泻肺降浊汤对肺心病急性期血液高凝状态的影响  

Influence of Xiefei Jiangzhuo Decoction to High Clotting Condition of Chronic Pulmonary Heart Disease in Acute Phase

作　　者：周兵[1] 樊松[2] 王月蓉 

机构地区：[1]乐山职业技术学院,四川乐山614000 [2]峨眉山市中医医院,四川乐山614000 [3]乐山市中医医院,四川乐山614000

出　　处：《中国实验方剂学杂志》2014年第12期222-225,共4页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：四川省教育厅基金项目(CJF13043)

摘　　要：目的:探讨泻肺降浊汤治疗肺心病(CPHD)急性期的疗效及对血液高凝状态的影响。方法:76例急性发作期CPHD患者随机按数字法分为对照组和观察组各38例。两组均给予休息,低盐饮食,低流量吸氧,纠正电解质和酸碱失衡及适当给予强心药物。左氧氟沙星注射液,0.3 g·d-1,静脉点滴。多索茶碱葡萄糖注射液,0.3 g·d-1,静脉点滴。盐酸氨溴索颗粒,15 mg/次,3次/d。观察组在对照组治疗的基础上加服泻肺降浊汤,1剂/d。两组疗程均为2周。检测治疗前后动脉二氧化碳分压(PaCO2)、氧分压(PaO2)和肺动脉压(mPAP);进行治疗前后血液流变学检测;检测治疗前后血浆P-选择素(GMP140)、血管性假血友病因子(vWF)和D-二聚体水平(D-D)水平。结果:观察组综合临床疗效总有效率为92.11%,对照组为73.68%,观察组优于对照组(P<0.05);治疗后两组PaO2均较治疗前升高,观察组PaO2高于对照组(P<0.01);治疗后两组PaCO2均较治疗前下降,观察组PaCO2低于对照组(P<0.01);治疗后两组mPAP均较治疗前下降(P<0.01),观察组mPAP低于对照组(P<0.01);治疗后观察组血浆GMP140,vWF和D-D水平低于对照组(P<0.01);治疗后观察组血液流变学指标(全血黏度、血小板聚集率、血浆黏度、纤维蛋白原及全血还原黏度)的改善优于对照组(P<0.01)。结论:在西医常规治疗的基础上,泻肺降浊汤改善了急性期CPHD患者血液高凝状态,有助于防治血栓前状态,减轻了肺循环阻力,降低了mPAP,改善了肺的通气/换气功能,促进了疾病的康复。Objective： Discuss curative effect of Xiefei Jiangzhuo decoction on chronic pulmonary heart disease （CPHD） in acute phase and influence to high clotting condition. Method： Seventy-six patients with CPHD in acute phase were randomly divided into control group （38 cases） and observation group （38 cases） by random number table. Both groups＇ patients received rest, low salt diet, low flow oxygen, adjusting electrolyte and acid base disturbance and cardiotonic drug properly. Patients in control group received Levofloxacin injection, 0.3 g/day, iv, Doxofylline and glucose injection, 0.3 g/day, iv and Ambroxol hydrochloride granules, 15 mg/ time, 3times/day. Based on the control group, patients in observation group added Xiefei Jiangzhuo decoction, 1 dose/day. Course of treatment in two groups were 2 weeks. After treatment, partial of CO2 （PaC0_2） in artery, partial of 02 （PaO2） and mean pulmonary artery pressure （mPAP） were detected. Before and after treatment,blood rheology was detected. And the level of P-selection （GMP140） in plasma, von willebrand factor （vWF） and D-dimer （D-D） were detected. Result： The comprehensive total effective rate of clinical curative effect in the observation group was 92. 11% superior to 73.68% in the control group （P 〈0.05）. Compared with the time before treatment, PaCO2in both groups increased, and PaCO2in observation group was higher than the control group （P 〈 0.01 ）. PaCO2in both groups decreased, and PaO2in observation group was lower than the control group （P 〈0.01）. mPAP in both groups decreased, and mPAP in observation group was lower than the control group （P 〈0.01）. And the level of GMP140 in plasma, vWF and D-D in observation group were lower than the control group （P 〈 0.01 ）. The amelioration of blood rheology indexes （whole blood viscosity, platelet aggregation rate, plasma viscosity, fibrinogen and whole blood reduced viscosity） in the observation group were superior to the control group （P 〈

关 键 词：慢性肺源性心脏病 急性发作期 泻肺降浊汤 血液流变学 P-选择素 血管性假血友病因子 D-二聚体 水平 

分 类 号：R287[医药卫生—中药学]