补心气口服液辅助治疗慢性肺心病急性发作期的临床分析
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摘要
目的:探讨在西医常规综合治疗方案的基础上补心气口服液治疗肺心病(CPHD)的临床疗效及作用机制。方法:将80例CPHD急性期患者随机按住院前后分为对照组和观察组各40例。对照组给予西医综合干预方案,包括抗感染、祛痰、止咳、平喘、利尿、抗心衰等综合措施。观察组在对照组的基础上,加服补心气口服液,10 mL次,3次/d,两组疗程为4周。两组治疗前后均检测动脉二氧化碳分压(PaCO2)和氧分压(PaO2),肺动脉压(mPAP),血浆内皮素-1(ET-1)和一氧化氮(NO)水平,血液流变学指标;记录治疗前后主要症状、体征评分。结果:经Ridit分析,观察组综合临床疗效优于对照组(P<0.05),mPAP低于对照组(P<0.01);治疗后观察组PaO2高于对照组,PaCO2低于对照组(P<0.01),ET-1低于对照组,NO水平高于对照组(P<0.01);治疗后观察组主要症状和体征积分低于对照组(P<0.01);治疗后观察组全血黏度、血浆黏度、纤维蛋白原及红细胞沉降率等血液流变指标的改善均优于对照组(P<0.01)。结论:在西医常规综合治疗方案的基础上,采用补心气口服液减轻了CPHD急性期患者临床症状,改善了患者心、肺功能,其作用机制可能与改善血液高凝状态和血管内皮功能有关。
Objective: The discuss recent curative effect and mode of action based on routine comprehensive treatment of western medicine added Buxinqi oral liquid to treat chronic pulmonary heart disease( CPHD). Method: Eighty cases of patients with CPHD in acute stage were randomly divided into control group( 40 cases) and observation group( 40 cases) by the sequence in hospital method. The patients in control group took comprehensive intervention of western-style plan,including measures as anti-infection,reducing phlegm,relieving a cough,relieving asthma,diuresis,relieving heart failure et. For patients in observation group,they took Buxinqi oral liquid on the basis of the control group,10 mL / time,3 dose / day. The treatment courses of both groups continued for 4 weeks. Detect arterial carbon dioxide partial pressure( PaCO2) and oxygen partial pressure( PaO2) before and after treatment. Measure pulmonary artery pressure( mPAP) before and after treatment. Level of plasma endothelin-1( ET-1) and nitric oxide( NO) are tested before and after treatment. Detect hemodynamic indexes and record cardinal symptom, signs score before and after treatment. Result: Analyzing by Ridit, the clinical comprehensive treatment of observation group was superior to control group( P < 0. 05),after treatment,mPAP of observation group was lower than control group( P < 0. 01),PaO2of observation group was superior to control group,and PaCO2of observation group was was lower than control group( P < 0. 01). ET-1 of observation group was lower than control group and the level of NO of observation group was superior to control group( P < 0. 01), the main symptom and scores of symptoms and signs of observation group were lower than control group( P < 0. 01). The improvement of viscosity of whole blood,plasma viscosity,fibrinogen,erythrocyte sedimentation rate and such hemodynamic indexes of observation group was superior to control group( P < 0. 01). Conclusion: On the basis of routine comprehensive treatment of western medicine,using Buxinqi oral liquid can reduce clinical symptoms of patients with CPHD in acute stage. Besides improve patients' heart and lung function. Its mechanism of action may be associated with improving hypercoagulable state and vascular endothelial function.
Objective: The discuss recent curative effect and mode of action based on routine comprehensive treatment of western medicine added Buxinqi oral liquid to treat chronic pulmonary heart disease( CPHD). Method: Eighty cases of patients with CPHD in acute stage were randomly divided into control group( 40 cases) and observation group( 40 cases) by the sequence in hospital method. The patients in control group took comprehensive intervention of western-style plan,including measures as anti-infection,reducing phlegm,relieving a cough,relieving asthma,diuresis,relieving heart failure et. For patients in observation group,they took Buxinqi oral liquid on the basis of the control group,10 mL / time,3 dose / day. The treatment courses of both groups continued for 4 weeks. Detect arterial carbon dioxide partial pressure( PaCO2) and oxygen partial pressure( PaO2) before and after treatment. Measure pulmonary artery pressure( mPAP) before and after treatment. Level of plasma endothelin-1( ET-1) and nitric oxide( NO) are tested before and after treatment. Detect hemodynamic indexes and record cardinal symptom, signs score before and after treatment. Result: Analyzing by Ridit, the clinical comprehensive treatment of observation group was superior to control group( P < 0. 05),after treatment,mPAP of observation group was lower than control group( P < 0. 01),PaO2of observation group was superior to control group,and PaCO2of observation group was was lower than control group( P < 0. 01). ET-1 of observation group was lower than control group and the level of NO of observation group was superior to control group( P < 0. 01), the main symptom and scores of symptoms and signs of observation group were lower than control group( P < 0. 01). The improvement of viscosity of whole blood,plasma viscosity,fibrinogen,erythrocyte sedimentation rate and such hemodynamic indexes of observation group was superior to control group( P < 0. 01). Conclusion: On the basis of routine comprehensive treatment of western medicine,using Buxinqi oral liquid can reduce clinical symptoms of patients with CPHD in acute stage. Besides improve patients' heart and lung function. Its mechanism of action may be associated with improving hypercoagulable state and vascular endothelial function.
引文
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[7]唐良法.血必净对慢性肺心病急性加重期血气分析和心功能的影响[J].中国实验方剂学杂志,2012,12(20):299.
[8]刘艳霞,徐学功.陈绍宏教授谈肺心病急性发作期中医施治思路[J].世界中西医结合杂志,2008,3(9):508.
[9]魏孟玲.补心气口服液联合西药治疗慢性心力衰竭心气虚损证的临床观察[J].中西医结合心脑血管病杂志,2012,10(11):1284.
[10]邹霞英,辛达监,陈小容.肺心病血管内皮细胞功能改变及双硝基异山梨醇干预的影响[J].岭南心血管病杂志,2003,9(3):171.
[2]杨亚勤.依那普利联合丹参酮治疗肺心病急性加重期患者[J].中国实验方剂学杂志,2012,18(8):252.
[3]余再新,吴春风,杨天伦,等.补心气口服液对慢性稳定型心绞痛患者生活质量影响及疗效观察[J].临床心血管病杂志,2011,27(2):116.
[4]王吉耀.内科学[M].北京:人民卫生出版社,2005:281.
[5]郑晓萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:77.
[6]王筠,张晓云,黄斌,等.宣肺平喘,温阳利水法治疗肺心病急性发作期合并心衰临床观察[J].中国中医急症,2008,17(11):1497.
[7]唐良法.血必净对慢性肺心病急性加重期血气分析和心功能的影响[J].中国实验方剂学杂志,2012,12(20):299.
[8]刘艳霞,徐学功.陈绍宏教授谈肺心病急性发作期中医施治思路[J].世界中西医结合杂志,2008,3(9):508.
[9]魏孟玲.补心气口服液联合西药治疗慢性心力衰竭心气虚损证的临床观察[J].中西医结合心脑血管病杂志,2012,10(11):1284.
[10]邹霞英,辛达监,陈小容.肺心病血管内皮细胞功能改变及双硝基异山梨醇干预的影响[J].岭南心血管病杂志,2003,9(3):171.