目的 探讨清咳平喘颗粒治疗慢性阻塞性肺疾病急性加重期（AECOPD）痰热壅肺证的临床有效性。方法 选取2022年3月—2023年4月莱西市人民医院和青岛市立医院收治的痰热壅肺型AECOPD患者100例，随机分为对照组（50例）和治疗组（50例）。对照组患者给予常规护理、氧疗支持、止咳平喘、祛痰及抗感染治疗在内的综合治疗。治疗组在对照组治疗的基础上口服清咳平喘颗粒，1袋/次，3次/d。两组患者治疗14 d。观察两组患者临床疗效，比较治疗前后两组患者中医证候积分、mMRC评分和CAT问卷评分，及第1秒用力呼气容积（FEV1）占预计值百分比（FEV1%）、FEV1/用力肺活量（FVC）、6 min步行距离（6MWT）、白细胞（WBC）和C反应蛋白（CRP）水平。结果 治疗后，治疗组总有效率（98.00%）显著高于对照组（86.00%，P＜0.05）。治疗后，两组患者WBC、CRP水平显著低于治疗前（P＜0.05），且治疗组炎症指标下降更明显（P＜0.05）。治疗后，两组患者FEV1%、FEV1/FVC和6MWT较治疗前均明显增加（P＜0.05），且治疗组的肺功能、6MWT显著优于对照组（P＜0.05）。治疗第7、14天后，两组患者中医证候积分，mMRC和CAT问卷评分均显著降低（P＜0.05），且治疗组患者在第7、14天的中医证候积分、mMRC和CAT问卷评分均显著低于对照组（P＜0.05）。结论 清咳平喘颗粒治疗AECOPD痰热肺证能够显著提高临床疗效，有效缓解咳嗽、咳痰、胸闷及气短等典型症状，促进患者肺功能的恢复，提高其运动耐量，并显著降低体内炎症指标水平。

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

青岛大学医疗集团科研项目（2022-KY-53）