加味川芎平喘合剂治疗痰瘀阻肺型慢性阻塞性肺疾病急性加重期合并肺动脉高压临床观察

Clinical observation of modified Chuanxiong Pingchuan mixture in the treatment of pulmonary hypertension combined with acute exacerbation of chronic obstructive pulmonary disease of phlegm and blood stasis obstructing lung type

目的观察加味川芎平喘合剂治疗痰瘀阻肺型慢性阻塞性肺疾病急性加重期(AECOPD)合并肺动脉高压的临床疗效。方法将80例痰瘀阻肺型AECOPD合并肺动脉高压患者按照随机数字表法分为2组。对照组40例予西医常规治疗;治疗组40例在对照组治疗基础上应用加味川芎平喘合剂。2组均治疗14 d。比较2组疗效;观察2组治疗前后中医证候评分变化;观察2组治疗前后肺动脉压及血清Rho关联含卷曲螺旋蛋白激酶1(ROCK1)水平变化。结果治疗组总有效率95.0%(38/40),对照组总有效率90.0%(36/40),2组疗效比较差异无统计学意义(P>0.05)。治疗后2组中医证候评分及总评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。治疗后2组肺动脉压、血清ROCK1水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论加味川芎平喘合剂治疗痰瘀阻肺型AECOPD合并肺动脉高压,可改善患者中医证候,降低肺动脉压,其机制可能与降低血清ROCK1水平、改善血管内皮收缩及重构功能有关。

Objective To observe the effect of modified Chuanxiong Pingchuan mixture in the treatment of pulmonary hypertension combined with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)of phlegm and blood stasis obstructing lung type.Methods 80 cases of AECOPD with pulmonary hypertension were randomly divided into two groups according to the random number table method.40 cases in control group were treated by conventional western medicine.40 cases in treatment group were treated by modified Chuanxiong Pingchuan mixture.Both groups were treated for 14 days.The therapeutic effect of the two groups was compared.The changes of TCM syndrome score and pulmonary function indexes before and after treatment were observed between the two groups.The changes of pulmonary hypertension and serum Rho associated protein kinase 1(ROCK1)before and after treatment were observed between the two groups.Results The total effective rate was 95.0%(38/40)in the treatment group and 90.0%(36/40)in the control group.There was no significant difference between the two groups(P>0.05).The TCM syndrome score and total score of the two groups were lower than that of the group before treatment(P<0.05),and the treatment group was significantly lower(P<0.05).After treatment,pulmonary artery pressure and ROCK1 in the two groups were lower than those before treatment(P<0.05),and the decrease in the treatment group was more significant(P<0.05).Conclusion The modified Chuanxiong Pingchuan mixture can reduce the TCM syndrome score and pulmonary artery pressure in patients with pulmonary hypertension combined with AECOPD of phlegm and blood stasis obstructing lung type.Its mechanism may be related to the decrease of serum rock 1 level,the improvement of vascular endothelial contraction and reconstruction function.