宁肺活血利水方对慢性阻塞性肺疾病合并肺动脉高压外周血内皮祖细胞计数及功能影响的临床及实验研究  

Clinical and experimental study on the effect of Ningfei Huoxue Lishui Recipe on the count and function of peripheral blood endothelial progenitor cells in chronic obstructive pulmonary disease complicated with pulmonary hypertension

作　　者：冷报浪[1] 张云霞[1] 赵娜 王海燕[1] 冯霞 LENG Bao-lang;ZHANG Yun-xia;ZHAO Na(Hangzhou Third People's Hospital,Hangzhou 310000,China)

机构地区：[1]杭州市第三人民医院,310000

出　　处：《中国实用医药》2022年第23期10-14,共5页China Practical Medicine

基　　金：浙江省中医药科技计划项目(项目编号:2019ZB103)。

摘　　要：目的分析慢性阻塞性肺疾病(COPD)合并肺动脉高压(PH)患者应用宁肺活血利水方治疗后所产生的效果及影响。方法60例COPD合并肺动脉高压患者,采用随机数字表法分为对照组及研究组,每组30例。对照组进行常规治疗,研究组采用常规治疗+宁肺活血利水方治疗。对比两组患者治疗前后中医证候积分、肺动脉压、外周血内皮祖细胞(EPCs)计数及功能、治疗效果。同时选取30只雄性SD大鼠,随机分为模型组、干预组及空白对照组,每组10只。模型组及干预组于项背部皮下注射1%的野百合碱以诱导形成肺动脉高压模型,空白对照组注射等量磷酸盐缓冲液(PBS)。干预组于第3天开始予以宁肺活血利水方水煎液灌胃,模型组以等量蒸馏水灌胃,空白对照组不进行灌胃治疗。对比三组大鼠右心室收缩压(RVSP)、静脉血EPCs计数及功能。结果临床研究中,治疗后,两组中医证候积分、肺动脉压均较治疗前降低,且研究组中医证候积分(5.46±0.71)分、肺动脉压(37.11±8.07)mm Hg(1 mm Hg=0.133 kPa)显著低于对照组的(9.98±1.01)分、(41.83±8.46)mm Hg,差异有统计学意义(P<0.05)。治疗后,两组EPCs计数、EPCs增殖能力、EPCs迁移能力、EPCs粘附能力均较治疗前升高,且研究组高于对照组,差异有统计学意义(P<0.05)。研究组的治疗总有效率为93.33%,明显高于对照组的73.33%,差异有统计学意义(P<0.05)。动物实验研究中,空白对照组RVSP低于模型组及干预组,EPCs计数、EPCs增殖数、EPCs粘附能力、EPCs迁移能力高于模型组及干预组,差异有统计学意义(P<0.05);干预组RVSP低于模型组,EPCs计数、EPCs增殖数、EPCs粘附能力、EPCs迁移能力高于模型组,差异有统计学意义(P<0.05)。结论将宁肺活血利水方应用在COPD合并肺动脉高压的临床治疗中,对于降低患者肺动脉压,改善心肺功能有显著效果,同时也有利于增加外周血EPCs计数,改善血EPCs各项功能,�Objective To analyze the effect and influence of Ningfei Huoxue Lishui Recipe on the count and function of peripheral blood endothelial progenitor cells in chronic obstructive pulmonary disease(COPD)complicated with pulmonary hypertension(PH).Methods A total of 60 patients with COPD and pulmonary hypertension were randomly divided into control group and research group,with 30 cases in each group.The control group received conventional treatment,while the research group received conventional treatment+Ningfei Huoxue Lishui Recipe.The traditional Chinese medicine syndrome score,pulmonary arterial pressure,peripheral blood endothelial progenitor cells(EPCs)count and function before and after treatment,and therapeutic effects were compared between the two groups.At the same time,30 male SD rats were selected and randomly divided into model group,intervention group and blank control group,with 10 rats in each group.The model group and the intervention group were injected subcutaneously with 1%monocrotaline on the back of the neck to induce the formation of pulmonary hypertension model,and the blank control group was injected with the same amount of phosphate buffered saline(PBS).The intervention group was gavaged with Ningfei Huoxue Lishui Recipe from the 3rd day,the model group was gavaged with an equal amount of distilled water,and the blank control group was not treated with gavage.The right ventricular systolic pressure(RVSP),venous blood EPCs count and function were compared among the three groups.Results In the clinical study,after treatment,the traditional Chinese medicine syndrome score and pulmonary arterial pressure in both groups were lower than those before treatment in this group;the traditional Chinese medicine syndrome score(5.46±0.71)points and pulmonary artery pressure(37.11±8.07)mm Hg(1 mm Hg=0.133 kPa)in the research group were significantly lower than(9.98±1.01)points and(41.83±8.46)mm Hg in the control group;the differences were all statistically significant(P<0.05).After treatment,the EPCs co

关 键 词：宁肺活血利水方 慢性阻塞性肺疾病 肺动脉高压 外周血内皮祖细胞 治疗效果 

分 类 号：R259[医药卫生—中西医结合]