辨证分型血府逐瘀汤+二陈汤苓+桂术甘汤联合西药治疗肺栓塞(痰瘀互结、水饮凌心)随机平行对照研究

Randomized Controlled Study of Xuefu Zhuyu Decoction combined with Western Medicine in Treatment of Pulmonary Embolism (Obstruction of Collaterals by Blood Stasis,Edema due to Yang Insufficiency or Yang Qi Collapse)

[目的]观察辨证分型血府逐瘀汤+二陈汤苓+桂术甘汤联合西药治疗肺栓塞(痰瘀互结、水饮凌心)随机平行对照研究疗效。[方法]将48例住院患者按数字表法随机分治疗组和对照组各24例;低氧血症氧疗;合并下肢深静脉栓塞卧床休息。对照组予以低分子肝素、尿激酶溶栓、华法林。治疗组,辨证分型,痰瘀互结:血府逐瘀汤+二陈汤;水饮凌心,血府逐瘀汤+苓桂术甘汤;1剂/d,水煎300 m L,早晚口服;西药治疗同对照组。连续治疗10d为1疗程。观测临床表现、PCO2、PO2、心率、呼吸频率、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组显效20例,有效3例,无效1例,总有效率98.80%;对照组显效16例,有效5例,无效3例,总有效率87.50%;两组间无明显差异(P>0.05)。呼吸频率两组均有改善(P<0.05,P<0.01),PCO2、Pa O2、心率治疗组明显改善(P <0.05,P<0.01),对照组无明显变化(P>0.05)。[结论]辨证分型血府逐瘀汤+二陈汤苓+桂术甘汤联合西药治疗肺栓塞(痰瘀互结、水饮凌心),疗效满意,无严重不良反应,值得推广。

[Objective]To observe the curative effect of Xuefu Zhuyu decoction combined with western medicine in the treatment of pulmonary embolism( obstruction of collaterals by blood stasis,edema due to Yang insufficiency or Yang Qi collapse). [Method]By the randomized parallel control method,48 hospitalized patients were randomly divided into two groups according to digital table method. Oxygen therapy was for patients with hypoxemia. Patients with deep vein embolism of lower extremity needed bed rest. The control group was given low molecular weight heparin,urokinase thrombolysis and warfarin. Treatment group’s 24 cases were given Xuefu Zhuyu decoction + Erchen decoction( obstruction of collaterals by blood stasis) or Xuefu Zhuyu decoction + Linggui Zhugan decoction( edema due to Yang insufficiency or Yang Qi collapse),1 dose/d. The western medicine treatment was the same as that of the control group. Continuous treatment for 10 days was a course of treatment. We observed the clinical manifestations,PCO2,PaO2,heart rate,respiratory rate and adverse reactions. After continuous treatment for 2 courses,the efficacy was determined.[Result]In the treatment group,20 cases were markedly effective,3 cases were effective and 1 case was ineffective. The total effective rate was 98. 80%. In the control group,16 cases were markedly effective,5 cases were effective and 3 cases were ineffective. The total effective rate was 87. 50%. There was no significant difference between the two groups( P > 0. 05). The respiratory frequency was improved in both groups( P < 0.05,P < 0.01). PCO2,PaO2 and heart rate were improved in the treatment group before and after treatment( P < 0. 05,P < 0. 01). There was no significant difference in the control group( P > 0.05). The improvement of treatment group was better than that of the control group( P<0.05,P<0.01). [Conclusion]The treatment of pulmonary embolism with Xuefu Zhuyu Decoction and western medicine (obstruction of collaterals by blood stasis,edema due to Yang insufficiency or Yang Qi collapse) has satisfactory curative effect,with no serious adverse reactions. It is worthy of promoting.