补肺化瘀通络汤联合阿替普酶治疗慢性肺栓塞临床研究

Clinical Study on Bufei Huayu Tongluo Tang Combined with Alteplase for Chronic Pulmonary Embolism

目的:观察补肺化瘀通络汤联合阿替普酶治疗慢性肺栓塞的临床疗效及对患者肺功能、动脉血气指标、凝血功能的影响。方法:选取62例慢性肺栓塞患者,随机分为观察组与对照组,每组31例。对照组给予阿替普酶注射液治疗,观察组在对照组基础上给予补肺化瘀通络汤治疗。2组均治疗2周。比较2组临床疗效及治疗前后肺功能指标、动脉血气分析指标和凝血功能指标。结果:观察组总有效率为90.32%,高于对照组的67.74%(P<0.05)。治疗后,2组第1秒用力呼气容积(FEV_(1))占预计值百分比、FEV_(1)/用力肺活量(FVC)、动脉血氧分压(PaO_(2))及动脉血二氧化碳分压(PaCO_(2))水平均较治疗前改善(P<0.05),观察组上述4项指标均较对照组改善更明显(P<0.05)。治疗后,2组凝血酶原时间(PT)均较治疗前延长(P<0.05),观察组PT长于对照组(P<0.05);2组纤维蛋白原(FIB)、血小板计数(BPC)水平均较治疗前升高(P<0.05),观察组FIB、BPC水平均高于对照组(P<0.05)。结论:补肺化瘀通络汤联合阿替普酶治疗慢性肺栓塞可提高临床疗效,有效改善患者的肺功能、动脉血气分析指标及凝血功能。

Objective:To observe the clinical effect of Bufei Huayu Tongluo tang combined with alteplase for chronic pulmonary embolism and its effect on the lung function,arterial blood gas indexes and coagulation function of patients.Methods:A total of 62 cases of patients with chronic pulmonary embolism were selected and randomly divided into the observation group and the control group,31 cases in each group.The control group was given injection of alteplase,and the observation group was additionally treated with Bufei Huayu Tongluo tang based on the treatment of the control group.The clinical effect was compared between the two groups.Indexes of the lung function,arterial blood gas analysis and coagulation function before and after treatment were compared between the two groups.Results:The total effective rate was 90.32%in the observation group,higher than that of 67.74%in the control group,the difference being significant(P<0.05).After treatment,percentage of the estimated forced expiratory volume in the first second(FEV_(1))and forced expiratory volume in first second/forced vital capacity(FEV_(1)/FVC),as well as levels of partial pressure of oxygen(PaO_(2))and partial pressure of carbon dioxide(PaCO_(2))in the two groups were improved when compared with those before treatment(P<0.05);the improvement of the four indexes above in the observation group was more significant than that in the control group(P<0.05).After treatment,prothrombin time(PT)in the two groups was prolonged when compared with that before treatment(P<0.05),and PT in the observation group was longer than that in the control group(P<0.05).After treatment,levels of fibrinogen(FIB)and blood platelet count(BPC)in the two groups were increased when compared with those before treatment(P<0.05),and the two levels in the observation group were higher than those in the control group(P<0.05).Conclusion:In the treatment of chronic pulmonary embolism,the therapy of Bufei Huayu Tongluo tang combined with alteplase can enhance the clinical effect and effectively improve the lung function,indexes of arterial blood gas analysis and coagulation function.