平胃散加减对阻塞性睡眠呼吸暂停低通气综合征患者间接性缺氧状况改善及脑白质损伤、血浆纤维蛋白原的影响  

Effect of Modified Pingwei Powder(平胃散加减)on the Improvement of Indirect Hypoxia,White Matter Damage and Plasma Fibrinogen in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

作　　者：王充 荀军锋 张姝媛 WANG Chong;XUN Junfeng;ZHANG Shuyuan(Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,Hebei,China)

机构地区：[1]石家庄市中医院,河北石家庄050000

出　　处：《辽宁中医药大学学报》2022年第12期163-167,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2020330)。

摘　　要：目的探讨平胃散加减对阻塞性睡眠呼吸暂停低通气综合征患者间接性缺氧状况改善及脑白质损伤、血浆纤维蛋白原的影响。方法选择2020年1月—2021年1月于石家庄市中医院门诊治疗的150例阻塞性睡眠呼吸暂停低通气综合征患者进行前瞻性研究,根据随机数字表法将纳入研究的病例分为对照组和中药联合组,两组患者采取不同的治疗方案。对照组采取内科保守治疗联合持续气道正压通气治疗(CPAP),中药联合组在此基础上联合服用平胃散加减进行治疗。两组患者均连续治疗4周,疗程结束后统计疗效。对比两组患者治疗前后睡眠期间每小时呼吸暂停和低通气的平均次数(AHI)指数、睡眠呼吸暂停指数(AI)以及低通气指数(HI)、夜间最低血氧饱和度(Sa O2)、Epworth嗜睡量表(ESS)评分、血浆缺氧诱导因子-1α(HIF-1α)含量、血浆纤维蛋白原(FIB)含量以及脑白质损伤情况。结果中药联合组治疗总有效率96.00%(72/75)明显高于对照组86.67%(65/75)(P<0.05);治疗后中药联合组AHI(13.28±2.27)明显低于对照组(16.49±2.15),中药联合组AI(8.78±2.36)明显低于对照组(11.65±2.69),治疗后中药联合组HI(3.48±1.16)明显低于对照组(4.35±1.22),治疗后中药联合组ESS评分(5.23±1.71)分明显低于对照组(7.48±1.56)分,治疗后中药联合组血浆HIF-1α含量(6.19±2.05)ng/L明显低于对照组(8.53±2.28)ng/L,治疗后中药联合组FIB含量(2.48±0.45)g/L明显低于对照组(2.73±0.49)g/L,治疗后中药联合组睡眠最低SaO2(88.73±3.35)%明显高于对照组(86.18±3.29)%,治疗后中药联合组脑白质损伤分级疗效优于对照组(P<0.05)。结论平胃散加减对阻塞性睡眠呼吸暂停低通气综合征患者疗效较好,可有效改善患者夜间血氧饱和度,降低缺氧诱导因子含量,改善脑白质损伤,同时降低血浆纤维蛋白原含量以防止血栓形成引发心血管事件。Objective To explore the effects of Modified Pingwei Powder(平胃散加减)on the improvement of indirect hypoxia,brain white matter damage and plasma fibrinogen in patients with obstructive sleep apnea hypopnea syndrome.Methods To select 150 patients with pre-obstructive sleep apnea hypopnea syndrome who were hospitalized in our hospital from January 2020 to January 2021 for a prospective study.According to the random number table method,the included cases were divided into control group and traditional Chinese medicine.In the combined group,two groups of patients took different treatment plans.The control group was treated with conservative medical treatment combined with continuous positive airway pressure(CPAP),and the traditional Chinese medicine group was treated with Modified Pingwei Powder on this basis.Patients in both groups were treated for 4 consecutive weeks,and the curative effect was calculated after the course of treatment.To compare the AHI index,sleep apnea index(AI)and hypopnea index(HI),minimum night blood oxygen saturation(SaO2),ESS score,and plasma hypoxia inducible factor-1α(HIF-1α)levels before and after treatment between the two groups of patients,plasma fibrinogen(FIB)content and white matter damage.Results The total effective rate of treatment in the Chinese medicine combination group was 96.00%(72/75),which was significantly higher than that of the control group 86.67%(65/75)(P<0.05);After treatment,the AHI(13.28±2.27)of the traditional Chinese medicine combination group was significantly lower than that of the control group(16.49±2.15),the AI(8.78±2.36)of the traditional Chinese medicine combination group was significantly lower than the control group(11.65±2.69),and the HI(3.48±1.16)of the traditional Chinese medicine combination group after treatment was significantly lower than the control group(4.35±1.22),the ESS score(5.23±1.71)of the Chinese medicine combination group after treatment was significantly lower than the control group(7.48±1.56),the plasma HIF-1αcontent o

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 平胃散加减 间接性缺氧 脑白质损伤 纤维蛋白原 

分 类 号：R563.9[医药卫生—呼吸系统]