清气化痰通络方治疗慢性阻塞性肺疾病急性加重期临床观察

Clinical efficacy of Qingqi Huatan Tongluo Decoction on treatment of acute exacerbation of chronic obstructive pulmonary disease

目的:清气化痰通络方治疗慢性阻塞性肺疾病急性加重期的临床疗效及对细胞因子、血液流变学和血栓前状态的影响。方法:将64例患者随机分为对照组与治疗组各32例,对照组给予西医常规治疗,治疗组在对照组基础上加服清气化痰通络方治疗,两组疗程均为14d。比较两组患者治疗前后中医证候积分,肺功能,血气分析,血液流变学指标,血清缺氧诱导因子-1α(HIF-1α)、白介素-6(IL-6)、白介素-8(IL-8)水平和血浆血管性血友病因子裂解酶(ADAMTS-13)、血管性血友病因子(vWF)、纤维蛋白原(Fg)水平及临床疗效。结果:治疗组临床疗效总有效率为96.67%,对照组为76.67%,治疗组显著优于对照组(P<0.05)。对照组治疗后中医证候积分、血清HIF-1α、IL-6、IL-8、血浆vWF水平与治疗前比较显著降低、PO2显著升高(P<0.05);治疗组治疗后中医证候积分、全血高切黏度、全血低切黏度、血浆黏度、血清HIF-1α、IL-6、IL-8水平、血浆vWF、Fg水平与治疗前比较显著降低,FEV1、FEV1%、FEV1/FVC、SaO2、PaO2和血浆ADAMTS-13水平与治疗前比较显著升高(P<0.05),且均优于对照组(P<0.05)。结论:清气化痰通络方治疗慢性阻塞性肺疾病急性加重期疗效确切且安全,能够有效缓解患者临床症状并改善肺功能,还能减轻患者炎性反应和血栓前状态发生。

Objective:To explore the clinical efficacy and effect of Qingqi Huatan Tongluo Decoction on treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and on cytokines,hemorheology and prothrombotic state.Methods:sixty-four AECOPD patients were randomly divided into control group(32 cases)and therapy group(32 cases)by random number table,The control group was treated with conventional therapy,based on the treatment in control group,the patients in therapy group also received the Qingqi Huatan Tongluo Decoction.The treatment course was 14 days for both groups.The main outcome measures were scores of TCM syndrome,the secondary indicators were pulmonary function,arterial blood gas analysis,and hemorheology indexes,In addition,the levels of serum Hypoxia inducible factor-1α(HIF-1α),interleukin-6(IL-6),interleukin-8(IL-8),plasma A Disintegrin-like and Metalloprotease with Thrombospondin type I repeats-13(ADAMTS-13),von Willebrand Factor(vWF),Fibrinogen(Fg)were detected,furthermore,Clinical efficacy was evaluated.Results:The total clinical effective rate was 96.67%in therapy group,higher than 76.67%in control group(P<0.05).After treatment,the TCM syndrome score,serum HIF-1α,IL-6,IL-8 and plasma vWF levels in the control group were significantly lower and PO2 was significantly higher than before treatment(P<0.05).After treatment,the TCM syndrome score,whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,serum HIF-1α,IL-6,IL-8 levels,plasma vWF,Fg levels in the treatment group were significantly lower than those before treatment,and the levels of FEV1,FEV1%,FEV1/FVC,SaO2,PaO2 and plasma ADAMTS-13 were significantly higher than those before treatment(P<0.05),and were all better than those in the control group(P<0.05).Conclusion:Qingqi Huatan Tongluo Decoction can control the symptoms safely,can relieve the patient’s clinical symptoms and improve pulmonary function,and can also reduce the patient’s inflammatory response and prothrombotic state.