Clinical Efficacy of Qiangli Pipa Syrup in Treating Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Its Influence on Pulmonary Function and Levels of Interleukin 6,C-reactive Protein and Procalcitonin / 广州中医药大学学报

Objective To investigate the clinical efficacy of Qiangli Pipa Syrup for the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to observe its effects on pulmonary function and interleukin 6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)levels in the patients.Methods Eighty patients with AECOPD of phlegm-heat obstructing the lung syndrome were randomly divided into the observation group and the control group,with 40 patients in each group.Patients in the control group were treated with conventional western medicine,and patients in the observation group were treated with Qiangli Pipa Syrup on the basis of treatment for the control group.Both groups were treated for 5 days.The two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores(including cough,expectoration,shortness of breath,and wheezing),pulmonary function parameters[the forced expiratory volume in one second(FEV1)and the ratio of FEV1 to the forced vital capacity(FVC)(FEV1/FVC)],blood gas indicators[arterial partial pressure of oxygen(PaO2),blood oxygen saturation(SaO2)and arterial partial pressure of carbon dioxide(PaCO2)]and the levels of the inflammatory factors of IL-6,CRP,and PCT before and after treatment.Moreover,the clinical efficacy and safety of the patients in the two groups were evaluated.Results(1)After 5 days of treatment,the total effective rate of the observation group was 95.00%(38/40),and that of the control group was 77.50%(31/40).The intergroup comparison(tested by chi-square test)showed that the therapeutic effect of the observation group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the TCM syndrome scores of cough,expectoration,shortness of breath,and wheezing in the two groups were reduced compared with those before treatment(P＜0.05),and the reduction in the observation group was significantly superior to that in the control group(P＜0.05).(3)After treatment,the pulmonary function parameters of FEV1/FVC and FEV1 in the two groups were improved compared with those before treatment(P＜0.05),and the improvement in the observation group was significantly superior to that in the control group(P＜0.05).(4)After treatment,the blood gas indicators of PaO2 and SaO2 levels in the two groups were increased compared with those before treatment(P＜0.05),and the PaCO2 level was decreased compared with that before treatment(P＜0.05).The increase of PaO2 and SaO2 levels and the decrease of PaCO2 level in the observation group were significantly superior to those in the control group(P＜0.05).(5)After treatment,the serum levels of inflammatory factors of IL-6,CRP,and PCT in the two groups were lower than those before treatment(P＜0.05),and the reduction in the observation group was significantly superior to that in the control group(P＜0.05).(6)The incidence of adverse reactions in the observation group was 10.00%(4/40),while that in the control group was 7.50%(3/40).There was no significant difference between the two groups(P＞0.05).Conclusion Qiangli Pipa Syrup exerts certain effect in treating patients with AECOPD of phlegm-heat obstructing the lung syndrome,which can effectively relieve the clinical symptoms,improve the pulmonary function and blood gas indicators,and inhibit inflammatory response of the patients,with high safety profile.

Clinical Observation on Therapeutic Effect of Huatan Jieyu Anshen Decoction Combined with Abdominal Vibration Tuina Manipulations on Chronic Insomnia in the Elderly / 广州中医药大学学报

Objective To investigate the therapeutic effect of Huatan Jieyu Anshen Decoction(mainly with the actions of resolving phlegm,relieving depression and calming mind)combined with abdominal vibration tuina manipulations on chronic insomnia in the elderly.Methods Ninety-four cases of elderly patients with chronic insomnia of phlegm-heat harassing the interior type were randomly divided into the observation group and the control group,with 47 cases in each group.The control group was given Huatan Jieyu Anshen Decoction orally,while the observation group was given oral use of Huatan Jieyu Anshen Decoction combined with abdominal vibration tuina manipulations.The course of treatment for the two groups lasted for 4 weeks.Before and after the treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,Pittsburgh Sleep Quality Index(PSQI)score,Athens Insomnia Scale(AIS)score,Fatigue Scale-14(FS-14)score,World Health Organization Quality-of-Life Brief Scale(WHOQOL-BREF)score,and the serum levels of melatonin(MT),dopamine(DA),and cortisol(CORT).After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 4 weeks of treatment,the total effective rate of the observation group was 97.88%(46/47),while that of the control group was 87.23%(41/47),and the intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the observation group was superior to that of the control group(P＜0.01).(2)After treatment,the scores of primary and secondary TCM symptoms in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease of the scores of primary and secondary TCM symptoms in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the PSQI scores,AIS scores,and FS-14 scores in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the WHOQOL-BREF scores were significantly increased compared with those before treatment(P＜0.05).The decrease of the PSQI scores,AIS scores and FS-14 scores as well as the increase of the WHOQOL-BREF scores in the observation group was significantly superior to that in the control group(P＜0.01).(4)After treatment,the serum MT level of both groups was significantly higher than that before treatment(P＜0.05),and the serum DA and CORT levels were significantly lower than those before treatment(P＜0.05).The increase in serum MT level and the decrease in serum DA and CORT levels of the observation group were significantly superior to those of the control group(P＜0.01).Conclusion The combined therapy of Huatan Jieyu Anshen Decoction combined with vibration tuina manipulations can achieve satisfactory efficacy in the elderly patients with chronic insomnia of phlegm-heat harassing the interior syndrome.The therapy is effective on regulating the central nervous system of the patients,improving the quality of the sleep,and promoting the relief of fatigue and the enhancement of the quality of life,which has great significance to the enhancement of the overall therapeutic efficacy of insomnia.

Therapeutic Efficacy of Wuhu Decoction Plus Tingli Dazao Xiefei Decoction Combined with Budesonide Atomization for Children with Bronchopneumonia and Its Effects on Inflammatory Response / 广州中医药大学学报

Objective To investigate the clinical efficacy of Wuhu Decoction plus Tingli Dazao Xiefei Decoction combined with Budesonide atomization for the treatment of pediatric bronchopneumonia with phlegm-heat obstructing the lung syndrome,and to observe its effect on inflammatory response.Methods Seventy children with bronchopneumonia of phlegm-heat obstructing the lung type were randomly divided into an observation group and a control group,with 35 cases in each group.The children in the control group were treated with atomized inhalation of Budesonide suspension,and the children in the observation group were treated with Wuhu Decoction plus Tingli Dazao Xiefei Decoction orally on the basis of treatment for the control group.Both groups were treated for a period of 7 days.The changes in the traditional Chinese medicine(TCM)syndrome scores and the serum levels of inflammatory factors of interleukin 6(IL-6),procalcitonin(PCT),and hypersensitive C-reactive protein(hs-CRP)in the two groups were observed before and after the treatment.Moreover,the clinical efficacy,time for the relief of symptoms and signs,and the incidence of adverse reactions in the two groups were compared.Results(1)After 7 days of treatment,the total effective rate of the observation group was 91.43%(32/35),and that of the control group was 71.43%(25/35).The intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the observation group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the TCM syndrome scores of the children in both groups were significantly lower than those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the time for the relief of symptoms and signs such as wheezing,cough,lung rales,constipation and fever in the observation group was significantly shortened compared with that in the control group(P＜0.01).(4)After treatment,the serum IL-6,PCT and hs-CRP levels in both groups were significantly lower than those before treatment(P＜0.05),and the reduction in the observation group was significantly superior to that in the control group(P＜0.01).(5)The incidence of adverse reactions in the observation group was 5.71%(2/35)and that in the control group was 8.57%(3/35),while the difference was not statistically significant between the two groups(P＞0.05).Conclusion Wuhu Decoction plus Tingli Dazao Xiefei Decoction combined with Budesonide atomization exert certain effect for the treatment of pediatric bronchopneumonia with phlegm-heat obstructing the lung syndrome,which can effectively relieve the clinical symptoms and alleviate the inflammatory response of the children.

Comprehensive Evaluation of Clinical Evidence and Value of Feilike Mixture in Treatment of Acute Bronchitis with Phlegm-heat Invading Lung / 中国实验方剂学杂志

ObjectiveTo comprehensively evaluate the clinical value of Feilike mixture and provide a basis for the allocation of medical resources， rational drug use， and hospital procurement and supply of Chinese patent medicines. MethodWith the data from available studies and provided by drug manufacturers， the methods of evidence-based medicine， pharmacoeconomics， and health technology assessment were employed to construct a multi-criteria decision-making analysis framework from the "6+1" dimensions of safety， effectiveness， economy， innovation， suitability， accessibility， and characteristics of traditional Chinese medicine （TCM）. The clinical evidence and value evaluation software of Chinese patent medicine， CSCv2.0， was used to comprehensively evaluate the clinical value of Feilike mixture. ResultBased on the existing clinical evidence， the following results were obtained. ① Safety： Multi-sources of evidence showed that Feilike mixture had little known risk and sufficient evidence， with the safety rated as grade A， which indicated good safety. ② Effectiveness： The systematic review and Meta-analysis showed that Feilike mixture combined with conventional Western medicine in the treatment of bronchitis shortened the time to disappearance of cough compared with conventional Western medicine alone， with the evidence rated as grade B by the Grading of Recommendations Assessment， Development， and Evaluations （GRADE） system， which indicated high effectiveness. ③ Economy： From the perspective of health system， Feilike mixture combined with conventional Western medicine was more economical than conventional Western medicine alone， and the quality evaluation of pharmacoeconomics rated the economy as grade B. ④ Innovation： Feilike mixture combined with conventional Western medicine improved the clinical treatment effect and had innovation advantages compared with similar drugs. From the aspects of cultivation， identification of medicinal materials， and production， the sufficient supply and safety of medicinal materials can be ensured for Feilike mixture. This medicine was rated as grade B in terms of the medicinal material quality， preparation technology， and patents， which indicated good innovation. ⑤ Suitability： According to the results of the questionnaire survey， the usage of Feilike mixture was easy to be mastered and accepted by doctors and nurses， without special administration time， complex personalized treatment， and special technical and management requirements. It is convenient for patients to use， with convenient supply and storage， and weak influences of policy， publicity， and drug information. Therefore， the suitability of Feilike mixture was rated as grade B. ⑥ Accessibility： Among the similar Chinese patent medicines， Feilike mixture had a moderate price， high production capacity， wide sales coverage， wide coverage of hospitals， sustainable supply of medicinal materials， and low costs of treatment for acute bronchitis， with the accessibility rated as grade A. ⑦ TCM characteristics： Feilike mixture is composed of Scutellariae Radix， Peucedani Radix， Stemonae Radix， Gentianae Rhodanthae Herba， Scleromitrion diffusum， Firmiana platanifolia Radix， and Aster ageratoides， with reasonable compatibility. This formula is derived from the medical experience of Miao ethnic group， with rich experience in human use and the TCM characteristics rated as grade B. According to the evaluation results in the "6+1" dimensions， Feilike mixture was evaluated as class B， with a high clinical value. ConclusionAccording to the existing clinical evidence， compared with conventional Western medicine alone， Feilike mixture combined with conventional Western medicine demonstrates a high clinical value and prominent TCM characteristics in the treatment of acute bronchitis with phlegm-heat invading lung. It is suggested that it should be translated into the basic clinical drug management policy results according to the conditions.

Evaluation of Clinical Efficacy of Modified Houpo Dahuangtang in Moderate and Severe ARDS Patients Based on Electrical Impedance Tomography / 中国实验方剂学杂志

ObjectiveTo evaluate the clinical efficacy of modified Houpo Dahuangtang in moderate and severe acute respiratory distress syndrome （ARDS） patients with phlegm-heat accumulation，and monitor the pulmonary ventilation changes of patients before and after treatment by electrical impedance tomography（EIT）. MethodThe 62 cases of moderate and severe ARDS patients with phlegm-heat accumulation who required mechanical ventilation in the department of intensive care unit （ICU） in Chongqing Hospital of Traditional Chinese Medicine from September 2021 to June 2022 were selected，and divided into an experimental group（31 cases）and a control group（31 cases）using a random number table. On the basis of regular Western medicine treatment，the experimental group received modified Houpo Dahuangtang and the control group received warm water by a nasogastric tube for seven days. The changes in the clinical efficacy of traditional Chinese medicine（TCM），the oxygenation index［arterial oxygen partial pressure （PaO2）/fractional inspired oxygen（FiO2），P/F］，lactic acid（Lac），acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ） score，compliance，plateau pressure，gas distribution parameters monitored by EIT（Z1，Z2，Z3 and Z4），inflammatory factors［interleukin-6 （IL-6），IL-10， tumor necrosis factor-α （TNF-α） and C-reactive protein （CRP）］ of both groups before and after treatment were recorded. Besides， the mechanical ventilation time， length of stay in ICU， 28-day mortality and incidence of adverse reactions（delirium，abdominal pain and diarrhea）in the two groups were also observed. ResultThere was no significant difference in the baseline indexes of patients in the two groups，and thus the two groups were comparable. After treatment for one week， the total effective rate for TCM syndromes in the experimental group was 90.30%（28/31）， higher than the 67.74%（21/31）in the control group（Z=-2.415，P<0.05）.Compared with the same group before treatment， the plateau pressure and Lac decreased （P<0.01）and the compliance and P/F increased （P<0.01） in experimental group， while the Lac decreased （P<0.05）and the P/F increased （P<0.05）， and the compliance and plateau pressure did not change significantly in the control group. After treatment，the plateau pressure and inflammatory factors in the experimental group were lower than those in the control group（P<0.05）， but the compliance and P/F in the experimental group were higher than those in the control group（P<0.05）， and the gas distribution parameters Z1，Z2，Z3，Z4，Z1+Z2，and Z3+Z4 monitored by EIT in the experimental group were all higher than those in the control group （P<0.05）. There was no significant difference in mechanical ventilation time， ICU hospitalization time， 28-day mortality， delirium， abdominal pain， diarrhea and other adverse reactions between the two groups. ConclusionModified Houpo Dahuangtang can significantly improve the P/F，pulmonary ventilation in gravity-dependent regions and pulmonary compliance，reduce the release of inflammatory factors in moderate and severe ARDS patients. Compared with conventional methods，EIT can timely monitor the pulmonary ventilation changes in ARDS patients，which suggests its clinical feasibility.

Observation of azithromycin sequential therapy combined with pediatric massage on chronic cough after mycoplasma pneumoniae infection in children / 中国药师

Objective To explore the clinical efficacy of azithromycin sequential therapy(AST)combined with infantile massage(IM)in children with chronic cough after mycoplasma pneumoniae infection(CCAMP)phlegm-heat closed lung syndrome(PHCLS),and provide a new scheme for the clinical diagnosis and treatment of CCAMP.Methods The study retrospectively collected children with CCAMP-PHCLS diagnosed in the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from March 2022 to March 2023.According to the treatment regimes,the children were divided into AST group and AST+IM group.The differences in cough symptoms integral and inflammatory factors(IL-6,PCT and CRP)between the two groups of CCAMP-PHCLS children were observed and compared.In addition,the total time to disappearance of clinical symptoms/signs,negative conversion of serum MP antibody(MP-IgM),total treatment response rate and incidence of adverse reactions were compared between the two groups.Results A total of 98 CCAMP-PHCLS children were collected,49 in each group.There were no significant differences between the AST+IM group and AST group in daytime cough symptoms points,nighttime cough symptoms points,serum IL-6 content,serum PCT content,and serum CRP content before treatment(P>0.05).After treatment,the daytime cough symptoms,serum IL-6,serum PCT and serum CRP in both groups significantly decreased compared to before treatment,and the above indicators in the AST+IM group were lower than those in the AST group(P<0.05).In terms of clinical characteristics,CCAMP-PHCLS children lost cough,fever and lung rales in the AST+IM group were shorter than the AST group(P<0.05),and the MP-IgM conversion rate was significantly higher than the AST group(P<0.05).In addition,in terms of clinical efficacy and safety,the total response rate of CCAMP-PHCLS in the AST+IM group was significantly higher than that in the AST group(P<0.05),while the incidence of adverse reactions of CCAMP-PHCLS in the AST+IM group was significantly lower than that in the AST group(P<0.05).Conclusion IM combined with AST has significant efficacy and high safety in children with CCAMP.The potential possible mechanism is that IM mediate production of inflammatory factors,and improves airway inflammation,thus alleviating clinical symptoms and signs.

Clinical Study on Feisu Granules for the Treatment of Acute Exacerbation of COPD with Syndrome of Phlegm-heat and Blood Stasis of Lung / 中国中医药信息杂志

Objective To observe the clinical efficacy of Feisu Granules,and its effects on quality of life,coagulation and immune function in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with syndrome of phlegm-heat and blood stasis of lung.Methods Totally 120 AECOPD patients were divided into observation group and control group according to random number table method,with 60 cases in each group.The control group was given conventional Western medicine treatment,and the observation group received Feisu Granules treatment on the basis of the control group,one bag each time,three times a day,orally.The treatment for both groups lasted for 7 d.The clinical efficacy of both groups were observed.TCM symptom scores,St.George's respiratory questionnaire(SGRQ)score,coagulation function indexes(fibrinogen,D-dimer),and immune function indexes(CD4+,CD8+,CD4+/CD8+)of both groups were compared.The side effects were observed.Results The total effective rate in the observation group(93.10%)was significantly higher than that of the control group(79.66%),with statistical significance(P<0.05).Compared with before treatment,TCM symptom scores,scores of cough,wheezing,venous congestion,and SGRQ score decreased in both groups after treatment(P<0.05);after treatment,the observation group had lower above scores than the control group(P<0.05).Compared with before treatment,both groups showed a decrease in plasma fibrinogen and D-dimer levels after treatment(P<0.05);after treatment,the observation group showed lower levels of plasma fibrinogen and D-dimer compared with the control group(P<0.05).Compared with before treatment,the peripheral blood CD4+ and CD4+/CD8+ levels in both groups significantly increased after treatment,while CD8+ levels significantly decreased(P<0.05);after treatment,the peripheral blood CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group,while CD8+ was lower than those in the control group(P<0.05).Neither group had any drug-related side effects.Conclusion On the basis of conventional Western medicine,the combination of Feisu Granules in the treatment of AECOPD with syndrome of phlegm-heat and blood stasis of lung can significantly improve clinical efficacy,improve patient quality of life,facilitate coagulation function recovery,and enhance cellular immune function.

Clinical Efficacy of Qimai Qinlou Prescription in Treating Elderly Community-acquired Pneumonia （Non-severe） with Qi and Yin Deficiency and Phlegm-heat Obstructing Lung Syndrome / 中国实验方剂学杂志

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.

Effect of Synergistic Treatment with Qingjin Huazhuo Formula （清金化浊方） on Thrombotic Events in Hospitalized Patients of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Phlegm Heat Stasis Obstructing in the Lung Syndrome： A Retrospective Cohort Study / 中医杂志

ObjectiveTo analyze the effect and possible mechanism of the synergistic treatment with Qingjin Huazhuo Formula （清金化浊方， QHF） on the occurrence of thrombotic events in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） and phlegm heat stasis obstructing in the lung syndrome. MethodsIn a retrospective cohort study， 305 AECOPD inpatients with the syndrome of phlegm heat stasis obstructing in the lung were included. According to whether using QHF （the course of treatment ≥ 7 days）， they were divided into the exposure group （193 cases） and the non-exposure group （112 cases）. Totally， 109 pairs of cases were obtained by 1∶1 propensity score matching （PSM）. After matching， the occurrence of thrombotic events during hospitalization， the remission of main symptoms or signs （including cough， expectoration， wheezing， cyanosis） after 10 days （±3 days） of treatment， and the difference of the indicators including D-dimer， percentage of neutrophils （NEUT%）， C-reactive protein （CRP）， arterial partial pressure of oxygen （PaO2）， and arterial partial pressure of carbon dioxide （PaCO2） before treatment and after 10 days （±3 days） of treatment during the first auxiliary examination. ResultsAfter matching， the incidence of thrombotic events during hospitalization in the exposure group （5 cases， 4.59%） were lower than that of the non-exposure group （15 cases， 13.76%， P＜0.05）. The exposure factor that taking QHF for 7 days or above was a protective factor for thrombotic events in AECOPD hospitalized patients with phlegm heat stasis obstructing in the lung syndrome （RR = 0.333， 95% CI 0.126 to 0.885）. The remission rates of cough （100/109， 91.74%）， expectoration （103/109， 94.50%）， wheezing （102/109， 93.58%）， and cyanosis （97/109， 88.99%） in the exposure group were significantly higher than those in the non-exposure group （90/109， 82.57%； 94/109， 86.24%； 89/109， 81.65%； 86/109， 78.90%） after treatment （P＜0.05）. After treatment， the levels of D-dimer， NEUT%， CRP and PaCO2 in both groups significantly decreased （all P＜0.05）， and the level of PaO2 significantly increased （P＜0.05）. The difference of the levels of D-dimer， NEUT% and PaO2 in the exposure group before and after treatment were larger than those in the non-exposure group （P＜0.05）， while the pre-post difference of CRP and PaCO2 were not significantly different between the two groups （P＞0.05）. ConclusionThe synergistic treatment with QHF can effectively reduce the occurrence of thrombotic events， alleviate the clinical symptoms or signs such as cough， expectoration， wheezing， and cyanosis， and can improve lung function in hospita-lized patients with AECOPD and phlegm heat stasis obstructing in the lung syndrome. Its mechanism may be related to improving blood coagulation and inflammatory status.

Effect of Qingjin Huazhuo Decoction combined with conventional therapy on blood hypercoagulability in patients with acute exacerbation of chronic obstructive pulmonary disease with phlegm-heat stasis and lung syndrome / 国际中医中药杂志

Objective:To investigate the effect of Qingjin Huazhuo Decoction combined with conventional western medicine on blood hypercoagulability in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) of phlegm-heat stasis lung syndrome.Methods:Randomized controlled trial. According to random number table method, allocation of cases in the observation and control groups. From April 2021 to March 2022, 66 hospitalized patients with AECOPD of phlegm-heat stasis and lung syndrome were randomly divided into control group ( n=32) and study group ( n=34). The control group was treated with conventional western medicine. The study group was treated with Qingjin Huazhuo Decoction on the basis of the control group. Both groups were treated for 7 days. Plasma thrombomodulin (TM), thrombin-antithrombin complex (TAT), tissue plasminogen activator-plasminogen activator inhibitor-1 complex (t-PAIC), plasmin-antiplasmin complex (PIC), prothrombin time (PT), partial thromboplastin time (APTT) and D-dimer levels were measured by automatic immunoassay analyzer; serum TNF-α levels were measured by ELISA and CRP levels were measured by immunoturbidimetry. Adverse reactions and acute thrombotic events during treatment were recorded. Results:During the treatment period, 4 of 66 patients had hemolysis, 2 were mistakenly included in the withdrawal study, 28 in the final control group and 32 in the study group were included for the analyses. After treatment, plasma t-PAIC [(6.19±1.93) μg/L vs. (7.42±2.71) μg/L, t=2.04] level in study group was significantly lower than that of the control group ( P<0.05), and the serum TNF-α [(71.15±25.25) ng/L vs. (122.60±98.76) ng/L, t=2.42] level was significantly lower than that of the control group ( P<0.05), plasma PT [(11.98±0.74) s vs. (11.55±0.77) s, t=-2.19] was significantly longer than that of the control group ( P<0.05). No thrombotic events occurred during hospitalization in the study group, and 1 case of acute myocardial infarction occurred in the control group. Conclusion:Qingjin Huazhuo Decoction combined with conventional western medicine therapy can improve the blood hypercoagulability of AECOPD patients with phlegm-heat stasis lung syndrome.

Effect of Modified Gualou Zhishitang Combined with Piperacillin Sodium and Tazobactam Sodium on Immune Function and Serum Levels of Inflammatory Cytokines in Patients with Stroke-associated Pneumonia with Syndrome of Phlegm-heat Accumulation in Lung / 中国实验方剂学杂志

ObjectiveTo explore the effects of modified Gualou Zhishitang combined with piperacillin sodium and tazobactam sodium on the immune function and serum levels of inflammatory cytokines in the patients with stroke-associated pneumonia （SAP， syndrome of phlegm-heat accumulation in lung）. MethodEighty SAP patients with the syndrome of phlegm-heat accumulation in lung were randomized into a control group （40 cases） and a study group （40 cases）. The SAP patients in the control group were treated with piperacillin sodium and tazobtam sodium， while those in the study group were treated with modified Gualou Zhishitang on the basis of the treatment in the control group for 2 consecutive weeks. The clinical therapeutic effects， immune function indexes， inflammation indexes， and lung function of SAP patients in the two groups before and after treatment were determined and compared. ResultAfter treatment， the scores of lesion， pulmonary rales， cough， fever， phlegm color， and constipation in both groups decreased （P<0.05）. After treatment， the ratio of forced expiratory volume in the first second to forced expiratory volume （FEV1/FVC） and forced expiratory volume in the first second as percentage of predicted value（FEV1%） in both groups improved （P<0.05）， and the study group outperformed the control group （P<0.05）. The treatment decreased the neutrophil to lymphocyte ratio （NLR） in the two groups （P<0.05）， and the study group had lower NLR than the control group after treatment （P<0.05）. The serum levels of procalcitonin （PCT） and hypersensitive C-reactive protein （hs-CRP） in both groups declined after treatment （P<0.05）， and the declines were more significant in the study group than in the control group （P<0.05）. After treatment， the study group was better than the control group （P<0.05）. The treatment in both groups elevated the levels of CD3+， CD4+， and CD4+/CD8+ in the peripheral blood and lowered the level of CD8+ （P<0.05）， and the changes were more significant in the study group than in the control group （P<0.05）. The total response rate of the study group was 95.00% （38/40）， which was higher than that （80.00%， 32/40） of the control group （χ2=4.114，P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups. ConclusionModified Gualhou Zhishitang combined with piperacillin sodium and tazobactam sodium demonstrates a significant therapeutic effect on the SAP patients with the syndrome of phlegm-heat accumulation in lung. This therapy can mitigate the clinical symptoms， improve the lung function， lower the serum levels of inflammatory cytokines， and improve the immune capacity， with high safety.

Efficacy of Qingqi Huatan Decoction combined with western medicine in the treatment of severe pneumonia and its influence on the level of inflammatory factors / 国际中医中药杂志

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.

Clinical study on Xiefei Tongfu Decoction combined with conventional western medicine therapy for the patients with pulmonary pseudomonas aeruginosa infection after brain trauma and syndrome of phlegm-heat and bowel-repletion / 国际中医中药杂志

Objective:To analyze the effects of Xiefei Tongfu Decoction on syndrome of phlegm-heat and bowel-repletion in patients with pulmonary pseudomonas aeruginosa infection after brain trauma.Methods:A total of 90 patients with pulmonary pseudomonas aeruginosa infection after traumatic brain injury received treatment in our hospital from August 2018 to May 2021 were selected and randomly divided into control group ( n=45) and study group ( n=45) by the random digital table method. The control group was treated with conventional western medicine, and the study group was treated with Xiefei Tongfu decoction and conventional western medicine. The TCM syndrome scores, inflammatory factor levels, like C-reactive protein (CRP), interleukin-6 (IL-6), white blood cell count (WBC), and lung function indexes, like forced vital capacity (FVC), forced expiratory volume rate in the first second (FEV1), expiratory volume percentage in forced vital capacity (FEV1/FVC) were compared between the two groups before and after treatment. The clinical effect and adverse events of the two groups were compared. Results:The total effective rate was 91.11% (41/45) in the study group and 73.33% (33/45) in the control group, with a statistically significant difference between the two groups ( χ2=4.97, P=0.027). After treatment, the scores of dizziness, headache, forgetfulness, insomnia and total scores in the study group were significantly lower than those in the control group ( t values were 9.65, 9.81, 8.62, 9.11, 9.34, all Ps<0.01). After treatment, CRP [(95.66±11.67) mg/L vs. (107.82±12.99) mg/L, t=4.67], IL-6 [(25.16±6.46) ng/L vs. (33.45±7.33) ng/L, t=5.69], WBC [(9.35±2.02)×10 9/L vs. (13.12±2.18)×10 9/L, t=8.51] in the control group were significantly lower than those in the control group ( P<0.01). After treatment, the FEV1 [(2.34±0.31) L vs. (1.92±0.33) L, t=6.22], FVC [(3.45±0.46) L vs. (2.96±0.37) L, t=5.57], FEV1/FVC [(68.82±8.64)% vs. (64.86±9.56)%, t=2.18] in the control group significantly higher than those in the control group ( P<0.01 or P<0.05), and no serious adverse events occurred in any groups, and there was no significant difference between the two groups ( χ2=1.39, P=0.238). Conclusion:The Xiefei Tongfu Decoction has a significant effect on patients with pulmonary pseudomonas aeruginosa infection after brain trauma, which can improve symptoms, relieve inflammatory response and enhance lung function with safety.

Clinical study of Huzhang Polou Decoction combined with acupoint application for the children with mycoplasma pneumonia complicated with atelectasis and phlegm-heat obstruction / 国际中医中药杂志

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.

Clinical Efficacy and Mechanism of Quyu Qingjintang on Stroke Complicated with Lung Infection with Phlegm-heat Accumulation Lung Syndrome and Blood Stasis Syndrome / 中国实验方剂学杂志

Objective:To explore the clinical efficacy and mechanism of Quyu Qingjintang in the treatment of stroke complicated with lung infection （SCLI） with phlegm-heat accumulation lung syndrome and blood stasis syndrome. Method:The 60 patients with SCLI with phlegm-heat accumulation lung syndrome and blood stasis syndrome were selected and divided into control group （30 cases） and observation group （30 cases）. The patients in both groups received basic treatments such as thrombolysis and anticoagulation， and were injected with imipenem cilastatin sodium and ambroxol hydrochloride. The patients in control group additionally received Tanreqing capsule on the basis of the conventional treatment while those in observation group were additionally treated with Quyu Qingjintang on the basis of the conventional treatment. The clinical efficacy， lung function， inflammatory factor levels， time to symptoms disappearance， haptoglobin （HPT） and amyloid A （SAA） levels， T lymphocyte subset level and safety index were compared between two groups. Result:The total effective rate was 93.33% （28/30） in observation group， significantly higher than 70.00% （21/30） in control group （<italic>χ²=</italic>5.450， <italic>P</italic><0.05）. After treatment， the symptoms of both groups were improved （<italic>P</italic><0.05）. The scores of fever， cough， wheezing， and expectoration in observation group were lower than those in control group （<italic>P</italic><0.05）. The levels of interleukin-6（IL-6）， white blood cell（WBC）， procalcitonin（PCT）， C-reactive protein（CRP）， HPT， and SAA in observation group were significantly lower than those in control group （<italic>P</italic><0.05）. The forced expiratory volume in one second （FEV₁）， forced vital capacity （FVC） and peak expiratory flow rate （PEF） in observation group were better than those in control group （<italic>P</italic><0.05）. The levels of CD3⁺， CD4⁺， CD4⁺/CD8⁺ in observation group were significantly higher than those in control group （<italic>P</italic><0.05）. The recovery time of WBC count， hospitalization time， lung rales， the time to fever and cough disappearance in observation group were lower than those in control group （<italic>P</italic><0.05）， no serious adverse reactions occurred in two groups. Conclusion:Quyu Qingjintang in the treatment of stroke complicated with lung infection with phlegm-heat accumulation lung syndrome and blood stasis syndrome can significantly improve the treatment efficiency， improve the symptoms of pulmonary infection， reduce the level of inflammatory factors， and improve lung function， with less adverse reactions and high safety， so it is worthy of clinical application.

Clinical Efficacy of Tanreqing Injection Combined with Western Medicine in Treatment of Pneumonia Caused by Multi-drug Resistant Bacteria in Elderly Patients / 中国实验方剂学杂志

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 （PO₂）. 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>²=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 PO₂ increased （<italic>P</italic><0.01）. The improvement of various inflammatory indexes and the PO₂ 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 PO₂，and alleviate clinical symptoms. It is worthy of clinical application.

Effect of Yuebi Jia Banxiatang on Inflammatory Markers and Prognosis of Patients with Community Acquired Pneumonia in Old People / 中国实验方剂学杂志

Objective:To observe the efficacy of Yuebi Jia Banxiatang on old patients with community acquired pneumonia （CAP） combined with syndrome of phlegm heat damming lung， and observe effect on inflammatory markers and prognosis. Method:A total of 120 patients with CAP were randomly divided into control group （60 cases） and observation group （60 cases） by random number table. In control group， 55 patients finished the therapy （3 patients fell off or were lost to follow-up， 2 were eliminated）， 55 patients in observation group completed the therapy （5 patients fell off or were lost to follow-up）. Both groups' patients got anti-infection and other comprehensive therapies. Patients in control group got Feilike mixture， 20 mL/time， 3 times/day. Patients in observation group obtained Yuebi Jia Banxiatang， 1 dose/day. The course of treatment for the two groups continued for 10 days. Antipyretic time and antipyretic rate at the 5th day after treatment， relief time of cough， expectoration and lung rale were recorded. And clinical pulmonary infection score （CPSI）， time （CPSI<6） and time to stop antibiotics were recorded. Before and after treatment， syndrome of phlegm heat damming lung was scored， and failure of initial treatment was also recorded. Levels of procalcitonin （PCT）， red blood cell volume distribution wid （RDW）， D-dimer （D-D） and synpeptin， high sensitivity C-reactive protein （hs-CRP）， tumor necrosis factor-α （TNF-α）， interleukin （IL-1β） and IL-6 were measured. Recurrence rate of chest radiograph was recorded， and safety was evaluated. Result:Relief time of antipyretic， cough， expectoration and lung rale in observation group were less than those in control group （P<0.01）. Antipyretic rate at the 5th day after treatment， antibiotic discontinuation rate， recurrence rate of chest radiograph were 85.45% （47/55）， 94.55% （52/55） and 90.91% （50/55）， which were higher than 65.45% （36/55）， 81.82% （45/55） and 74.55% （45/55） in control group. And initial treatment failure rate was 5.54% （3/55）， which was lower than 20.00% （11/55） in control group （P<0.05）. Scores of CPSI and syndrome of phlegm heat damming lung were less than those in control group （P<0.01）. And levels of PCT， RDW， D-D， peptide， hs-CRP， TNF-α， IL-1β and IL-6 were all below the level in control group （P<0.01）. Total effective rate of traditional Chinese medicine （TCM） syndrome was 96.36% （53/55）， which was higher than 83.64% （46/55） in control group （χ2=4.949， P<0.05）. And there was no adverse reactions relating to traditional Chinese medicine. Conclusion:In addition to anti-infection and other comprehensive therapies， Yuebi Jia Banxiatang can control the clinical symptoms， reduce the degree of pulmonary infection and disease， control the inflammatory reaction， shorten the course of disease and improve the prognosis， with a significant effect and safety in clinical use.

Clinical Effect of Addition and Subtraction Therapy of Wuhutang Combined with Qingjin Jianghuotang to Community Acquired Pneumonia in Children with Syndrome of Phlegm Heat Closing Lung / 中国实验方剂学杂志

Objective:To discuss clinical effect of addition and subtraction therapy of Wuhutang combined with Qingjin Jianghuotang to community acquired pneumonia (CAP) in children with syndrome of phlegm heat closing lung, and to study the influence to inflammatory factors. Method:One hundred and forty patients were randomly divided into control group (69 cases) and observation group (71 cases) by random number table. Patients in two group of chidren got comprehensive symptomatic treatment measures of anti-infection, antipyretic, expectorant, antiasthmatic and respiratory support of inflammatory factors. The control group was treated with Lingyang Qingfei granules.1 g/time,3 time/day. Patients in observation group added addition and subtraction therapy of Wuhutang combined with Qingjin Jianghuotang, 1 dose/day. The courses of treatment in two groups were 7 days. And temperature, time of antipyretic, time of complete antipyretic and rate of complete antipyretic at the 7th day after treatment were recorded. And release time and disappearance time of cough, expectoration, disappearance time of pulmonary rales and treatment failure were also recorded. And before and after treatment, scores of syndrome of phlegm heat closing lung were graded, and levels of serum high sensitive C-reactive protein (hs-CRP), procalcitonin (PCT), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected. Result:Analyzed by rank sum test, effect in observation group was better than that in control group (Z=2.106, P<0.05), and curative effect of traditional Chinese medicine (TCM) syndrome was also better than that in control group (Z=2.119, P<0.05). Time of antipyretic, time of complete antipyretic, release time and disappearance time of cough and expectoration and disappearance time of pulmonary rales were all shorter than those in control group (P<0.01). Rate of complete antipyretic at the 7th day after treatment in observation group was 96.92%（63/65） higher than 82.81%（53/64） in control group (χ2=7.085, P<0.05). Failure rate of treatment was 9.23%（6/65） lower than 23.44%（15/64） in control group (χ2=4.775, P<0.05). And major symptom, physical sign score, minor symptom score, the total score of syndrome of phlegm heat closing lung and levels of hs-CRP, PCT, TNF-α and IL-6 were all lower than those in control group (P<0.01). Conclusion:On the basis of comprehensive anti-infection treatment, addition and subtraction therapy of Wuhutang combined with Qingjin Jianghuotang can control the clinical symptoms, and the advantages of rapid onset, rapid symptom regression, short course of disease can be found, and it can also reduce the inflammatory reaction, control the progress of the disease. The complete antipyretic rate, disease efficacy and TCM syndrome efficacy are better.

The clinical research on the efficacy of Tanreiqing injection combined with routine western medicine in treating chronic obstructive pulmonary disease at acute and aggravating period with syndrome of phlegm-heat obstructing lung / 国际中医中药杂志

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.

Clinical Efficacy of Modified Qingjin Huatan Tang on Bronchiectasis with Syndrome of Phlegm-heat Accumulating Lung at Acute Exacerbation / 中国实验方剂学杂志

<b>Objective::To observe the clinical efficacy of modified Qingjin Huatan Tang on bronchiectasis with syndrome of phlegm-heat accumulating lung at acute exacerbation and its inhibitory effect on pro-inflammatory factors and proteolytic activity. <b>Method::One hundred and thirty patients were randomly divided into control group and observation group by random number table. Patients in control group got tazobactam sodium and piperacillin sodium for injection, 3.375 g/time, 1 time/6 hours, and the types of antibiotics were regulated according to the bacterial culture results. And patients in control group also got Ambroxol Hydrochloride injection, 30 mg/time, 2 time/days, and postural drainage. In addition to the therapy of control group, patients in observation group were also given modified Qingjin Huatan Tang, 1 dose/day. Before and after treatment, symptoms and signs were scored. And levels of white blood cell count (WBC), neutrophile granulocyte (GRAN), C-reactive protein (CRP), procalcitonin (PCT) were detected. And scores of forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), peak expiratory flow rate (PEFR) and BODE were graded. And levels of tumor necrosis factor-<italic>α</italic> (TNF-<italic>α</italic>), interleukin-4 (IL-4), IL-6 and IL-8 in sputum, peripheral neutrophil elastase (NE) and cathepsin G were detected. <b>Result::By rank sum test, the clinical efficacy in observation group was better than that in control group (Z=2.086, <italic>P</italic><0.05), while scores of symptoms and signs in observation group were lower than those in control group (<italic>P</italic><0.01). WBC, GRAN, CRP, PCT, airflow limitation (O), dyspnea (D), motor ability (E) score, BODE index, TNF-<italic>α</italic>, IL-4, IL-6, IL-8, plasma NE and cathepsin G were all lower than those in control group (<italic>P</italic><0.01). And levels of FEV₁, FVC, PEF and FEV₁/FVC were higher than those in control group (<italic>P</italic><0.01). <b>Conclusion::In addition to routine anti-infection and expectoration western medicine therapy, modified Qingjin Huatan Tang can be added to control symptoms and signs, alleviate the degree of illness, improve pulmonary function and the quality of life of patients, and inhibit expression of airway pro-inflammatory factor and proteolysis, with a better clinical efficacy than pure western medicine.