目的 探讨清咳平喘颗粒联合西医常规方案治疗支气管扩张症的疗效及对患者出院后再次急性加重的影响。方法 选取2021年2月—2023年6月在上海中医药大学附属龙华医院肺病科出院的122例支气管扩张症患者进行回顾性分析，按治疗方案不同将其分为治疗组61例和对照组61例。对照组出院后仅接受西医常规治疗方案，疗程为1周；治疗组在对照组基础上联合清咳平喘颗粒治疗，疗程为8周。以患者出院为起点随访24周，对比两组出院后24周内出现的急性加重比例，基线（出院第1天）及入组24周后圣乔治呼吸问卷（St. George’s respiratory questionnaire，SGRQ）评分、肺功能指标并记录不良事件。结果 治疗组总有效率为65.6%，对照组总有效率为44.3%，差异具有统计学意义（P＜0.05）。出院后24周内，治疗组的急性加重比例明显低于对照组（19.7% vs 36.1%，P＜0.05）；与对照组相比，治疗组再次出现急性加重的时间［（137.23±57.14）d vs（157.18±44.07）d］延长（P＜0.05）。入组24周后，两组SGRQ评分（症状、活动、心理评分和总分）均较基线显著降低（P＜0.05）；治疗组SGRQ活动评分改善值显著高于对照组（P＜0.05）；两组肺功能指标［第1秒用力呼气容积（Forced expiratory volume for 1 second，FEV1）、用力肺活量（forced vital capacity，FVC）、FEV1/FVC］均较基线升高，但差异无统计学意义（P＞0.05），治疗组肺功能指标改善值与对照组比较差异无统计学意义（P＞0.05）。两组总不良反应发生率差异无统计学意义（P＞0.05）。结论 清咳平喘颗粒联合西医常规方案能够有效降低支气管扩张症患者出院后24周内再次急性加重风险，助力改善慢性呼吸道症状及活动能力，且具有较好的安全性。

Objective To investigate the curative effect of Qingke Pingchuan Granule combined with conventional Western medicine in the treatment of bronchiectasis and its effect on the acute exacerbation of bronchiectasis patients after discharge. Methods A retrospective analysis was performed on 122 patients with bronchiectasis discharged from the pulmonary Department of Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from February 2021 to June 2023, and they were divided into treatment group (n = 61) and control group (n = 61) according to different treatment regiments. The control group only received conventional Western medicine treatment after discharge, the course of treatment was one week; and the treatment group combined with Qingke Pingchuan granules on the basis of the control group. The course of treatment of Qingke Pingchuan granules was eight weeks. The patients were followed up for 24 weeks after discharge. The proportion of acute exacerbations within 24 weeks after discharge, St. George's Respiratory Questionnaire (SGRQ) scores and pulmonary function indicators at baseline and 24 weeks after enrollment were compared between the two groups, and adverse events were recorded. Results The total effective rate of the treatment group was 65.6%, and that of the control group was 44.3%. The difference was statistically significant (P < 0.05). Within 24 weeks after discharge, the rate of acute exacerbations in the treatment group was lower than that in the control group (19.7% vs 36.1%, P < 0.05). Compared with the control group, the time of recurrence of acute exacerbations in the treatment group was longer [(157.18 ±44.07) d vs (137.23 ±57.14) d, P < 0.05]. At the 24 weeks after enrollment, SGRQ scores (symptoms, activities, psychological scores and total scores) in both groups were lower than those at baseline (P < 0.05). The improvement value of SGRQ activity score in the treatment group was higher than that in control group (P < 0.05). At the 24 weeks after enrollment, the pulmonary function indexes (FEV1, FVC, FEV1/FVC) of the two groups were higher than those at baseline, and the difference was no significant difference (P > 0.05). There was no significant difference in the improvement value of lung function between the treatment group and the control group (P > 0.05). There was no significant difference in the incidence of total adverse reactions between the two groups (P > 0.05). Conclusion Qingke Pingchuan Granule combined with conventional Western medicine regimen can effectively reduce the risk of re-acute exacerbation in patients with bronchiectasis within 24 weeks after discharge, help improve chronic respiratory symptoms and mobility, and has a good safety.

R285.64

上海市公共卫生重点学科项目（GWVI-11.1-08）；上海市卫健委中医药科研项目（20234Y0109）；上海市申康中心项目（SHDC12023106）；上海市科技计划项目（22Y11920400）；上海市徐汇区院地合作项目（23XHYD-25）