益气活血法对慢性阻塞性肺疾病急性加重患者血浆纤维蛋白原及D-二聚体的影响  

Effect of Qi Benefiting Blood Activating Method on Plasma Fibrinogen and D-dimer in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

作　　者：王胜[1] 陈悦[1] 任薇[1] 朱春冬[1] 李春颖[1] 周群[1] 季红燕[1] 

机构地区：[1]安徽中医药大学第一附属医院干部呼吸内科,合肥230031

出　　处：《中国中西医结合杂志》2015年第5期537-540,共4页Chinese Journal of Integrated Traditional and Western Medicine

摘　　要：目的观察益气活血法对慢性阻塞性肺疾病急性加重(AECOPD)血瘀证患者血浆纤维蛋白原(Fg)及D-二聚体(D-D)的影响,以探讨其对AECOPD的治疗作用。方法将60例AECOPD血瘀证患者随机分为对照组和治疗组,对照组给予AECOPD常规治疗,治疗组在常规治疗基础上加用生脉注射液和丹参酮ⅡA注射液,观察两组患者的临床疗效及治疗前后血浆Fg、D-D水平与动脉血氧分压(Pa O2)及动脉二氧化碳分压(Pa CO2)等指标变化。结果治疗组有效率为93.3%(28/30),高于对照组73.3%(22/30)(P<0.05);治疗前两组患者Fg、D-D、Pa O2及Pa CO2比较,差异无统计学意义(P>0.05),治疗后两组患者各指标均较治疗前有显著改善(均P<0.01),但治疗组Fg及D-D水平低于对照组,Pa O2高于对照组(均P<0.01);60例患者治疗前血浆Fg、D-D水平与Pa O2呈显著负相关(r=-0.493,r=-0.438,P<0.01),治疗后血浆Fg、D-D水平与Pa O2亦呈显著负相关(r=-0.452,r=-0.325,P<0.01,P<0.05),治疗前后血浆Fg、D-D水平与Pa CO2均无明显相关(P>0.05)。结论益气活血法可改善AECOPD血瘀证患者的血栓前状态而发挥治疗作用。Fg、D-D水平与AECOPD的严重程度有一定的相关性。Objective To explore the therapeutic effect of qi benefiting blood activating method （QBBAM） on acute exacerbation of chronic obstructive pulmonary disease （AECOPD） patients with blood stasis syndrome （BSS） by observing its effect on plasma fibrinogen （Fg） and D-dimer （D-D） levels. Methods Sixty AECOPD patients with BSS were randomly assigned to the treated group and the control group, 30 in each group. All patients received conventional therapy for AECOPD. Those in the treated group were additionally injected with Shengmai Injection and Tanshinone I]A Injection. Clinical efficacy and indices including levels of Fg, D-D, PaO2, and PaCO2 were measured and compared before and after treatment. Results The effective rate was 93. 3% （28/30 cases） in the treated group, higher than that of the control group [73. 3% （22/30 cases）, P 〈 0. 05）]. There was no significant difference in all indices between the treated group and the control group before treatment （P 〉0. 05）. After treatment all indices were significantly improved in the two groups （P 〈0. 01 ）. But in the treated group levels of Fg and D-D decreased more and levels of PaO2 increased more （P 〈0.01 ）. Plasma levels of Fg and D-D levels were negatively correlated with PaO2 （r = -0.493, r = -0.438, P 〈0.01 ） before treatment, and also negatively correlated with PaO2 （r = -0.452, r = -0.325, P 〈0.01, P 〈0.05） after treat- ment, but they were not significantly correlated with PaCO2 before and after treatment （P 〉0.05）. Conclusions QBBAM could play a therapeutic role in improving prethrombotic states of AECOPD patients with BSS. Plasma levels of Fg and D-D were related to the severity of AECOPO.

关 键 词：慢性阻塞性肺疾病 益气活血法 纤维蛋白原 D-二聚体 动脉血气 

分 类 号：R259[医药卫生—中西医结合]