清金化浊方结合西医常规疗法对慢性阻塞性肺疾病急性加重痰热瘀肺证患者血液高凝状态的影响  

Effect of Qingjin Huazhuo Decoction combined with conventional therapy on blood hypercoagulability in patients with acute exacerbation of chronic obstructive pulmonary disease with phlegm-heat stasis and lung syndrome

作　　者：汪伟[1] 黄丽娜 来薛[1] 李珊[1] 吴蔚[1] 张立春[1] 董永丽[1] 董国伟[1] 高峰[1] Wang Wei;Huang Lina;Lai Xue;Li Shan;Wu Wei;Zhang Lichun;Dong Yongli;Dong Guowei;Gao Feng(Respiratory Department,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院呼吸科,北京100102

出　　处：《国际中医中药杂志》2023年第10期1217-1221,共5页International Journal of Traditional Chinese Medicine

基　　金：中国中医科学院望京医院院级科研课题(WJYY2020-20)。

摘　　要：目的探讨清金化浊方结合西医常规疗法对慢性阻塞性肺疾病急性加重(AECOPD)痰热瘀肺证患者血液高凝状态的影响。方法随机对照试验研究。选取2021年4月-2022年3月本院66例AECOPD痰热瘀肺证住院患者作为研究对象,采用随机数字表法分为对照组32例、研究组34例。对照组采用西医常规疗法治疗,研究组在对照组基础上服用清金化浊方。2组均治疗7 d。采用全自动免疫分析仪检测血浆血栓调节蛋白(TM)、凝血酶-抗凝血酶复合物(TAT)、组织纤溶酶原激活物-纤溶酶原激活物抑制剂-1复合物(t-PAIC)、纤溶酶-抗纤溶酶复合物(PIC)及凝血酶原时间(PT)、部分凝血活酶时间(APTT)、D-二聚体水平;采用ELISA法检测血清TNF-α水平,免疫比浊法检测CRP水平。记录治疗期间的不良反应及急性血栓事件。结果治疗期间,66例患者中4例标本溶血,2例误纳入退出研究,最终对照组28例、研究组32例进入疗效统计。治疗后,研究组血浆t-PAIC[(6.19±1.93)μg/L比(7.42±2.71)μg/L,t=2.04]水平低于对照组(P<0.05),血清TNF-α[(71.15±25.25)ng/L比(122.60±98.76)ng/L,t=2.42]水平低于对照组(P<0.05),血浆PT[(11.98±0.74)s比(11.55±0.77)s,t=-2.19]较对照组延长(P<0.05)。研究组住院期间未出现血栓事件,对照组出现1例急性心肌梗死。结论清金化浊方结合西医常规疗法可有效改善AECOPD痰热瘀肺证患者的血液高凝状态。Objective To investigate the effect of Qingjin Huazhuo Decoction combined with conventional western medicine on blood hypercoagulability in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)of phlegm-heat stasis lung syndrome.Methods Randomized controlled trial.According to random number table method,allocation of cases in the observation and control groups.From April 2021 to March 2022,66 hospitalized patients with AECOPD of phlegm-heat stasis and lung syndrome were randomly divided into control group(n=32)and study group(n=34).The control group was treated with conventional western medicine.The study group was treated with Qingjin Huazhuo Decoction on the basis of the control group.Both groups were treated for 7 days.Plasma thrombomodulin(TM),thrombin-antithrombin complex(TAT),tissue plasminogen activator-plasminogen activator inhibitor-1 complex(t-PAIC),plasmin-antiplasmin complex(PIC),prothrombin time(PT),partial thromboplastin time(APTT)and D-dimer levels were measured by automatic immunoassay analyzer;serum TNF-αlevels were measured by ELISA and CRP levels were measured by immunoturbidimetry.Adverse reactions and acute thrombotic events during treatment were recorded.Results During the treatment period,4 of 66 patients had hemolysis,2 were mistakenly included in the withdrawal study,28 in the final control group and 32 in the study group were included for the analyses.After treatment,plasma t-PAIC[(6.19±1.93)μg/L vs.(7.42±2.71)μg/L,t=2.04]level in study group was significantly lower than that of the control group(P<0.05),and the serum TNF-α[(71.15±25.25)ng/L vs.(122.60±98.76)ng/L,t=2.42]level was significantly lower than that of the control group(P<0.05),plasma PT[(11.98±0.74)s vs.(11.55±0.77)s,t=-2.19]was significantly longer than that of the control group(P<0.05).No thrombotic events occurred during hospitalization in the study group,and 1 case of acute myocardial infarction occurred in the control group.Conclusion Qingjin Huazhuo Decoction combined with convention

关 键 词：肺疾病 慢性阻塞性 急性加重 痰热瘀肺证 清金化浊方 高凝状态 

分 类 号：R563.9[医药卫生—呼吸系统]