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ObjectiveTo evaluate the clinical efficacy of Qimai Qinlou prescription in the treatment of elderly community-acquired pneumonia （CAP） （non-severe） with Qi and Yin deficiency and phlegm-heat obstructing lung syndrome and its impact on immune-inflammatory factors. MethodA total of 120 eligible patients were randomly divided into an observation group （60 cases） and a control group （60 cases）. Both groups received intravenous cefoxitin sodium. In addition， the observation group received oral Qimai Qinlou prescription， while the control group received an oral placebo simulating Qimai Qinlou prescription. The treatment course was 14 days. The disappearance time of major clinical symptoms and signs was recorded. Traditional Chinese medicine （TCM） syndrome scores and the Clinical Research Outcome （CAP-CRO） scale scores for pneumonia of the two groups were compared. Chest computed tomography （CT） scans were performed， and peripheral blood levels of procalcitonin （PCT）， interleukin-6 （IL-6）， serum amyloid A （SAA）， high-sensitivity C-reactive protein （hs-CRP）， CD4+， CD8+， and CD4+/CD8+ were measured. The conversion rate to severe condition during hospitalization， readmission rate within 30 days after discharge， and safety evaluation were recorded. ResultAfter treatment， the observation group showed significantly shorter time of fever， cough， expectoration， and disappearance time of lung moist rales than the control group （P<0.01）. The TCM syndrome scores， CAP-CRO scores in all dimensions， and total scores in both groups were significantly reduced as compared with those before treatment （P<0.01）. After treatment， the observation group had a more significant reduction than the control group （P<0.01）. The levels of PCT， IL-6， SAA， and hs-CRP in both groups were significantly reduced as compared with those before treatment （P<0.01）. After treatment， the observation group showed a more significant reduction than the control group （P<0.01）. There was no statistically significant difference in the changes of CD4+， CD8+， and CD4+/CD8+ in the control group before and after treatment. However， in the observation group， CD4+ and CD4+/CD8+ levels significantly increased （P<0.01）， while CD8+ level significantly decreased （P<0.01） after treatment. After treatment， CD4+ and CD4+/CD8+ in the observation group significantly increased （P<0.01）， and CD8+ significantly decreased as compared with those in the control group （P<0.01）. At 7， 10， and 14 days after treatment， the curative rates in the observation group were 53.33% （32/60）， 85.00% （51/60）， and 91.67% （55/60）， respectively， which were higher than 31.67% （19/60）， 61.67% （37/60）， and 68.33% （41/60） in the control group （χ2=5.763， 8.352， 10.208， P<0.05）. After treatment， the total effective rate of CT scanning in the observation group was 93.33% （56/60）， higher than 80.00% （48/60） in the control group （χ2=4.615， P<0.05）. The conversion rate to severe condition during hospitalization in the observation group was 3.33% （2/60）， lower than 15.00% （9/60） in the control group （χ2=4.904， P<0.05）. The readmission rate within 30 days after discharge in the observation group was 8.33% （5/60）， lower than 23.33% （14/60） in the control group （χ2=5.065， P<0.05）. No serious adverse drug reactions were observed in either group during the treatment period. ConclusionQimai Qinlou prescription can enhance immune function， alleviate inflammatory reactions， significantly relieve clinical symptoms， shorten the duration of the disease， improve the curative rate and CT scanning efficacy， prevent disease progression， reduce the readmission rate in the short term， and is clinically safe for the treatment of elderly patients with non-severe CAP with Qi and Yin deficiency and phlegm-heat obstructing lung syndrome. It is worthy of further research and application.
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Objective:To evaluate the clinical efficacy of Huzhang Polou Decoction combined with acupoint application in the treatment of children with mycoplasma pneumoniae pneumonia (MPP) complicated with atelectasis.Methods:A total of 105 MPP children with atelectasis and phlegm-heat obstructing lung syndrome in our hospital from August 2019 to March 2022, who met the inclusion criteria, were divided into control group (53 cases) and observation group (52 cases), by random number table method. The control group was given azithromycin sequential therapy on the basis of conventional western medicine treatment, and the observation group was given Huzhang Polou Decoction and acupoint application on the basis of the control group. Both groups were treated for 19 days. TCM syndromes were scored before and after treatment. The FEV1 and peak expiratory flow rate (PEF) were measured by pulmonary function measurement instrument. The CRP was measured by immunoturbidimetry and procalcitonin (PCT) was measured by ELISA. The recovery time of fever, disappearance time of cough and sputum, disappearance time of lung rales, lung recruitment time, and adverse reactions during treatment were recorded, and the clinical efficacy was evaluated.Results:The total effective rate was 96.15% (50/52) in the observation group and 84.91% (45/53) in the control group, and the difference between the two groups was statistically significant ( χ2=3.85, P=0.050). After treatment, the TCM syndrome score of the observation group was significantly lower than that of the control group ( t=22.78, P<0.01). FEV1 [(1.87±0.29) L vs. (1.54±0.28) L, t=5.93] and PEF [(79.82±6.29) L/min vs. (74.32±6.30) L/min, t=4.48] were significantly higher than those in the control group ( P<0.01). The levels of serum CRP [(9.18±2.98) mg/L vs. (12.34±3.00) mg/L, t=5.42] and PCT [(0.60±0.15) ng/L vs. (0.96±0.21) ng/L, t=9.93] were significantly lower than those in the control group ( P<0.01). The recovery time of fever, disappearance time of cough and sputum, disappearance time of lung rale and lung recruitment time in the observation group were significantly earlier than those in the control group ( t=7.27, 6.84, 3.76, 5.87, all Ps<0.01). During treatment, the incidence of adverse reactions was 3.77% (2/53) in the control group and 1.92% (1/52) in the observation group, and there was no significant difference between the two groups ( χ2=0.32, P=0.569). Conclusion:The Huzhang Polou Decoction combined with acupoint application can improve the pulmonary function of children with MPP complicated with atelectasis, reduce the level of serum inflammatory cytokines, improve the clinical efficacy safely.
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Objective:To evaluate the efficacy of Qingqi Huatan Decoction combined with conventional western medicine therapy in the treatment of severe pneumonia with phlegm-heat obstructing the lung syndrome.Methods:A total of 84 patients with severe pneumonia with phlegm-heat obstructing lung syndrome admitted to Zhangjiagang Hospital of Traditional Chinese Medicine from February 2018 to June 2020 were randomly divided into two groups, 42 in each group. The control group was treated with bronchoalveolar lavage (BAL) on the basis of routine treatment, and the combined group was treated with Qingqi Huatan Decoction on the basis of the control group. Both groups were treated for 7 days. The Clinical Pulmonary Infection Score (CPIS) was used to evaluate the degree of pulmonary infection, and the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) was used to evaluate the severity of the disease. The Serum CRP and IL-6 levels were detected by ELISA, and procalcitonin (PCT) levels were detected by electrochemiluminescence method to evaluate clinical efficacy.Results:The total effective rate was 88.1% (37/42) in the combined group and 69.0% (29/42) in the control group, with a statistically significant difference between the two groups ( χ2=4.53, P=0.033). After treatment, the CPIS (2.19±0.42 vs. 3.66±0.69, t=11.79) and APACHE Ⅱ (9.84±1.31 vs. 11.25±3.22, t=2.63) in the combination group were significantly lower than those in the control group. The serum CRP, PCT, and IL-6 levels in the combination group were significantly lower than those in the control group ( t=30.32, 8.59, 6.08, all Ps<0.001). During the treatment period, there was no obvious abnormality of liver and kidney function in both groups. Conclusion:Qingqi Huatan Decoction combined with conventional western medicine therapy can reduce the degree of pulmonary infection in patients with severe pneumonia with phlegm-heat obstructing the lung syndrome, reduce the level of inflammatory cytokines, and improve clinical efficacy.
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Objective:To observe the clinical effect of Tanreqing injection combined with western medicine on pneumonia caused by multi-drug resistant bacteria （MDRB） in elderly patients. Method:A total of 140 MDRB-induced pneumonia inpatients with the syndrome of phlegm-heat obstructing lung in the intensive care unit （ICU） of Dalian Hospital of Traditional Chinese Medicine from December 2018 to December 2020 were divided into an observation group （70 cases） and a control group （70 cases）） according to the random number table method. The patients in the control group received conventional treatment by western medicine， and those in the observation group received conventional treatment by western medicine combined with Tanreqing injection. The course of treatment was 7 days. The main efficacy indexes of the two groups before and after treatment were recorded，including the total clinical efficacy of traditional Chinese medicine （TCM） syndrome，total TCM syndrome score，clinical pulmonary infection score （CPIS）， and the clearance rate of MDRB. Secondary efficacy indexes included temperature recovery and cough remission time，procalcitonin （PCT），C-reactive protein （CRP），white blood cell count （WBC），interleukin-6 （IL-6），interleukin-8 （IL-8）， and oxygen partial pressure （PO<sub>2</sub>）. Result:The total effective rates of the observation group and the control group were 90.00% （63/70） and 75.70% （53/70），respectively，and the observation group had superior curative efficacy （<italic>Z</italic>=-2.147，<italic>P</italic><0.05）. After treatment，CPIS and total TCM syndrome scores in both groups decreased compared with those before treatment，and the decrease was more significant in the observation group （<italic>P</italic><0.01）. The clearance rate of MDRB in the observation group was 67.1% （47/70），superior to 48.6% （34/70） in the control group （<italic>χ</italic><sup>2</sup>=4.951，<italic>P</italic><0.05）. The temperature recovery and cough remission time in the observation group was shorter than that in the control group （<italic>P</italic><0.01）. After treatment，the levels of PCT，CRP，WBC，IL-6， and IL-8 in both groups were reduced compared with those before treatment，while the levels of PO<sub>2</sub> increased （<italic>P</italic><0.01）. The improvement of various inflammatory indexes and the PO<sub>2</sub> level in the observation group was better than that in the control group （<italic>P</italic><0.01）. Conclusion:The clinical efficacy of Tanreqing injection combined with western medicine in the treatment of MDRB-induced pneumonia in elderly patients is significant，which can control infection，reduce inflammatory damage，improve the clearance rate of MDRB and PO<sub>2</sub>，and alleviate clinical symptoms. It is worthy of clinical application.
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Objective@#To evaluate effect of Tanreqing injection combined conventional western medicine therapy on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) of Phlegm heat obstructing Lung.@*Methods@#A total of 112 patients with AECOPD were randomly divided into two groups with digital table method from February 2015 to February 2018, 56 cases in each group. The control group was treated byconventional western medicine therapy, and treatment group was treated by Tanreqing injection based on control group. Both groups' treatment lasted for 2 weeks. The modified version of British Medical Reseach Council respiratory questionnaire (mMRC) was used for severity evaluation in breath difficulty. The COPD assessment test (CAT) was used for the assessment of symptoms, activity ability, psychological, social impact and sleep. The FEV1% and FEV1/FVC were recorded. The SaO2, PaO2 and PaCO2 were recorded. The phlegm heat obstructing lung symptom scores were detected. The adverse reactions were recorded.@*Results@#The total effective rate of treatment group was 94.4% (51/54), and the control group was 77.3% (41/53). There was statistically significant difference between two groups (χ2=5.138, P=0.023). After treatment, the mMRC and CAT scores in the treatment group were significantly lower than those in the control group (t value were 17.233, 17.111, respectively, all Ps<0.01); the cough, wheezing, shortness of breath, fever, dry mouth, constipation scores were significantly lower than the control group (t value were 27.717, 29.387, 27.227, 30.268, 28.430, 29.738, respectively, all Ps<0.01). After treatment, the FEV1% (52.34% ± 5.79% vs. 46.98% ± 5.72%, t=4.817), FEV1/FVC (61.36 ± 6.52 vs. 56.93 ± 5.94, t=3.675) in the treatment group were significantly higher than the control group (P<0.01); SaO2 (90.11% ± 9.53% vs. 83.56% ± 8.84%, t=3.684); the PaO2 (91.22 ± 9.79 mmHg vs. 85.18 ± 8.80 mmHg, t=3.354) significantly higher than the control group (P<0.01), and PaCO2 (44.75 ± 4.94 mmHg vs. 51.05 ± 5.46 mmHg, t=6.261) significantly lower than the control group (P<0.01). The incidence of adverse reactions in the treatment group was 11.1% (6/54), and the control group was 7.5% (4/53). There was no statistically significant difference between two groups (χ2=0.091, P=0.763).@*Conclusions@#Tanreiqing injection combined with conventional western medicine therapy can take effectsimprove levels of SaO2 and PaO2, reduce PaCO2 level of the AECOPD patients.
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Objective: To explore the clinical efficacy of modified Qingqi Huatan Wan in treatment of acute exacerbation of chronic obstructive pulmonary disease (syndrome of phlegm-heat obstructing lung) and investigate its effects on serum tumor necrosis factor-alpha (TNF-α),interleukin-8(IL-8) and matrix metalloproteinase-9(MMP-9).Method: Sixty-four patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were randomly divided into control group (32 cases) and treatment group (32 cases) by random number table.The control group was treated with routine western medicine therapy according to the guidance and disease conditions.Based on treatment in control group,patients in treatment group also received modified Qingqi Huatan Wan.The treatment course was 14 days for both groups.The scores of traditional Chinese medicine (TCM) syndrome,chronic obstructive pulmonary disease (COPD) assessment test (CAT),and modified version of the British Medical Research Council's Respiratory Questionnaire (mMRC),pulmonary function,blood gas analysis indicators,levels of serum TNF-α,IL-8 and MMP-9,clinical efficacy and safety were evaluated and compared once before treatment and 14 d after treatment.Result: The total clinical effective rate was 96.67% in treatment group,higher than 76.67% in control group (χ2=5.192,PPP1),percent of FEV1 in predicted value (FEV1%),and ratio of FEV1 to forced vital capacity (FEV1/FVC) were increased in both groups after treatment (PP2) and partial pressure of oxygen (PaO2) were increased in both groups,while partial pressure of carbon dioxide (PaCO2) was decreased (P2 and PaO2 in treatment group were higher than those in control group,while PaCO2 was lower than that in control group (Pα,IL-8 and MMP-9 were decreased in both groups (PPConclusion: Modified Qingqi Huatan Wan can control the symptoms safely and ameliorate pulmonary function,reduce the levels of serum TNF-α,IL-8,MMP-9 and inflammation in treatment of AECOPD.
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Chief physician Wang Fade is involved in the third and fourth batches of instructors to inherit the academic experiences of veteran Chinese medicine in China, and he is good at treating stroke and related diseases. The stroke-associated pneumonia (SAP) refers to the stroke patients originally without pulmonary infection contract the pulmonary parenchymal inflammatory infection, and the stroke patients are in the SAP onset crowd group. There is no name of SAP in traditional Chinese medicine (TCM). Chief physician Wang Fade believes that SAP belongs to the categories of "cough syndrome" or "asthma syndrome" in TCM. From the etiological analysis, SAP is neither due to external cause nor internal cause, but belongs to not internal and external cause. Strictly speaking, SAP is due to an external cause. The pathogenesis of SAP is due to the mistake of inhalation and accumulation, evil toxins directly enter into the lungs, obstructing the lung qi, transforming into heat and production of phlegm, phlegm and heat together forming obstruction of Qi mechanism, inducing loss of lung clearance, leading to the occurrence of cough, asthma, phlegm, fever and other syndromes. Although the location of SAP is mainly in the lungs, the spleen, stomach, liver, kidney, large intestine and other visceral organs can also be involved. According to clinical experiences, SAP can be divided into 3 types of syndrome: phlegm-heat obstructing the lung, phlegm-dampness obstructing the lung and lung-yin deficiency. In the treatment of acute stage, eliminating pathogens is the main method, such as clearing heat, resolving phlegm, eliminating dampness and depressing qi, etc, while in the middle and late stages, eliminating pathogens and strengthening qi are combined. According to which being the priority, the healthy energy or the evil, the following measures can be used: when evil being significant in the disease and the patient's health basically alright, eliminating evil is the main therapy and promoting the healthy energy secondary; when the evil is not very obvious in the disease, and the patient's general condition is relatively weak, consolidating the healthy energy is the main therapy, and eliminating evil secondary.
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Objective To observe the effect of psychological intervention combined with Kechuanning oral liquid in treatment of infant bronchiolitis with phlegm heat obstructing lung type and its influence on inflammatory factor in sputum. Methods 106 infant with bronchiolitis in our hospital from January 2015 to February 2017 were divided into two groups by coin toss, with 53 cases in each group.Two groups were treated with basic treatment and observation group was treated another with psychological intervention. Results The total effective rate of observation group was 96.23%,higher than control group 79.25%(P<0.05).Symptom disappearance time of observation group were shorter than that of control group(P<0.05).Pulmonary function and inflammatory levels of observation group were better than that of control group(P<0.05).There were no obvious adverse reactions in the two groups. Conclusion Psychological intervention can significantly improve effect of infant bronchiolitis with phlegm heat obstructing lung type.
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OBJECTIVE:To observe the clinical efficacy and safety of Qingjin huatan decoction for patients with AECOPD phlegm-heat obstructing lung. METHODS:120 patients with AECOPD phlegm-heat obstructing lung were divided into observation group and control group according to random number table,with 60 cases in each group. Control group received routine therapy as low-flow oxygen therapy,anti-infective,bronchiectasis,expectorant,etc.;observation group additionally received Qingjin huatan decoction(decocted by 400 ml pure water),tid,on the basis of control group. The levels of IL-8,IL-17,IL-23 and TNF-α were observed in 2 groups before and 7 d after treatment. Clinical efficacies and the occurrence of ADR were compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in the levels of IL-8,IL-17,IL-23 and TNF-α between 2 groups (P>0.05). After treatment,the levels of IL-8,IL-17,IL-23 and TNF-α in observation group were significantly decreased and lower than in control group,with statistical significance (P0.05). Excellent rate of observation group was 95.00%,which was significantly higher than 78.95% of control group,with statistical significance(P0.05). CONCLUSIONS:Qingjin huatan decoction shows signifi-cant therapeutic efficacy in the treatment of AECOPD phlegm-heat obstructing lung,and can improve inflammatory factors with good safety.
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Objective To evaluated the effectiveness and safety ofLianhua Jizhi Tablets for acute trachitis and bronchitis with syndrome of phlegm-heat obstructing.Methods A randomized double-blind, placebo-controlled and multi-center clinical trial design was selected. Totally 240 cases were randomly divided into experimental group and control group, 120 cases in each group, of which 237 cases were included in the analysis of FAS. Experimental group was givenLianhua Jizhi Tablets, while control group was given placebo, 12 tablets/day, 7 days for a course. Curative effect of acute trachitis and bronchitis, TCM syndrome and disappearance of cough, cough and sputum symptom scores and area under the curve (AUC) were observed. The safety was evaluated. Results The cure rates of disease in experimental group and control group were 66.67% (78/117) and 29.17% (35/120), respectively;cure rates of TCM syndrome in experimental group and the control group were 68.38% (80/117) and 27.50% (33/120), respectively;there was statistically significant difference in area under the curve of cough and sputum symptom score between the two groups (P<0.01). Disappearance rates (cure) of daytime cough in experimental group and control group were 52.99% (62/117) and 13.33% (16/120), respectively;disappearance rates (cure) of nocturnal cough in experimental group and control group were 76.52% (88/115) and 31.90% (37/116), respectively;there were no side effects in experimental group.ConclusionLianhua Jizhi Tablets can significantly relieve clinic symptoms in the treatment of acute trachitis and bronchitis, and have good clinical efficacy and safety.
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Objective To observe the clinical efficacy of Shiwei Longdanhua Capsule combined with western medicine on patients with mild acute exacerbation of chronic obstructive pulmonary disease (COPD) with phlegm-heat obstructing lung syndrome. Methods Totally 192 cases of COPD with mild acute exacerbation (phlegm-heat obstructing lung syndrome) were recruited. They were randomly divided into the treatment group (96 cases) and the control group (96 cases). Patients in the control group were treated in line with the regular Western treatment, while patients in the treatment group were additionally treated by Shiwei Longdanhua Capsule. After 10-day treatment, the changes of TCM syndrome score, symptom integral and the lung function before and after treatment were compared. Results After treatment, 14 patients withdrew from the treatment group and 15 patients withdrew from the control group. The total efficiency rate of TCM syndrome was 80.49% (66/82) in the treatment group, while it was 56.79% (46/81) in the control group, with statistical difference between the two groups (P<0.05). The severity and frequency of cough and expectoration of the treatment group were better than the control group (P<0.05). The breathing symptom and pulmonary function of patients in the two groups improved, with similar efficacy. Conclusion The efficiency of Shiwei Longdanhua Capsule combined with Western medicine in the treatment of acute exacerbation of COPD is superior to that of simple Western medicine treatment, especially in terms of relieving cough and expectoration.
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Objective To assess the clinical efficacy ofMaxing-Shigan decoction in patients with severe pneumonia due to phlegm-heat obstructing the lung.Methods Sixty patients with severe pneumonia in the TCM Department of Dalian Municipal Central Hospital from January to December 2013 were randomly divided into a control group and a treatment group by random number table method, 30 in each group. The control group was treated with anti-infection, fluid infusion and mechanical ventilation. On the basis of treatment in the control group, the treatment group was also givenMaxing-Shigan decoction through nasogastric gavage. The mean arterial pressure (MAP), lactic acid (Lac) and PaO2/FiO2 were compared before and after the treatment in both groups. The scores of the Clinical Pulmonary Infection Score (CPIS) and the Acute Physiology and Chronic Health Evaluation II (APACHEⅡ) were compared between the two groups.Results The total effective rate in the treatment group was significantly higher than that in the control group (80.0%vs.73.3%;χ2=4.800,P=0.029). In both groups, MAP (treatment group: 102.4 ± 11.9 mmHgvs. 70.4 ± 6.4 mmHg, t=12.972,P=0.000; control group: 101.2 ± 12.5 mmHgvs. 69.8 ± 6.6 mmHg,t=12.1672,P=0.000), PaO2/FiO2 (treatment group: 265.4 ± 19.7 mmHgvs. 78.6 ± 10.5 mmHg,t=45.833,P=0.000; control group: 124.8 ± 13.4 mmHg vs. 79.1 ± 11.1 mmHg;t=14.385,P=0.000) after the treatment were significantly higher than before the treatment, and the Lac level were significantly lower (treatment group: 1.04 ± 0.42 mmol/Lvs. 6.37 ± 2.27 mmol/L,t=12.65, P=0.000; control group: 3.88 ± 1.45 mmol/Lvs. 6.39 ± 2.32 mmol/L,t=5.025,P=0.000). The improvements in Lac (t=10.304,P=0.000) and PaO2/FiO2 (t=32.323,P=0.000) in the treatment group were superior to the control group. The scores of the CPIS (treatment group: 2.2 ± 1.5vs. 6.7 ± 1.7,t=10.872,P=0.000; control group: 4.5 ± 2.7 vs. 6.8 ± 1.8,t=3.882,P=0.000) and APACHEⅡ(treatment group: 5.3 ± 2.1vs. 13.8 ± 3.8,t=10.723,P=0.000; control group: 9.3±3.5vs. 13.7 ± 3.5,t=4.869,P=0.000) after the treatment were significantly lower than before the treatment in both groups, and the changes of CPIS (t=4.079,P=0.000) and APACHEⅡ(t=5.368,P=0.000) in the treatment group were greater than those in the control group.ConclusionsMaxing-Shigan decoction has definite therapeutic effects for severe pneumonia due to phlegm-heat obstructing the lung..