摘要
目的:观察豁痰祛瘀方联合大剂量重组织型纤溶酶原激活剂(recombinant tissue-type plasminogen activator,rt-PA)溶栓治疗急性肺栓塞的临床疗效,并观察对中医证候积分、血气分析指标、肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)、D-二聚体水平的影响。方法:142例急性肺栓塞患者按抽签方式分为对照组(n=71)与观察组(n=71)。对照组患者给予大剂量rt-PA溶栓治疗,观察组在对照组基础上给予豁痰祛瘀方。比较治疗前后两组血气分析(PaCO_2、PaO_2)、临床证候积分、TNF-α、D-二聚体的水平,并评价两组患者临床疗效。结果:观察组有效率为94.37%(67/71),明显高于对照组的81.69%(58/71),差异具有统计学意义(P<0.05)。治疗后,观察组中医证候积分为(9.36±1.55)分,对照组中医证候积分为(15.64±1.47)分,两组比较,差异有统计学意义(P<0.05)。治疗后,对照组PaCO_2、PaO_2分别为(33.52±1.26)mm Hg(1 mm Hg=0.133 k Pa)、(75.63±1.67)mm Hg,观察组PaCO_2、PaO_2分别为(37.21±1.33)mm Hg、(80.24±1.87)mm Hg,两组比较,差异均有统计学意义(P<0.05)。治疗后,对照组TNF-α、D-二聚体分别为(4.35±1.42)μg·L^(-1)、(486.52±121.42)μg·L^(-1),观察组分别为(2.52±0.87)μg·L^(-1)、(425.63±102.35)μg·L^(-1),两组比较,差异均有统计学意义(P<0.05)。结论:豁痰祛瘀方联合大剂量rt-PA溶栓治疗急性肺栓塞,可显著提高临床疗效,缓解临床症状,提高血气分析指标,降低TNF-α、D-二聚体的水平。
Objective: To investigate the clinical efficacy of Huotan Quyu decoction combined with large doses of recombinant tissue-type plasminogen activator( rt-PA) thrombolysis in the treatment of acute pulmonary embolism( APE) and its influence on TCM syndrome integral,blood gas analysis index,tumor necrosis factor-alpha( TNF-α) and D-Dimer level. Methods: 142 cases of APE patients were divided into control group( n = 71) and observation group by draw lots. Control group took large doses of rt-PA thrombolysis and observation group took Huotan Quyu decoction on the basis of control group. The arterial blood gas analysis( PCO2,PO2),clinical symptom,TNF-α,D-Dimer level of two groups before and after treatment were compared,and clinical efficacy of two groups were evaluated. Results: The effective rate of observation group was 94. 37%( 67/71),which was significantly higher than 81. 69%( 58/71) of control group( P〈 0. 05); after treatment,TCM syndrome integral of the observation group was( 9. 36 ± 1. 55) points,the control group was( 15. 64 ± 1. 47),the difference was statistically significant( P 〈0. 05). After treatment,PCO2,PO2 of the control group respectively were( 33. 52 ± 1. 26) mm Hg( 1 mm Hg = 0. 133 k Pa),( 75. 63 ± 1. 67)mm Hg,and the observation group were respectively( 37. 21 ± 1. 33) mm Hg,( 80. 24 ± 1. 87) mm Hg,the differences were statistically significant( P 〈0. 05). After treatment,TNF-α,D-two dimers of the control group were( 4. 35 ± 1. 42) μg · L-1,( 486. 52 ± 121. 42) μg·L-1,and the observation group respectively( 2. 52 ± 0. 87) μg·L-1,( 425. 63 ± 102. 35) μg·L-1,and the differences were statistically significant( P〈 0. 05). Conclusion: Huotan Quyu decoction combined with large doses of rtPA thrombolysis for treating APE can effectively improve clinical efficacy,relieve clinical symptom and improve blood gas analysis index,reduce the level of TNF-α alpha and D-Dimer two dimer level.
出处
《中医学报》
CAS
2017年第10期1870-1874,共5页
Acta Chinese Medicine
基金
江苏省中医药管理局课题(LZ09041)
江苏省医学重点人才项目(RC2011066)
关键词
豁痰祛瘀方
重组织型纤溶酶原激活剂
急性肺栓塞
血气分析
肿瘤坏死因子-α
D-二聚体
中西医结合
Human Quyu decoction
recombinant tissue-type plasminogen activator
acute pulmonary embolism
blood gas analysis
tumor necrosis factor alpha
D-Dimer
combination of traditional Chinese and Western medicine