痰热清注射液联合华法林治疗老年慢性阻塞性肺疾病疗效观察

Clinical observation of treatment of chronic obstructive pulmonary disease with tanreqing injection combined with warfarin

目的探讨痰热清注射液联合华法林治疗老年慢性阻塞性肺疾病临床疗效及对病人免疫功能和血清炎性因子水平的影响。方法以2017年1月至2018年1月我院收治的76例慢性阻塞性肺疾病病人为研究对象。按照随机数字表法分为观察组和对照组,每组各38例。所有病人均给予常规治疗,对照组给予华法林抗凝治疗,观察组在对照组基础上给予痰热清注射液静脉滴注治疗。比较2组病人临床疗效、不良反应发生情况及治疗前后血气指标、肺功能、体液免疫指标(CD4+、CD8+、CD4+/CD8+)、凝血功能指标(D-二聚体)、血清炎性因子[C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子α(TNF-α)]变化情况。结果观察组总有效率为89.47%,对照组为71.05%,2组比较差异具有统计学意义(P<0.05)。治疗前,2组病人酸碱度(pH)值、动脉血二氧化碳分压(PaCO 2)、动脉血氧分压(PaO 2)、一秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、CD4+、CD8+、CD4+/CD8+、D-二聚体、CRP、PCT、TNF-α水平比较差异无统计学意义(P>0.05)。治疗后,2组病人pH值、PaO 2、FEV1、FVC、FEV1/FVC、CD4+、CD4+/CD8+水平均显著上升,而PaCO 2、CD8+、D-二聚体、CRP、PCT、TNF-α水平均显著下降(P<0.05),且观察组除外D-二聚体水平,上述指标改善均较对照组更显著(P<0.05)。治疗期间,2组均有2例病人出现不良反应,表现为轻度恶心、呕吐。结论痰热清注射液联合华法林治疗慢性阻塞性肺疾病临床效果显著,可促进病人免疫功能恢复,改善凝血功能,降低炎性反应,且不良反应发生率低。

Objective To investigate the clinical efficacy of Tanreqing injection combined with warfarin in the treatment of chronic obstructive pulmonary disease and the effects on immune function and the levels of serum inflammatory factors.Methods Seventy-six patients with chronic obstructive pulmonary disease admitted to our hospital from January 2017 to January 2018 were enrolled.According to the random number table method,76 cases were divided into observation group and control group.The control group was given warfarin on the basis of conventional treatment,and the observation group was given intravenous infusion of Tanreqing injection on the basis of the control group.The clinical efficacy,adverse reactions and blood gas indexes,lung function and humoral immunity indexes(CD4+,CD8+,CD4+/CD8+),coagulation function index(D-dimer),serum inflammatory factors[C reactive protein(CRP),procalcitonin(PCT),tumor necrosis factorα(TNF-α)]were compared between the two groups.Results The total effective rate was 89.47%in the observation group,compared with 71.05%in the control group(P<0.05).Before treatment,there were no significant differences in pH,PaCO 2,PaO 2,FEV1,FVC,FEV1/FVC,CD4+,CD8+,CD4+/CD8+,D-dimer,CRP,PCT,TNF-αlevels between the two groups(P>0.05).After treatment,the levels of pH,PaO 2,FEV1,FVC,FEV1/FVC,CD4+,CD4+/CD8+of the two groups increased significantly,while the levels of PaCO 2,CD8+,D-dimer,CRP,PCT and TNF-αwere significantly decreased(P<0.05),especially in the observation group except D-dimer(P<0.05).During the treatment period,two patients in both groups had mid adverse reactions.Conclusions Tanreqing injection combined with warfarin has significant clinical effects in the treatment of chronic obstructive pulmonary disease,which can promote the recovery of immune function,improve blood coagulation function,reduce inflammatory reaction,and the incidence of adverse reactions is low.