真武汤合苏葶丸治疗肺心病急性发作期合并左心衰竭的临床疗效及作用机制

Clinical Effect and Mechanism of Action of ZhenWu Tang Combined with SuTing Pill in Treating Pulmonary Heart Disease at Acute Attack Stage Complicated with Left Heart Failure

目的:观察真武汤合苏葶丸治疗肺心病急性发作期(AECPHD)合并左心衰竭(LHF)的临床疗效,并分析其作用机制。方法:将78例AECPHD合并LHF患者随机分为2组,观察组39例应用常规西医综合治疗,对照组39例在对照组的基础上加用真武汤合苏葶丸治疗,对比2组的临床疗效及相关实验室指标。结果:总有效率观察组为94.87%,对照组为84.62%,2组比较差异有统计学意义(P<0.05);中医证候积分、二氧化碳分压(Pa CO_2)、血清白介素-8(IL-8)、血清氨基末端B型利钠肽前体(NT-pro BNP)及血浆内皮素-1(ET-1)治疗后观察组均显著低于对照组(P<0.05),左室射血分数(LVEF)、第1秒用力肺活量(FEV1)、用力肺活量(FVC)、FEV_1/FVC、及血氧分压(Pa O_2)、血浆一氧化氮(NO)均显著高于对照组(P<0.05)。结论:真武汤合苏葶丸治疗AECPHD合并LHF能够通过调节炎症因子、改善心肺血管功能、降低血NT-pro BNP等而提高临床疗效,改善临床症状。

Objective： To observe therapeutic effect of ZhenWu Tang combined with SuTing pill for acute exacerbation chronic pulmonary heart disease （AECPHD） complicated with left heart failure （LHF） and analyze its mechanism of action. Methods： Seventy-eight patients with AECPHD complicated with LHF were divided into two groups at random： thirty-nine patients from the observation group were treated comprehensively with conventional western medicine and thirty-nine patients from the control group were treated with ZhenWu Tang combined with SuTing pill on the basis of the control group. Clinical efficacy and related laboratory indexes of the two groups were compared. Results： Total effective rate of the observation group was 94.87% and the control group was 84.62%. The difference was statistically significant between the two groups （P〈0.05）. After treatment, TCM syndrome scores, partial pressure of carbon dioxide （PaCO2）, Serum interleukin-8 （IL-8）, Serum amino terminal B type natriuretic peptide （NT-proBNP） and endothelin-1 （ET-1） of the observation group were all significantly lower than those of the control group （P〈0.05）.The plasma nitric oxide （NO）, forced vital capacity of the first second （FEV0, forced vital capacity （FVC）, FEV1/FVC, left ventricular ejection fraction（LVEF）, and partial pressure of blood oxygen（PaO2） of the observation group were all significantly higher than those of the control group （P〈0.05）. Conclusion： The treatment of ZhenWu Tang combined with SuTing pill for AECPHD complicated with LHF can enhance curative effect as well as ameliorate clinical symptoms through regulating inflammatory factors, improving cardiovascular and pulmonary function, reducing blood NT-proBNP and so on.