活血化痰苗药“滇瓜散”对慢性阻塞性肺疾病急性加重期血栓前状态干预的临床研究

Clinical Research of Dianguasan with Acute Exacerbation Chronic Obstructive Pulmonary Diseases

目的:观察活血化痰苗药"滇瓜散"对慢性阻塞性肺疾病急性加重期(AECOPD)血栓前状态(PTS)干预的临床疗效,并从细胞因子水平探讨其作用机制。方法:将86例患者随机分为治疗组和对照组,两组均予西药常规治疗,治疗组加服苗药"滇瓜散",3周后观察治疗前后两组患者症状变化,评价临床疗效;并测定治疗前后两组患者血清中TXB2、FIB、s-Es、D-dimer、TNF-α水平。结果:治疗组患者咳、喘及肺部哮鸣音等体征改善明显(P<0.05);两组患者血清中TXB2、FIB、s-Es、D-dimer、TNF-α水平均下降,其中FIB、s-Es、D-dimer、TNF-α等4项指标显著下降,与治疗前的差异具有统计学意义(P<0.05);治疗组血清中TXB2、FIB、s-Es、D-dimer、TNF-α数值显著降低,与对照组的差异具有统计学意义(P<0.05,P<0.01)。结论:活血化痰苗药"滇瓜散"对可有效干预AECOPD血栓前状态,其机制可能是下调TXB2、FIB、s-Es、D-dimer、TNF-α水平,抑制和减轻炎症反应,从而干预PTS。

Objective ：This study is to observe the clinical effect of Dianguasan which is used to interfere prethrombotic state of chronic obstructive pulmonary disease and to explore its function mechanism in terms of cell factors. Methods ：86 patients are ran- domly divided into two groups：the treatment group and the control group. Besides the conventional western medicine therapies that are given to patients from both groups, patients from the treatment group take the Miao ethnic medicine, Dianguasan, as an additional treatment. Observation are made three weeks later to discover the changes that have taken place to patients from both groups and the evaluation of clinical effect is made. The levels of TXB2, FIB, s - Es, and D - dimer, and TNF -α in the blood serum of patients after the treatment are also tested. Results ： Physical signs such as coughing and wheezing are evidently less seen on patients from the controlled group （P 〈 0. 05 ）. There is a decrease of the levels of TXB2, FIB, s - Es, D - dimer, and TNF - α in the blood serum of patients from both groups. The indices of FIB, s - Es, D - dimer, and TNF -α fall so greatly that the difference between them and those before the treatment is of statistic value （P 〈 0. 05 ）. The levels of TXB2, FIB, s - Es, D - dimer,TNF - α in the blood serum of the patients from the treatment group decrease apparently and the difference between these figures and those of the patients from the controlled group is of statistic value （ P 〈 0. 05,P 〈 0. 01 ）. Conclusion：Miao ethnic medicine, Dianguasan, which can invigorate the circulation of blood and is expectorant, can effectively interfere the prethrombotic state of acute exacerbation chronic obstructive pulmonary disease through the mechanism of reducing the levels of TXB2, FIB, s - Es, D - dimer, TNF -α to restrain the inflammation and interfere PTS.