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Journal of Chinese Integrative Medicine ›› 2009, Vol. 7 ›› Issue (2): 105-109.doi: 10.3736/jcim20090202

• Original Clinical Research • Previous Articles     Next Articles

Therapy for clearing heat and resolving phlegm in treatment of systemic inflammatory response syndrome in acute deterioration stage of chronic obstructive pulmonary disease: A randomized controlled trial

 Ning Chena, Hui Lia,Li-yun Zhaoa,Jian-bo Liub,Qin Huanga,Tong-han Wanga,Xiao-mei Haoa   

  1. a Department of Respiratory Diseases, Guangdong Second Provincial Traditional Chinese Medicine Hospital, Guangzhou, Guangdong Province 510095, China
    b Department of Respiratory Diseases, the First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province 510405, China
  • Received:2008-10-18 Accepted:2008-12-11 Online:2009-02-20 Published:2009-02-15

Objective

To investigate the effects of traditional Chinese medicine (TCM) therapy for clearing heat and resolving phlegm on systemic inflammatory response syndrome (SIRS) in acute deterioration stage of chronic obstructive pulmonary disease (COPD) and the serum procalcitonin (PCT) level.
Methods

 One hundred patients suffering from SIRS in acute deterioration stage of COPD were included and randomly divided into treatment group (50 cases) and control group (50 cases). Patients in the treatment group were treated with routine Western medicine and Chinese herbal medicine for clearing away heat and eliminating phlegm, while patients in the control group were treated with routine Western medicine only. Patients in the two groups were treated for one week. The serum PCT levels in the two groups were measured at days 1, 3, and 7, and clinical symptom scores were recorded at days 1 and 7 in hospital to determine the effects.
Results

Clinical symptom scores in the two groups decreased after the treatment (P<0.05), and the symptom score in the treatment group was lower than that in the control group (P<0.05). The effect of integrated traditional Chinese and Western medicine treatment was obviously better than that of the Western medicine treatment when improving rates in clinical symptom score were divided into over 70% and less than 70% (P<0.05). Serum PCT concentration was in direct proportion to clinical symptom score (P<0.05). The patients with higher clinical symptom score were in more serious pathogenetic condition. There were no significant differences in the serum PCT concentrations among days 1, 3 and 7 in hospital.
Conclusion

The effect of TCM therapy for clearing heat and removing phlegm combined with Western medicine treatment is better than that of the Western medicine treatment. TCM therapy has a satisfied effect in improving clinical symptoms. The serum PCT concentration is correlated with the severity of SIRS in acute deterioration stage of COPD.

Key words: Chronic obstructive pulmonary disease, Clearing heat and resolving phlegm, Systemic inflammatory response syndrome, Procalcitonin, Randomized controlled trial

Table 1

Clinical symptom score before and after the treatment in two groups (x±s)"

Group n Before treatment After treatment Difference
Control 50 8.02±2.54 3.04±1.58** 4.98±1.67
Treatment 50 8.26±3.06 2.42±1.31** 5.84±2.62

Table 2

Correlations of item number of SIRS diagnosis index and average clinical symptom score and positive ratio of PCT"

Item number of SIRS
diagnosis index
n Average clinical
symptom score
PCT grading (Cases) Positive ratio
of PCT (%)
1 2 3 4
4 8 12.38▲▲□□ 3 3 2 0 62.5□□
3 34 9.29□□ 15 14 4 1 52.9□□
2 58 6.88 49 8 1 0 15.5
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