活血化瘀辅助治疗慢性肺源性心脏病脾肾阳虚症的观察

Observation of blood-activating and stasis-dissolving drugs in adjuvant treatment of spleen-kidney yang deficiency syndrome of chronic pulmonary heart diseases

目的探讨活血化瘀辅助治疗慢性肺源性心脏病脾肾阳虚症的疗效。方法选择肺心病脾肾阳虚症患者25例,在常规治疗的基础上加参麦注射液,川芎嗪注射液12d,观察治疗前后两组患者二氧化碳分压(Pa CO2)、血氧分压(Pa O2)和脑钠肽(BNP)变化情况,并与25例常规治疗组比较。结果治疗组治疗前Pa CO2、Pa O2、BNP水平分别为(75.3±6.1)mm Hg、(52.8±4.5)mm Hg和(3726.8±651.5)pg/m L,治疗后为(52.4±5.2)mm Hg、(67.3±3.4)mm Hg和(245.6±83.7)pg/m L;对照组治疗前为(74.9±5.1)mm Hg、(53.2±4.1)mm Hg和(3635.4±688.5)pg/m L,治疗后为(66.7±5.5)mm Hg、(58.5±3.7)mm Hg和(533.1±156.5)pg/m L。两组Pa CO2、BNP治疗前水平高,治疗后水平下降(P<0.01),Pa O2治疗前水平低,治疗后提高(P<0.01),提示两组治疗均有效,治疗组和对照组治疗前Pa CO2、Pa O2和BNP水平比较差异无统计学意义(P>0.05),治疗组治疗后Pa CO2、BNP水平,Pa O2水平较对照组好(P<0.01),提示参麦注射液,川芎嗪注射液辅助治疗肺心病治疗优于常规治疗组。结论活血化瘀辅助治疗肺心病可有效改善慢性肺源性心脏病患者血清Pa CO2,Pa O2和BNP水平,对改善患者心肺功能,提高对临床疗效有益。

Objective To explore curative effect of blood-activating and stasis-dissolving drugs in adjuvant treatment of spleen-kidney yang deficiency syndrome of chronic pulmonary heart diseases. Methods 25 patients with spleen-kidney yang deficiency syndrome of chronic pulmonary heart diseases were selected. They received shenmai injection and tetramethylpyrazine injection for 12 days at the basis of routine treatment. Changes of partial pressure of carbon dioxide in arterial blood（Pa CO2）, alveolar oxygen partial pressure（Pa O2） and brain natriuretic peptide（BNP） before and after treatment of patients in two groups were observed. In addition, they were compared with 25 cases in routine treatment group. Results Pa CO2, Pa O2 and BNP levels before treatment of the treatment group were（75.3±6.1）mm Hg,（52.8±4.5）mm Hg and（3726.8±651.5）pg/m L. Pa CO2, Pa O2 and BNP levels after treatment of the treatment group were（52.4±5.2）mm Hg,（67.3±3.4）mm Hg and（245.6±83.7）pg/m L. PaCO2, PaO2 and BNP levels before and after treatment of the control group were（74.9±5.1）mm Hg,（53.2±4.1）mm Hg,（3635.4±688.5）pg/m L and（66.7±5.5）mm Hg,（58.5±3.7）mm Hg,（533.1±156.5）pg/m L respectively. Pa CO2 and BNP levels of two groups were high and they were decreased after treatment（P〈0.01）. Pa O2 level before treatment was low and it was improved after treatment（P〈0.01）, suggesting that treatment of two groups were effective. Differences in Pa CO2, Pa O2 and BNP levels before treatment of the treatment group and the control group had no statistical significance（P〉0.05）. Pa CO2,Pa CO2 and BNP levels after treatment of the treatment group were better than that of the control group（P〈0.01）, suggesting that shenmai injection and tetramethylpyrazine injection in adjuvant treatment of pulmonary heart diseases had a better curative effect than that of the routine treatment group. Conclusion Blood-activating and stasis-dissolving drugs in adjuvant treatment of chronic pulmonary heart diseases can effectively improve Pa CO2, Pa O2 and BNP levels of patients which are benefit to improve patients＇ cardiopulmonary function and clinical curative effect.