康艾注射液联合低分子肝素钙治疗老年慢性阻塞性肺疾病急性加重期的临床研究

Clinical study on Kang'ai Injection combined with low molecular weight heparins calcium in treatment of acute exacerbation of chronic obstructive pulmonary disease

目的探讨康艾注射液联合低分子肝素钙治疗老年慢性阻塞性肺疾病急性加重期的临床疗效。方法选取2015年9月—2016年9月在兴安盟人民医院进行治疗的老年慢性阻塞性肺疾病急性加重期患者92例,随机分为对照组(46例)和治疗组(46例)。对照组皮下注射低分子肝素钙注射液,0.6 m L/次,2次/d。治疗组在对照组的基础上静脉滴注康艾注射液,60 m L加入5%葡萄糖注射液250 m L中,1次/d。两组患者均连续治疗2周。观察两组临床疗效,同时比较两组患者治疗前后临床症状评分、肺功能和动脉血气指标以及血清P-选择素和D-二聚体(DD)水平变化。结果治疗后,对照组和治疗组的总有效率分别为80.43%和95.65%,两组总有效率比较差异有统计学意义(P<0.05)。治疗后,两组患者咳嗽、咳痰及气促评分均显著降低(P<0.05);且治疗组上述临床症状评分降低更明显(P<0.05)。治疗后,两组患者第1秒时间肺活量(FEV1)、用力肺活量(FVC)、最大呼气流量(PEF)等肺功能和血氧分压(pO_2)、二氧化碳分压(pCO_2)动脉血气指标水平均明显降低(P<0.05);且与对照组相比,治疗后治疗组降低的更明显(P<0.05)。治疗后,两组患者血清P-选择素和DD水平均明显降低(P<0.05);且与对照组相比,治疗组降低更明显(P<0.05)。结论康艾注射液联合低分子肝素钙治疗老年慢性阻塞性肺疾病急性加重期效果显著,可明显改善患者临床症状及肺功能,具有一定的临床应用价值。

Objective To investigate the clinical efficacy of Kang＇ai Injection combined with low molecular weight heparins calcium in treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods Patients （92 cases） with acute exacerbation of chronic obstructive pulmonary disease in Neimenggu Xing＇an League People＇s Hospital from September 2015 to September 2016 were randomly divided into the control （46 cases） and treatment （46 cases） groups. The patients in the control group were sc administered with Low Molecular Weight Heparins Calcium Injection, 0.6 mL/time, twice daily. The patients in the treatment group were iv administered with Kang＇ai Injection on the basis of the control group, 60 mL added into 5% glucose injection 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the changes of clinical symptom scores, pulmonary function and arterial blood gas indexes, serum levels of P-selectin and DD in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment group were 80.43% and 95.65%, respectively, and there were differences between two groups （P 〈 0.05）. After treatment, cough, expectoration, and shortness of breath scores in two groups were significantly decreased （P 〈 0.05）. And these clinical symptom scores in treatment group were more significantly decreased than those in the control group （P 〈 0.05）. After treatment, FEV1, FVC, PEF, pO2, and pCO2 in two groups were significantly decreased （P 〈 0.05）. And compared with the control group, these observation indexes in the treatment group were more obviously decreased than those in the control group （P 〈 0.05）. After treatment, P-selectin and DD levels in two groups were significantly decreased （P 〈 0.05）. And compared with the control group, these indicators in the treatment group were more significantly decreased than those in the control group （P 〈 0.05）. Conclusion Kang＇ai Injection combined with low molecularweight heparins calcium has a significant clinical efficacy in treatrnent of acute exacerbation of chronic obstructive pulmonary disease, can significantly improve the clinical symptoms and pulmonary function, which has a certain clinical application value.