益气温阳活血化痰方药治疗慢性阻塞性肺疾病合并肺动脉高压的临床疗效研究

Study on clinical effect of Yiqi Wenyang and Huoxue Huatang Prescription on the pulmonary artery pressure with COPD

目的:探讨益气温阳活血化痰方药对慢性阻塞性肺疾病(COPD)合并肺动脉高压患者临床疗效的影响。方法:选取COPD合并肺动脉高压患者,随机分为对照组和治疗组。治疗组在常规治疗基础上给予益气温阳活血化痰方药口服,共12周;观察患者治疗前后临床症状、生活质量、6min步行距离及Borg呼吸困难评分,超声心动图测肺动脉压力,检测血浆一氧化氮(NO)和内皮素-1(ET-1)水平。结果:两组治疗后临床症状、生活质量、肺动脉压力、6min步行距离、Borg呼吸困难评分、NO和ET-1均得到明显改善(P<0.05),但治疗组在改善咳嗽、喘息和紫绀症状、提高生活质量和6min步行距离、降低Borg呼吸困难评分、调节NO和ET-1等方面明显优于对照组(P<0.05);治疗组总有效率显著优于对照组(P<0.05)。结论:益气温阳活血化痰方药能提高COPD合并肺动脉高压患者的临床疗效,可能与调节血管活性物质水平有关。

Objective：To investigate the clinical efficacy of Yiqi Wenyang and Huoxue Huatang Prescription（YWHH）on chronic obstructive pulmonary disease（COPD） complicated by pulmonary hypertension.Methods：Fifty-six cases of COPD complicated by pulmonary hypertension were randomly divided into the control group and the treatment group.The treatment group was added Yiqi Wenyang and Huoxue Huatang Prescription on the basis of conventional therapy.The changes in the mean pulmonary artery pressure,major clinical symptoms,life quality,the 6min walk test distance,Brog dyspnea score and the levels of endothelin-1（ET-1） and nitric oxide（NO） were observed in both groups for 12 weeks.Results：There were significant differences before and after treatment in two groups on the major clinical symptoms,life quality,6min walk test distance,Brog dyspnea score,SPAP,the level of NO and ET-1（P〈0.05）.However,compared with the control group,the symptoms of cough,gasping and cyanosis were significantly improved,the scores of life quality and Brog dyspnea were significantly decreased,the 6min walk test distance was significantly increased,the level of NO and ET-1 were regulated in treatment group（P〈0.05）.There was significantly difference the total effective rate between the treatment group and control group（P〈0.05）.Conclusion：The results suggest that YWHH could improve the COPD combined pulmonary hypertension clinical efficacy.Furthermore,it has one of a possible mechanism effects on regulating the plasma NO and ET-1 level.