刘楠楠　　姚岚　　秦琦

[摘要] 目的 研究清肺化痰湯治疗痰热郁肺型慢性支气管炎急性发作的临床疗效。 方法 随机抽取2017年10月至2019年12月沈阳市第四人民医院中医科门诊收治的诊断为慢性支气管炎急性发作（痰热郁肺型）的患者90例，并采取随机分组的方法将其分为试验组45例及对照组45例。试验组患者采用西药联合清肺化痰汤治疗，对照组单纯应用西药治疗，两组患者治疗疗程均为2周。比较两组治疗总有效率、治疗前后症状评分、6个月复发情况。 结果 试验组治疗总有效率为95.6%，显著高于对照组的71.1%，差异有统计学意义（P<0.05）;两组治疗前症状评分比较，试验组评分（19.31±1.29）分，对照组评分（19.28±1.43）分，差异无统计学意义（P>0.05）;治疗后，两组症状评分均较治疗前显著降低，试验组评分（6.28±1.33）分，对照组评分（8.62±2.01）分，试验组显著低于对照组，差异有统计学意义（P<0.05）。6个月后对两组进行病情随访，试验组复发率为13.33%，显著低于对照组的24.44%，差异有统计学意义（P<0.05）。 结论 清肺化痰汤在痰热郁肺型慢性支气管炎急性发作的临床治疗中疗效显著、预后良好，对于疾病的治疗及预防、患者体质的调养均有良好的疗效，值得临床推广。

[关键词] 清肺化痰汤;痰热郁肺;慢性支气管炎;咳嗽;肺失宣肃

[中图分类号] R562.2          [文献标识码] B          [文章编号] 1673-9701（2021）09-0143-04

Research on the clinical efficacy of Qingfei Huatan Decoction on acute attack of chronic bronchitis with pattern of phlegm-heat stagnation of lung

LIU Nannan   YAO Lan   QIN Qi

Department of Traditional Chinese Medicine， the Fourth People′s Hospital of Shenyang， Shenyang   110000， China

[Abstract] Objective To research the clinical efficacy of Qingfei Huatan Decoction on acute attack of chronic bronchitis with pattern of phlegm-heat stagnation of lung. Methods A total of 90 patients diagnosed as acute attack of chronic bronchitis（pattern of phlegm-heat stagnation of lung） admitted to outpatient of traditional Chinese medicine of the Fourth People′s Hospital of Shenyang from October 2017 to December 2019 were randomly selected and divided into the experimental group（n=45） and the control group（n=45）. Patients in the experimental group were treated with western medicine combined with Qingfei Huatan Decoction， while those in the control group were treated with western medicine singly. The two groups of patients were treated for 2 weeks. The total treatment efficacy rate， the symptom scores before and after treatment， and the incidence of illness relapse after 6 months′ between the two groups were compared. Results The total treatment efficacy rate in the experimental group was 95.6%， statistically significantly higher than 71.1% in the control group（P<0.05）. Before treatment， the scores of symptoms were（19.31±1.29） points in the experimental group and（19.28±1.43） points in the control group， without statistically significant difference（P>0.05）. After treatment， scores of the experimental group were（6.28±1.33） points， significantly lower than（8.62±2.01） of the control group. The scores of symptoms after treatment were significantly lower than those before treatment in both groups， meanwhile， score reduction of the experimental group was significantly higher than that of the control group before and after treatment （P<0.05）. Follow-up within 6 months showed that the relapse rate of the experimental group was 13.33%， significantly lower than 24.44% of the control group（P<0.05）. Conclusion Qingfei Huatan Decoction has remarkable therapeutic efficacy and good prognosis in the clinical treatment of acute attack of chronic bronchitis with pattern of phlegm-heat stagnation of lung. It has good therapeutic efficacy in the treatment and prevention of diseases and the recuperation of patients′ physique， which is worthy of promotion in clinic.

[Key words] Qingfei Huatan Decoction; Phlegm-heat stagnation of lung; Chronic bronchitis; Cough; Lung′s dysfunction of diffusion and purification and descending

慢性支气管炎为各种因素导致的气管、支气管慢性非特异性炎症，以咳嗽、咳痰、呼吸困难、哮喘等为主要临床表现[1]，在其急性发作期，上述症状急性加重，且伴有发热的临床表现，严重威胁着患者的身体健康，如没能够及时而有效的治疗，很可能合并有阻塞性肺气肿及肺心病等危重疾病。慢性支气管炎目前尚不存在确切的病理机制，其属于多种因素长期相互作用而产生的复杂结果，其致病因与有害气体、有害颗粒、病毒感染、免疫力低下、气候条件及年龄有密不可分的联系。同时，慢性支气管炎具有病程迁延及起病缓慢等临床特点，呈现反复急性发作，一旦遭遇细菌、病毒等呼吸道致病菌的感染，存在进入急性加重期的可能性，造成咳痰、咳嗽及喘息等臨床症状进一步加重，直接影响到患者生活质量，威胁着患者的生命健康与安全。……