目的 探討清咳平喘顆粒治療慢性阻塞性肺疾病急性加重期（AECOPD）痰熱壅肺證的臨床有效性。方法 選取2022年3月—2023年4月萊西市人民醫(yī)院和青島市立醫(yī)院收治的痰熱壅肺型AECOPD患者100例，隨機分為對照組（50例）和治療組（50例）。對照組患者給予常規(guī)護理、氧療支持、止咳平喘、祛痰及抗感染治療在內的綜合治療。治療組在對照組治療的基礎上口服清咳平喘顆粒，1袋/次，3次/d。兩組患者治療14 d。觀察兩組患者臨床療效，比較治療前后兩組患者中醫(yī)證候積分、mMRC評分和CAT問卷評分，及第1秒用力呼氣容積（FEV1）占預計值百分比（FEV1%）、FEV1/用力肺活量（FVC）、6 min步行距離（6MWT）、白細胞（WBC）和C反應蛋白（CRP）水平。結果 治療后，治療組總有效率（98.00%）顯著高于對照組（86.00%，P＜0.05）。治療后，兩組患者WBC、CRP水平顯著低于治療前（P＜0.05），且治療組炎癥指標下降更明顯（P＜0.05）。治療后，兩組患者FEV1%、FEV1/FVC和6MWT較治療前均明顯增加（P＜0.05），且治療組的肺功能、6MWT顯著優(yōu)于對照組（P＜0.05）。治療第7、14天后，兩組患者中醫(yī)證候積分，mMRC和CAT問卷評分均顯著降低（P＜0.05），且治療組患者在第7、14天的中醫(yī)證候積分、mMRC和CAT問卷評分均顯著低于對照組（P＜0.05）。結論 清咳平喘顆粒治療AECOPD痰熱肺證能夠顯著提高臨床療效，有效緩解咳嗽、咳痰、胸悶及氣短等典型癥狀，促進患者肺功能的恢復，提高其運動耐量，并顯著降低體內炎癥指標水平。

Objective To evaluate the effectiveness of Qingke Pingchuan Granules in treatment of phlegm-heat obstructing lung syndrome of acute exacerbation of chronic obstructive pulmonary disease.Methods Patients (100 cases) with phlegm-heat obstructing lung syndrome of acute exacerbation of chronic obstructive pulmonary disease in Laixi People’s Hospital and Qingdao Municipal Hospital from March 2022 to April 2023 were randomly divided into control (50 cases) and treatment (50 cases) group. Patients in the control group were administered with comprehensive treatment including routine care, oxygen therapy support, cough and asthma, and expectorant treatment. Patients in the treatment group were po administered with Qingke Pingchuan Granules, 1 bag/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluations were evaluated, the TCM syndrome scores, mMRC and CAT questionnaire scores, the levels of FEV1%, FEV1/FVC, 6MWT, WBC and CRP in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group (98.00%) was significantly higher than that in the control group (86.00%, P < 0.05). After treatment, the levels of WBC and CRP in two groups were significantly lower than that of before treatment (P < 0.05), and the decrease in inflammatory indicators in the treatment group was more significant (P < 0.05). After treatment, FEV1%, FEV1/FVC and 6MWT in two groups were significantly increased compared with before treatment (P < 0.05), and the lung function and 6-minute walking distance in the treatment group were significantly better than those in the control group (P < 0.05). After the 7th and 14th days of treatment, the TCM syndrome scores, mMRC and CAT questionnaire scores in two groups were significantly reduced (P < 0.05), and the TCM syndrome scores, mMRC and CAT questionnaire scores of patients in the treatment group on the 7th and 14th days were significantly lower than those in the control group (P < 0.05). Conclusion Qingke Pingchuan Granules can significantly improve clinical efficacy in the treatment of AECOPD (phlegm heat lung syndrome), demonstrating significant relief effects on typical symptoms such as cough, sputum production, chest tightness, and shortness of breath. It effectively promotes the recovery of lung functions, enhances their exercise tolerance, and significantly reduces the level of inflammatory markers.

R974

青島大學醫(yī)療集團科研項目（2022-KY-53）