世界中医药

目的：探讨左氧氟沙星联合加味千金苇茎汤治疗急性发作期慢性支气管炎的临床效果。方法：选取2015年1月至2016年10月达州市中西医结合医院呼吸内科门诊收治的慢性支气管炎急性发作期患者60例，采取单盲随机分组法随机分为对照组、观察组，各30例，对照组采用左氧氟沙星治疗，观察组在左氧氟沙星治疗的同时加用千金苇茎汤治疗，比较2组患者的临床有效率、症状缓解时间、肺通气功能指标、外周单核细胞T淋巴细胞（Th17）百分率以及不良反应发生率。结果：临床有效率，观察组明显高于对照组（P<0.05）；症状缓解时间，观察组明显短于对照组（P<0.05）；肺通气功能指标，2组均较治疗前得到改善（P<0.05），但观察组治疗后优于对照组（P<0.05）；观察组治疗后CD4+IL-17+T细胞百分率为（1.21±0.21）%，较对照组（2.47±0.32）%低，差异有统计学意义（P<0.05）。2组在不良反应发生率差异无统计学意义（P>0.05）。结论：采用左氧氟沙星与千金苇茎汤联合治疗慢性支气管炎急性发作具有显著的临床疗效，可有效促进其症状缓解，改善肺部通气功能，还可保证安全性，其作用机制可能与降低Th17表达有关。

English Summary:

To study and explore the clinical effect of the levofloxacin combined with Jiawei Qianjin Weijing Decoction in the treatment of chronic bronchitis with acute attack. Methods:Sixty patients with chronic bronchitis on acute exacerbation who were admitted and treated in department of respiratory medicine of our hospital from January 2015 to October 2016 were selected. By using single blind random method, all patients were randomly divided into control group and observation group, with 30 patients in each group. The patients in the control group were treated with levofloxacin, and the patients in the observation group were treated with Qianjin Weijing decoction on basis of control group. The two groups were compared in clinical total effective rate, symptoms remission time, pulmonary function indicators, peripheral monocyte T iymphocyte (Th17) percentage and the adverse effects rate. Results:The clinical total efficiency rate of the observation group was significantly higher than that of the control group (P<0.05); symptom remission time of the observation group was significantly shorter than that of the control group (P<0.05); pulmonary function indicators of both groups were improved (P<0.05), but the patients in the observation group were better than the patients in the control group (P<0.05); after treatment, the percentage of CD4+IL-17+T cells of observation group was （1.21±0.21）%, which was lower than that of the control group, and there were no significant differences between the groups during the treatment. Conclusion:Levofloxacin combined with Qianjin Weijing decoction in treating chronic bronchitis on acute exacerbation has significant clinical efficacy, and effectively promote the remission of symptoms, and improve the pulmonary ventilation function, and also ensure safety. Its mechanism of action may be related to the reduction of Th17 expression.

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