瓜蒌薤白半夏汤联合痰热清注射液治疗慢性肺心病急性发作期55例  

Effect of Gualou Xiebai Banxia Decoction Combined with Tanreqing Injection in Treating 55 Cases with Acute Attack of Chronic Pulmonary Heart Disease

作　　者：杨文斌[1] 李勇 张波[1] 

机构地区：[1]乐山职业技术学院,四川乐山614000 [2]乐山市红会医院,四川乐山614000

出　　处：《中国实验方剂学杂志》2015年第15期180-183,共4页Chinese Journal of Experimental Traditional Medical Formulae

摘　　要：目的:观察瓜蒌薤白半夏汤联合痰热清注射液治疗慢性肺心病急性发作期的临床疗效及对超敏C-反应蛋白(hs-CRP)和N-末端脑钠肽前体(NT-pro BNP)的影响。方法:将108例患者随机按数字表法分为对照组53例和观察组55例。对照组采用西医综合治疗措施,包括注射用硫酸头孢匹罗,2 g/次,静脉注射,1次/d;盐酸氨溴索颗粒,30 mg/次,3次/d,口服;昔萘沙美特罗气雾剂,每次吸入两揿(2×25)μg,2次/d。观察组在对照组治疗的基础上加用瓜蒌薤白半夏汤内服,1剂/d,和痰热清注射液,30 m L/次,静脉滴注,1次/d。两组疗程均为14 d。进行治疗前后纽约心脏病协会(NYHA)进行分级和主要症状、体征评分;检测治疗前后用力肺活量(FVC),1 s用力呼气量(FEV1),呼气流量峰值(PEF),动脉血氧分压(Pa O2)和血氧饱和度(Sa O2);检测治疗前后hs-CRP和NT-pro BNP水平。结果:治疗后观察组心功能总有效率为90.91%,对照组为77.36%,观察组高于对照组,但差异无统计学意义;治疗后观察组综合临床疗效总有效率为89.09%,对照组为69.81%,观察组高于对照组(P<0.05);治疗后两组FVC,FEV1,PEF,Pa O2和Sa O2均比治疗前有所增加(P<0.01),观察组PEF,Pa O2和Sa O2高于对照组(P<0.05),两组间FVC和FEV1差异无统计学意义;治疗后两组咳嗽、咯痰、气喘、胸闷和肺部啰音评分均比治疗前明显下降(P<0.01),观察组除气喘其他症状、体征评分低于对照组(P<0.01);治疗后观察组hs-CRP和NT-pro BNP水平低于对照组(P<0.01)。结论:在西医常规治疗的基础上,瓜蒌薤白半夏汤内服联合痰热清注射液静脉注射能改善肺心病急性发作期患者痰、咳、喘、闷等症状,能改善心、肺功能,减轻了炎症反应,提高了疾病的综合疗效。Objective： To observe the clinical effect of Gualou Xiebai Banxia decoction combined with Tanreqing injection in treating acute attack of chronic pulmonary heart disease（ CPHD） and their influence on hypersensitive C-reactive protein（ hs-CRP） and N-terminal brain natriuretic peptide precursor（ NT-pro BNP）.Method： Totally 108 patients were randomly divided into the control group（ 53 cases） and the observation group（ 55 cases） according to the digital table method. The control group was treated with comprehensive western medicine therapies,including intravenous injection with cefpirome sulfate（ 2 g / time,qd）,oral administration with ambroxol hydrochloride granules（ 30 mg / time,tid） and of Salmeterol xinafoate aerosol two puffs,（ 2 × 25） μg,2bid. Based on the therapies of the control group, the observation group was additionally treated with oral administration with Gualou Xiebai Banxia decoction（ qd）,intravenous infusion with Tanreqing injection（ 30 m L /time,qd）. Both groups were treated for 14 days. Before and after the treatment,New York Heart Association（ NYHA） graded and scored main symptoms and signs,tested the forced vital capacity（ FVC）,forced expiratory volume in 1 second（ FEV1）,peak expiratory flow（ PEF）,arterial partial pressure of oxygen（ Pa O2）,oxygen saturation（ Sa O2）,hs-CRP and NT-pro BNP levels. Result： After the treatment,the total effective rate of cardiac function in the observation group was 90. 91% and higher than 77. 36% in the control group,but with no statistical significance in their difference. The total effective rate of comprehensive clinical efficacy in the observation group was 89. 09% and higher than 69. 81% in the control group（ P 〈 0. 05）. The levels of FVC,FEV1,PEF,Pa O2 and Sa O2 in both group were slightly higher than that before the treatment（ P 〈 0. 01）,with higher PEF,Pa O2 and Sa O2 in the observation group than that in the control group（ P 〈 0. 05） and no statistical significance in

关 键 词：肺心病 急性发作期 瓜蒌薤白半夏汤 痰热清注射液 超敏C-反应蛋白 N-末端脑钠肽前体 

分 类 号：R287[医药卫生—中药学]