【摘要】 目的：评价理气消痰法（六君子汤合苓甘五味姜辛汤）治疗嗜酸性粒细胞（EOS）增高型慢性阻塞性肺疾病急性加重期（AECOPD）的疗效和安全性。方法：选取2023年4月至2024年4月于金华市中医医院肺病科住院的68例EOS增高型AECOPD的患者，随机分配到观察组或对照组。两组均给予常规西药治疗，观察组在此基础上加服六君子汤合苓甘五味姜辛汤，治疗后对疗效指标进行检测。主要疗效指标包括氧分压（PaO₂）和二氧化碳分压（PaCO₂）；次要疗效指标包括中医证候评分、COPD评估测试（CAT）、呼吸困难评分（mMRC）和住院时间。在基线期、干预第3天和第7天进行指标采集，并通过不良事件评估药物安全性。结果：两组患者的基线特征差异无统计学意义，资料具有可比性。干预第3天，两组患者PaO₂（P=0.773）、PaCO₂（P=0.632）、CAT评分（P=0.336）差异无统计学意义；干预第7天，与对照组治疗后比较，观察组的PaO₂（P=0.004）、PaCO₂（P=0.008）和CAT评分（P=0.013）均有明显改善。与对照组治疗后比较，观察组的中医证候评分在第3天（P=0.005）和第7天（P<0.001）均显著降低。两组组间各时间点mMRC评分（P=0.514,P=0.176）及住院时长均差异无统计学意义（P=0.915）。广义线性混合模型（GLMM）显示，与对照组比较，观察组在PaO₂、PaCO₂、中医证候评分、CAT和mMRC评分方面随着时间的推移均有明显改善。试验过程中两组均无严重不良事件报告。结论：理气化痰法联合西医常规疗法，可明显改善EOS增高型AECOPD患者的临床症状和肺功能，且安全性较好。更多还原

【Abstract】 Objective: To assess the efficacy and safety of the Qi-regulating and phlegm-removing method（Liu Junzitang Combined with Linggang Wuwei Jiangxintang） for treating acute exacerbations of chronic obstructive pulmonary disease（AECOPD） with increased eosinophils（EOS）. Methods: Sixty-eight AECOPD patients with increased EOS who were hospitalized in the Department of Pulmonary Diseases of Jinhua Traditional Chinese Medicine Hospital from April 2023 to April 2024 were recruited and randomly assigned to an experimental group（EG） or a control group（CG）. Both groups received conventional Western medicine, with the EG additionally receiving Liujunzitang and Linggan Wuwei Jiangxintang. The therapeutic efficacy indicators were measured after the treatment. The main therapeutic efficacy indicators included partial pressure of oxygen（PaO₂） and partial pressure of carbon dioxide（PaCO₂）. The secondary efficacy indicators included the TCM symptom scores, the COPD Assessment Test（ CAT） score, the Modified Medical Research Council（mMRC） Dyspnea Scale score, and the length of hospital stay. The indicators were measured at baseline and on days 3 and 7 of intervention. The safety was evaluated based on the adverse events. Results: Baseline characteristics were not statistically different between the two groups. Compared with CG, EG showed no significant difference in PaO₂（ P=0.773）, PaCO₂（P=0.632） and or CAT score（P=0.336） at on day 3 but better PaO₂（ P=0.004）, PaCO₂（ P=0.008）, and CAT score（ P=0.013） were significantly better at on day 7. Compared with CGAfter treatment, EG had lower TCM syndrome scores of than CG EG on day 3（P=0.005） and day 7 were significantly decreased（P<0.001）. There was no significant difference in mMRC score between the two groups on day 3（P=0.514） and day 7（P=0.176） as wasor the length of hospital stay（P=0.915）. The generalized linear mixed model（GLMM） showed that compared with CG, EG had significant improvements over time in PaO₂, PaCO₂, TCM syndrome symptom scores, CAT score, and mMRC score. Conclusion: Regulating qi Qi and removing phlegm combined with conventional Western medicine can significantly alleviateimprove the clinical symptoms and improve the lung function of AECOPD patients with increased EOS increased AECOPDwhich has and demonstrates good safety.更多还原