养心宣肺汤对肺心病急性加重期患者疗效及炎症因子、凝血状态的影响研究  

Influence of Yangxin Xuanfei Decoction on the Efficacy of Patients with Acute Exacerbation of Chronic Pulmonary Heart Disease and Its Effect on Inflammatory Factors and Coagulation Status

作　　者：林莉娴 龙邦盛 王宝爱 LIN Li-Xian;LONG Bang-Sheng;WANG Bao-Ai(The Fifth Dept.of Internal Medicine,Haikou Traditional Chinese Medicine Hospital,Haikou 570203 Hainan,China;Dept.of Critical Care Medicine,Haikou Hospital of Traditional Chinese Medicine,Haikou 570203 Hainan,China;The First Dept.of Internal Medicine,Haikou Traditional Chinese Medicine Hospital,Haikou 570203 Hainan,China)

机构地区：[1]海口市中医医院内五科,海南海口570203 [2]海口市中医医院重症医学科,海南海口570203 [3]海口市中医医院内一科,海南海口570203

出　　处：《广州中医药大学学报》2023年第6期1334-1341,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：海南省自然科学基金青年基金项目(编号:818QN324)。

摘　　要：【目的】探究养心宣肺汤对慢性肺源性心脏病(简称肺心病)急性加重期患者的血清炎症因子、凝血状态及临床疗效的影响。【方法】将96例肺心病急性加重期(心肺气虚、痰湿阻肺证)患者随机分为研究组和对照组,每组各48例。对照组给予西医常规综合治疗,观察组在对照组的基础上加用养心宣肺汤治疗,疗程为2周。观察2组患者治疗前后中医证候积分、心肺功能指标、肺动脉压、血气分析指标、血清炎症因子、凝血状态指标的变化情况,并评价2组患者的临床综合疗效。【结果】(1)治疗2周后,研究组的总有效率为91.67%(44/48),对照组为70.83%(34/48),组间比较(秩和检验),研究组的临床综合疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的中医证候积分均较治疗前明显降低(P<0.05),且研究组的降低作用明显优于对照组(P<0.01)。(3)治疗后,2组患者的舒张早期及舒张晚期流速峰值比值(E/A)、左心室射血分数(LVEF)、第1秒用力呼气容积(FEV1)、肺活量(FVC)均较治疗前改善(P<0.05),且研究组的改善作用均明显优于对照组(P<0.01)。(4)治疗后,2组患者的肺动脉平均压(MPAP)、肺动脉收缩压(PASP)等均较治疗前明显降低(P<0.05),且研究组的降低作用均明显优于对照组(P<0.01)。(5)治疗后,2组患者的二氧化碳分压(PaCO_(2))均较治疗前明显降低(P<0.05),氧分压(PaO_(2))均较治疗前明显升高(P<0.05),且研究组对PaCO_(2)的降低作用及对PaO_(2)的升高作用均明显优于对照组(P<0.01)。(6)治疗后,2组患者的血清降钙素原(PCT)、肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)、N末端B型利钠肽原(NT-proBNP)水平均较治疗前明显降低(P<0.05),且研究组的降低作用均明显优于对照组(P<0.01)。(7)治疗后,2组患者的血小板ɑ颗粒膜蛋白140(GMP-140)、D-二聚体(D-D)、血管性假血友病因子(vWF)等凝血状态指标均较治疗前明显降低(P<0.05),且研究�Objective To investigate the influence of Yangxin Xuanfei Decoction on the clinical efficacy of patients with acute exacerbation of chronic pulmonary heart disease(CPHD)and to observe its effect on the serum inflammatory factors and coagulation status of the patients.Methods Ninety-six patients with acute exacerbation of CPHD differentiated as heart-lung qi deficiency and phlegm-damp obstructing the lung syndrome were randomly divided into the study group and the control group,with 48 cases in each group.The control group was given conventional comprehensive treatment with western medicine,while the study group was treated with Yangxin Xuanfei Decoction(mainly with the actions of nourishing heart and ventilating lung)based on the treatment for the control group.Both groups of patients were treated for a period of 2 weeks.Changes in the traditional Chinese medicine(TCM)syndrome scores,cardiopulmonary function indexes,pulmonary artery pressure,blood gas analysis indicators,serum inflammatory factors and coagulation status index in the two groups were observed before and after treatment,and the clinical comprehensive efficacy of the two groups after treatment was evaluated.Results(1)After 2 weeks of treatment,the overall effective rate of the study group was 91.67%(44/48)and that of the control group was 70.83%(34/48).The intergroup comparison by rank sum test showed that the clinical comprehensive efficacy of the study group was significantly superior to that of the control group(P<0.05).(2)After treatment,the TCM syndrome scores of patients in both groups were significantly decreased compared with those before treatment(P<0.05),and the effect on decreasing the scores in the study group was significantly superior to that in the control group(P<0.01).(3)After treatment,the early diastolic E-peak velocity to late diastolic Apeak velocity(E/A),left ventricular ejection fraction(LVEF),forced expiratory volume in one second(FEV1)and forced vital capacity(FVC)in both groups were improved compared with those before treatm

关 键 词：养心宣肺汤 慢性肺源性心脏病 急性加重期 心肺功能 炎症因子 凝血状态 

分 类 号：R259.415[医药卫生—中西医结合]