温阳活血泄肺利水方治疗失代偿期慢性肺源性心脏病的临床研究

The therapeutic efficacy of Wenyang Huoxue Xiefei Lishui Formula in decompensation of chronic cor pulmonale

目的探讨温阳活血泄肺利水方治疗失代偿期慢性肺源性心脏病(CCP)患者的临床疗效。方法选取2017年3月—2018年7月于首都医科大学附属北京地坛医院顺义院区就诊的CCP(失代偿期)患者74例,用随机分组表分为常规组(常规西医治疗)和干预组(常规治疗联合温阳活血泄肺利水方中药治疗),比较两组患者症状、体征、心功能、血液流变学指标变化情况及药物不良反应发生情况。结果两组患者治疗前咳嗽咳痰、喘息、胸闷及水肿证候评分比较,差异无统计学意义(P>0.05)。干预组咳嗽咳痰、喘息、胸闷、水肿证候评评分均较常规组低(P <0.05)。干预组心功能改善总有效率高于常规组(P <0.05)。干预组治疗14 d后血浆黏度、全血黏度水平均低于常规组(P <0.05)。两组患者肝功能异常、肾功能异常、心电图异常及皮疹发生率比较,差异无统计学意义(P>0.05)。结论温阳活血泄肺利水方辅助治疗失代偿期CCP患者能促进改善患者症状和体征,提高患者疗效,具有较高用药安全性。

Objective To explore the clinical efficacy of Wenyang Huoxue Xiefei Lishui Formula in decompensation of chronic cor pulmonale(CCP). Methods We selected 74 patients with decompensation of CCP in Beijing Ditan Hospital from Mar 2017 to July 2018, and divided them into conventional group(conventional western medicine treatment, 37 cases) and the intervention group(conventional treatment combined with Wenyang Huoxue Xiefei Lishui Formula, 37 cases). The symptoms, signs, cardiac function, hemorheological parameters and adverse drug reactions were compared between the two groups. Results The symptom scores of cough, expectoration,wheezing, chest tightness and edema in the intervention group were significantly lower than those in conventional group(P < 0.05). The overall effective rate of cardiac function improvement in the intervention group was significantly higher than that in the conventional group(97.06% vs. 78.13%, P < 0.05). After 14 days of treatment,the plasma viscosity, whole blood viscosity, and hematokrit of the intervention group were significantly lower than those of the conventional group(P < 0.05). There was no significant difference in abnormalities of liver function,renal function, and electrocardiogram as well as the incidence of rash between the conventional group and the intervention group(P > 0.05). Conclusions Wenyang Huoxue Xiefei Lishui Formula is an adjuvant treatment for patients with decompensation of CCP. It can improve the symptoms and signs of patients and the curative effect with high safety.