益气活血化痰法对慢性阻塞性肺疾病急性期患者肺功能及凝血的影响

Effects of Qi-supplementing, Blood-activating And Phlegm-resolving on Lung Function And Blood Coagulationin Among Patients of Chronic Obstructive Pulmonary Disease in Acute Stage

目的:观察益气活血化痰法对慢性阻塞性肺疾病(COPD)急性期血瘀证患者的疗效及对肺功能的改善情况,同时观察该法对患者血浆纤维蛋白原、D-二聚体的影响,为COPD的中医临床治疗提供参考。方法:选取2015年10月至2017年7月在山东省临朐县人民医院就诊且符合血瘀证的174例COPD急性期患者,随机分为对照组和研究组,对照给予常规西药治疗,研究组在常规西药治疗基础上加用益气活血化痰法的中药治疗。观察两组患者的临床疗效、治疗前后肺功能改变及血浆纤维蛋白原、D-二聚体变化。结果:研究组总疗效为95.4%,对照组总疗效为79.3%,差异有统计学意义(P<0.05)。Pearson相关性研究显示血浆纤维蛋白原(r=-0.79,P<0.05)、D-二聚体(r=-0.84,P<0.05)与PaO_2呈密切负相关。治疗前两组患者肺功能及血浆纤维蛋白原、D-二聚体无明显差异(P>0.05),治疗后两组患者各项指标均明显改善,其中研究组患者改善更为明显,组间比较差异有统计学意义(P<0.05)。结论:血浆纤维蛋白原、D-二聚体表达水平COPD关系密切,益气活血化痰法可改善COPD急性期患者的临床症状、血瘀状态及肺功能,疗效显著。

This study was aimed to observe the therapeutic effect of qi-supplementing, blood-activating and phlegmresolving on chronic obstructive pulmonary disease（COPD） patients with blood stasis syndrome in the acute stage, and to evaluate the lung function improvement condition. Observation was also made on plasma fibrinogen and D-dimer, in order to provide references for traditional Chinese medicine（TCM） clinical treatment of COPD. A total of 174 acute COPD patients with blood stasis syndrome were selected from October 2015 to July 2017 in the Linqu County Peoples Hospital of Shandong Province. Patients were randomly divided into the control group and the study group. Conventional western medicine treatment was given to the control group. On the basis of routine western medicine treatment, the study group was treated with TCM qi-supplementing, blood-activating and phlegm-resolving method. The clinical efficacy,changes of lung function, plasma fibrinogen and D-dimer before and after treatment were observed in both groups. The results showed that the total efficacy of the study group was 95.4%, and the total efficacy of the control group was 79.3%.The difference was statistically significant（P〈0.05）. Pearson correlation study showed that plasma fibrinogen（r =-0.79,P〈0.05） and D-dimer（r =-0.84, P〈0.05） were negatively correlated with PaO2. Before treatment, there was no significant difference in lung function, plasma fibrinogen and D-dimer between two groups（P〈0.05）. After treatment,indicators of both groups were significantly improved, in which the improvement of the study group was more obvious.The difference between two groups was statistically significant（P〈0.05）. It was concluded that the expression levels of plasma fibrinogen and D-dimer were closely related to COPD. Qi-supplementing, blood-activating and phlegmresolving method can improve clinical symptoms, blood stasis status and lung function of COPD patients in the acute stage with remarkable curative effect.