用，緩解臨床癥狀，改善肺功能，療效及安全性均較好。

Objective To observe the clinical efficacy of Qingke Pingchuan Granules in treatment of patients with chronic obstructive pulmonary disease (COPD) in acute exacerbations. Methods 70 patients with acute exacerbation of COPD hospitalized in the respiratory department of Shanghai Public Health Clinical Center (affiliated to Fudan University) from November 2019 to may 2021 were selected retrospectively. According to the drug treatment methods, they were divided into experimental group and control group, with 35 cases in each group. Pateints in the control group were given low flow oxygen therapy, anti-infection, antispasmodic, asthma and phlegm treatment according to the condition. Pateints in the experimental group were treated with Qingke Pingchuan Granule, 10 g each time, three times a day. Both groups were treated for ten days. The curative effects of TCM syndromes, chronic obstructive pulmonary disease symptom assessment test (CAT) score, pulmonary function, arterial blood gas, inflammatory indexes and adverse reactions were observed before and after treatment. Results The total effective rate of TCM syndrome in the experimental group (88.6%) was significantly higher than that in the control group (68.6%) (P<0.05). There was no significant difference in CAT score, arterial blood gas and pulmonary function between the experimental group and the control group before treatment (P>0.05). After treatment, the CAT score and arterial carbon dioxide partial pressure (pCO₂) of the two groups were significantly lower than those before treatment (P<0.05). Arterial oxygen partial pressure(pO₂), the first second forced expiratory volume (FEV1) and the first second forced expiratory volume/forced vital capacity (FEV1/FVC) were significantly higher than those before treatment (P<0.05). After treatment, the CAT score, arterial blood gas and pulmonary function indexes in the experimental group were significantly improved compared with those in the control group (P<0.05). Before treatment, there was no significant difference in peripheral blood leukocyte (WBC), C-reactive protein (CRP) and serum procalcitonin (PCT) levels between the two groups (P>0.05). After treatment, the levels of WBC, CRP and PCT in two groups were significantly lower than those before treatment (P<0.05), and the levels of WBC, CRP and PCT in the experimental group were significantly lower than those in the control group (P<0.05). The incidence of adverse reactions in the experimental group was 14.3%, and there was no significant difference between the experimental group and the control group (8.6%) (P>0.05). Conclusion Qingke Pingchuan Granule has synergistic effect in treatment of patients with acute exacerbation of COPD, alleviating clinical symptoms and improving pulmonary function. It has good curative effect and safety.

R974

上海市科學技術(shù)委員會資助項目(20Z11901002);上海市衛(wèi)生健康委面上項目(202040332)