加味千金苇茎汤治疗肺源性心脏病急性加重期及其对内皮细胞保护作用的研究

Study on effect of modified Qianjin Weijing decoction(加味千金苇茎汤) on cor pulmonale of acute aggravated stage and its protective effect on endothelial cells

目的:观察加味千金苇茎汤对慢性肺源性心脏病(肺心病)急性加重期患者的临床疗效以及对可溶性血栓调节蛋白(sTM)的影响。方法:60例肺心病急性加重期患者随机分为两组,每组各30例。对照组单用常规西药治疗;治疗组在常规西药治疗基础上加用加味千金苇茎汤。治疗前和治疗后10d,分别测定并记录两组患者的症状、体征、血气分析及血浆sTM水平,并进行临床分析。结果:治疗组显效率为70.00%,明显高于对照组23.33%(P<0.01);两组患者治疗后sTM水平、动脉血氧分压、动脉血二氧化碳分压均较治疗前明显改善(P均<0.01),且治疗组更优于对照组(P均<0.05)。结论:加味千金苇茎汤具有清肺化痰、散结通瘀的作用,能有效保护血管内皮系统,有利于慢性肺心病急性加重期患者的治疗。

Objective: To investigate clinical therapeutic effect of modified Qianjin Weijing decoction(加味千金苇茎汤) on acute aggravated stage of cor pulmonale and its effect on soluble thrombomodulin(sTM). Methods: Sixty patients who suffered from cor pulmonale in acute aggravated stage were divided randomly into two groups (n=30 in each group). The patients of control group were treated with routine medicine only and the patients of treatment group were treated with modified Qianjin Weijing decoction beside of routine treatment. The symptoms and signs, blood gas indices and sTM were recorded and analyzed in all patients before and 10 days after treatment. Results: The effective rate in treatment group (70.00%) was higher than that of control group(23.33%, P<0.01). The sTM, partial pressure of oxygen in artery (PaO_2) and partial pressure of carbon dioxide (PaCO_2) were improved in both groups after treatment compared with those before treatment (all P<0.01), especially in the treatment group (all P<0.05). Conclusion: Modified Qianjin Weijing decoction can protect vascularendothelial system effectively through clearing lung and dispersing sputum (清肺化痰) as well as resolving masses and removing blood stasis (散结通瘀), and is beneficial to the treatment of patients with cor pulmonale in acute aggravated stage.