目的 探討清咳平喘顆粒聯(lián)合西醫(yī)常規(guī)方案治療支氣管擴(kuò)張癥的療效及對(duì)患者出院后再次急性加重的影響。方法 選取2021年2月—2023年6月在上海中醫(yī)藥大學(xué)附屬龍華醫(yī)院肺病科出院的122例支氣管擴(kuò)張癥患者進(jìn)行回顧性分析，按治療方案不同將其分為治療組61例和對(duì)照組61例。對(duì)照組出院后僅接受西醫(yī)常規(guī)治療方案，療程為1周；治療組在對(duì)照組基礎(chǔ)上聯(lián)合清咳平喘顆粒治療，療程為8周。以患者出院為起點(diǎn)隨訪24周，對(duì)比兩組出院后24周內(nèi)出現(xiàn)的急性加重比例，基線（出院第1天）及入組24周后圣喬治呼吸問卷（St. George’s respiratory questionnaire，SGRQ）評(píng)分、肺功能指標(biāo)并記錄不良事件。結(jié)果 治療組總有效率為65.6%，對(duì)照組總有效率為44.3%，差異具有統(tǒng)計(jì)學(xué)意義（P＜0.05）。出院后24周內(nèi)，治療組的急性加重比例明顯低于對(duì)照組（19.7% vs 36.1%，P＜0.05）；與對(duì)照組相比，治療組再次出現(xiàn)急性加重的時(shí)間［（137.23±57.14）d vs（157.18±44.07）d］延長(zhǎng)（P＜0.05）。入組24周后，兩組SGRQ評(píng)分（癥狀、活動(dòng)、心理評(píng)分和總分）均較基線顯著降低（P＜0.05）；治療組SGRQ活動(dòng)評(píng)分改善值顯著高于對(duì)照組（P＜0.05）；兩組肺功能指標(biāo)［第1秒用力呼氣容積（Forced expiratory volume for 1 second，F(xiàn)EV1）、用力肺活量（forced vital capacity，F(xiàn)VC）、FEV1/FVC］均較基線升高，但差異無統(tǒng)計(jì)學(xué)意義（P＞0.05），治療組肺功能指標(biāo)改善值與對(duì)照組比較差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）。兩組總不良反應(yīng)發(fā)生率差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）。結(jié)論 清咳平喘顆粒聯(lián)合西醫(yī)常規(guī)方案能夠有效降低支氣管擴(kuò)張癥患者出院后24周內(nèi)再次急性加重風(fēng)險(xiǎn)，助力改善慢性呼吸道癥狀及活動(dòng)能力，且具有較好的安全性。

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

上海市公共衛(wèi)生重點(diǎn)學(xué)科項(xiàng)目（GWVI-11.1-08）；上海市衛(wèi)健委中醫(yī)藥科研項(xiàng)目（20234Y0109）；上海市申康中心項(xiàng)目（SHDC12023106）；上海市科技計(jì)劃項(xiàng)目（22Y11920400）；上海市徐匯區(qū)院地合作項(xiàng)目（23XHYD-25）