金匮肾气丸加减配合丹参川芎嗪注射液治疗慢性肺源性心脏病临床研究

Clinical study on the effect of Jingui-Shenqi pill combined with salvia miltiorrhiza ligustrazine injectionfor the chronic pulmonary heart disease

目的 评价金匮肾气丸加减配合丹参川芎嗪注射液治疗慢性肺源性心脏病（chronic pulmonary heart disease,CPHD）的疗效.方法 将符合入选标准的CPHD住院患者150例,按病历尾号随机分为2组,每组75例.对照组在西医常规治疗基础上静脉注射丹参川芎嗪注射液,观察组在对照组基础上配合服用加减金匮肾气丸.2组均治疗14 d.采用纽约心脏病协会（New York Heart Association,NYHA）心功能分级标准评价心功能,并进行血气分析及心脏指数、肺动脉压（pulmonary artery pressure,PASP）及外周阻力心收缩力（peripheral resistance heart contraction force,BPPaO2）、PaCO2、动脉血氧饱和度（arterial blood oxygen saturation,SaO2）检测,评价临床疗效.结果 观察组总有效率为92.0%（69/75）、对照组为78.7%（59/75）,2组比较差异有统计学意义（χ2=5.842,P=0.020）.治疗后,观察组心功能I级患者37例（49.3%）明显多于对照组的24例（32.0%）（χ2=7.368,P=0.001）.治疗后,观察组心脏指数[（4.82±1.57）L·min-1·m-2比（3.76±1.30）L·min-1·m-2,t=6.542]、BPPaO2[（9.86±1.53）kPa比（8.53±1.40）kPa,t=5.956]、SaO2[（99.65±2.83）%比（96.03±5.47）%,t=7.062]高于对照组（P〈0.05）,PASP[（4.01±0.53）kPa比（5.42±0.83）kPa,t=4.986]、PaCO2[（6.12±0.36）kPa比（6.37±0.34）kPa,t=5.024]低于对照组（P〈0.05）.结论 金匮肾气丸加减配合丹参川芎嗪注射液可明显改善CPHD患者心肺功能,疗效优于西医常规疗法配合丹参川芎嗪注射液治疗.

Objective To evaluate the clinical curative effect ofJingui-Shenqipill combined with salvia miltiorrhiza ligustrazine injection treatment for CPHD.Methods A total of 150 patients with CPHD were randomly divided into the observation group and control group according to the medical records number, 75 patients in each group.The control group was given intravenous salvia miltiorrhiza ligustrazine injection on the basis of the conventional western medicine treatment, and the observation group takingJingui-Shenqipill on the basis of the control group, two weeks as a course. The New York heart association （NYHA） classification standard, heart function and blood gas analysis and lung function related indicators, and the clinical curative effect were assessed.Results The observation group total effective rate was 92.0% （69/75）, the control group was 78.7% （59/75）. There was statistical significance between two groups （χ2=5.842,P=0.020）. After treatment, the observation group of patients with cardiac function grade I have 37 patients （49.3%）, significantly more than the control group of 24 patients （32.0%）, （χ2=7.368,P=0.001）; After treatment, the CI （4.82 ± 1.57 L·min-1·m-2 vs.3.76 ± 1.30·min-1·m-2,t=6.542）, BPPaO2 （9.86 ± 1.53 kPavs.8.53 ± 1.40 kPa,t=5.956）, SaO2 （99.65% ± 2.83%vs.96.03% ± 5.47%,t=7.062） in the observation group were significantly higher than those in the control;group （P〈0.05）. The PASP （4.01 ± 0.53 kPavs.5.42 ± 0.83 kPa,t=4.986）, PaCO2 （6.12 ± 0.36 kPavs.6.37 ± 0.34 kPa, t=5.024） in the observation group were significantly lower than those in the control group （P〈0.05）. Conclusions TheJingui-Shenqi pill combined with salvia miltiorrhiza ligustrazine injection could improve CPHD cardiopulmonary function and curative effect, compared with the conventional western medicine therapy combined with salvia miltiorrhiza ligustrazine injection treatment.