丹参川芎嗪与无创通气改善老年肺心病患者的心肺功能

Salvia miltiorrhiza ligustrazine injection combined with non-invasive positive pressure ventilation improve heart and lung function in elderly patients with cor pulmonale

目的评价丹参川芎嗪配合无创正压机械通气(non-invasive positive pressure ventilation,NIP-PV)治疗老年肺心病失代偿期患者的临床疗效。方法随机将肺心病失代偿期的老年患者120例分为对照组(常规治疗)和观察组1(丹参川芎嗪+常规治疗),观察组2(NIPPV+常规治疗),观察组3(丹参川芎嗪+NIPPV+常规治疗),观察治疗前后患者的心率、呼吸频率、水肿程度、血气分析及心肺功能等指标。结果治疗1天时4组患者的心率、呼吸频率、水肿症状开始改善,血气分析、心肺功能等指标呈好转趋势,但4组间比较,差异无显著性。治疗7天时,患者心率、呼吸频率、血气分析及肺功能的进一步改善,观察组1、2、3的疗效优于对照组(P<0.05),观察组3的疗效优于观察组1、2(P<0.05),而观察组1与观察组2之间差异无显著性;在治疗水肿、降低肺动脉压及改善右心功能上,观察组1、3疗效优于对照组及观察组2(P<0.05),而观察组1与观察组3之间、观察组2与对照组间疗效接近(P>0.05)。结论丹参川芎嗪配合NIPPV治疗老年肺心病呼吸衰竭并心力衰竭疗效显著,为中西医结合治疗老年肺心病失代偿期开辟新途径。

Objective To evaluate the clinical curative effect of Salvia miltiorrhiza ligustrazine injection combined with non-invasive positive pressure ventilation （NIPPV） on cor pulmonale instable stage as an adjunctive therapy. Methods One hundred and twenty patients with cor pulmonale instable stage were randomly divided into four groups. Thirty cases were in control group and treated with conventional therapy only. Thirty cases were in the first observation group and treated with Salvia mihiorrhiza ligustrazine injection and conventional therapy. Twen- ty-nine cases were in the second observation group and treated with NIPPV and conventional therapy. Thirty-one cases were in the third observation group and treated with Salvia miltiorrhi- za ligustrazine injection combined with NIPPV and conventional therapy. The heart rate, breathing frequency, blood gas analysis, edema and cardio-pulmonary function in the four groups were detected before and after treatment. Results At the 1 st day after treatment, heartrate, respiratory rate decreased, edema and cardio-pulmonary function symptoms began to im- prove, blood-gas analysis showed a better trend. Comparison between the four groups, clinical symptoms and signs, blood-gas analysis and cardio-pulmonary function showed no significant difference. At the 7th day after treatment, clinic efficacy in patients improved more obviously. The first, the second and the third observation group were significantly better than the control group （ P 〈 0.05 ）, and the curative effect of the third observation was better than the first and the second observation group （P 〈 0. 05）. However, Between the first observation group and the second group had no significant difference. In the treatment of controling edema, reducing pulmonary artery pressure and improving the right heart function, the first and the third obser- vation group were significantly better than the second group and control group （ P 〈 0.05 ）. And there were similar effects between group 1 and group 3, group 2 and control group （P 〉 0. 05）. Conclusion The effect of Salvia miltiorrhiza ligustrazine combined with NIPPV for se- nile cor pulmonale breath failure and heart failure is distinct, which affords a new way to treat chronic pulmonary heart disease with the method of integrated traditional Chinese and western medicine.