ABSTRACT
Objective:To evaluate the clinical efficacy of external therapy with self-made Huatan Prescription combined with conventional western medicine therapy in the treatment of severe pneumonia of phlegm turbidity obstructing lung.Methods:Randomized controlled trial. A total of 114 patients with severe pneumonia of phlegm turbidity obstructing lung in the hospital between July 2020 and December 2021 were enrolled in this study. The patients were divided into two groups by the random number table method, with 57 in each group. On the basis of conventional western medicine therapy, the treatment group was given external therapy of self-made Huatan Prescription, and the control group was given the placebo. Both groups were applied continuously for 5 days. The TCM syndromes were scored before and after treatment. The disease severity was evaluated by Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ). The levels of WBC and procalcitonin (PCT) were detected by automatic blood analyzer. The levels of serum CRP and IL-6 were detected by ELISA. The adverse reactions during treatment were recorded and the clinical efficacy was evaluated.Results:After treatment, the total respinse rate was 92.98% (53/57) in treatment group and was 70.18% (40/57) in control group ( χ2=9.87, P=0.002). The scores of fever, unconsciousness, cough and expectoration, nausea and vomiting, tongue coating and pulse and total score in treatment group were significantly lower than those in the control group ( t=8.95, 7.30, 6.93, 7.37, 12.02, 12.59, 14.29, P<0.01). SOFA (18.12±3.55 vs. 21.46±3.58, t=5.00) and APACHE Ⅱ (13.39±2.72 vs. 16.52±3.13, t=5.70) in treatment group were significantly lower than those in the control group ( P<0.01). The levels of WBC [(11.12±1.61) ×10 9/L vs. (12.69±1.82) ×10 9/L, t=4.88], PCT [(3.72±0.81) μg/L vs. (5.19±0.92) μg/L, t=9.05], serum CRP [(62.09±11.41) mg/L vs. (91.77±15.54) mg/L, t=11.62] and IL-6 [(193.14±32.28) ng/L vs. (235.68±38.75) ng/L, t=6.37] in treatment group were significantly lower than those in the control group ( P<0.01). During treatment, there were no obvious adverse reactions in both groups. Conclusion:Self-made Huatan Prescription external therapy combined with conventional western medicine therapy can improve the clinical symptoms, inhibit the inflammatory response, relieve the disease condition and improve the prognosis of patients with severe pneumonia of phlegm turbidity obstructing lung safely.
ABSTRACT
Objective To investigate the effect of Kuanxiong Lifei decoction on inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and turbid phlegm obstructing lung syndrome. Methods Two hundred patients with AECOPD and turbid phlegm obstructing lung syndrome diagnosed by traditional Chinese medicine (TCM) differentiation visiting four hospitals of Longhua Hospital Affiliated to Shanghai University of TCM, Shanghai Seventh People's Hospital, Punan Hospital of Shanghai Pudong New Area, Gongli Hospital of Shanghai Pudong New Area were selected from May 2017 to March 2018, and they were divided into a test group and a control group by a random number table, 100 cases per group. The patients in the two groups were treated with routine western medicine according to the guidelines, and in the test group, additionally Kuanxiong Lifei decoction (components: pinellia ternate 15 g, allium macrostemon 12 g, ephedra 9 g, trichosanthes 30 g, poria cocos 15 g, almond 12 g, lumbricus 12 g, citrus peels 12 g, peach kernel 12 g , roasted licorice 6 g) was used for 10 days, the decoction was uniformly made by Chinese Medicine Pharmacy of Longhua Hospital, 1 dose daily, 2 times a day orally taken, warm 200 mL each time, 0.5 hours before or after meal. The efficacy was evaluated after treatment for 10 days. The level changes of white blood cell count (WBC), neutrophils (N), C-reactive protein (CRP), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) before and after treatment and the improvement of TCM syndrome scores and clinical efficacy were observed in two groups. Results After treatment, the levels of WBC, N, CRP, IL-8, TNF-α, TCM syndrome score of the patients in the two group were significantly decreased compared with those before treatment in the two groups (P < 0.05), and the above indexes in the test group were all significantly lower than those in the control group after treatment [WBC (×109/L): 6.58±1.41 vs.7.44±1.85, N: 0.58±0.08 vs. 0.64±0.08, CRP (mg/L): 7.3±1.8 vs. 9.6±1.7, IL-8 (ng/L): 23.5±6.2 vs. 27.8±9.8, TNF-α (ng/L): 9.45±2.18 vs. 10.25±1.67, TCM syndrome total score: 4.0 (3.0, 8.0) vs. 8.0 (5.0, 10.0), all P < 0.05]. The total effective rate of the test group was significantly higher than that of the control group [88% (88/100) vs. 84% (84/100), P < 0.05]. Conclusion Kuanxiong Lifei decoction can significantly reduce lung inflammatory factors, ameliorate overall symptoms and improve the prognosis of AECOPD patients with turbid phlegm obstructing lung syndrome.