补肺化瘀通络汤结合西医常规疗法治疗慢性肺栓塞临床研究

Clinical study of Bufei-Huayu-Tongluo Decoction and western medicine for chronic pulmonary embolism

目的评价补肺化瘀通络汤结合西医常规疗法治疗慢性肺栓塞(pulmonary embolism,PE)的疗效。方法将符合入选标准的2016年1月-2019年5月本院120例慢性PE患者按随机数字表法分为2组,每组60例。对照组给予西医常规疗法治疗,研究组在对照组基础上服用补肺化瘀通络汤。2组均治疗4周。采用肺功能仪测定FVE1、FVC,采用凝血分析仪检测纤维蛋白原(fibrinogen,FIB)和凝血酶原时间(prothrombin time,PT),采用免疫比浊法检测D-二聚体,采用ELISA法检测高迁移率族蛋白B1(high mobility group proteinB1,HMGB-1)、肌钙蛋白(troponin,cTnI);记录不良反应,评价临床疗效。结果研究组总有效率为93.3%(56/60)、对照组为78.3%(47/60),2组比较差异有统计学意义(χ^(2)=5.551,P=0.018)。治疗后,研究组FVE1[(1.74±0.26)L比(1.55±0.29)L,t=3.779]、FVC[(66.73±7.54)%比(58.69±6.32)%,t=6.330]高于对照组(P<0.01);血清FIB水平[(2.85±0.30)g/L比(2.36±0.31)g/L,t=8.798]、PT[(15.31±0.73)s比(11.27±0.52)s,t=34.915]高于对照组(P<0.01);血清D-二聚体[(0.66±0.23)mg/L比(1.18±0.32)mg/L,t=9.447]、HMGB-1[(3.59±0.75)μg/L比(6.14±1.28)μg/L,t=13.280]、cTnI[(0.62±0.26)μg/L比(1.02±0.26)μg/L,t=8.896]水平低于对照组(P<0.01)。治疗期间对照组不良反应发生率为13.3%(8/60)、研究组为15.0%(9/60),2组比较差异无统计学意义(χ^(2)=0.069,P=0.793)。结论补肺化瘀通络汤结合西医常规疗法可有效改善慢性PE患者的肺功能及凝血功能,且安全性较好。

Objective To explore the clinical effect of Bufei-Huayu-Tongluo decoction combined with western medicine on chronic pulmonary embolism(PE).Methods A total of 120 patients with chronic PE,who met the inclusion criteria in our hospital from January 2016 to May 2019,were randomly divided into two groups,60 cases in each group.The control group was given conventional western medicine treatment,and the study group was given Bufei-Huayu-Tongluo Decoction on the basis of the control group.Both groups were treated for 4 weeks.The forced expiratory volume in one second(FVE1)and forced vital capacity(FVC)were measured by pulmonary function analyzer;the fibrinogen(FIB)and prothrombin time(PT)were detected by coagulation analyzer;and D-dimer was detected by immunoturbidimetry;high mobility group protein B1(HMGB-1),troponin(cTnI)were detected by ELISA,adverse reactions were recorded and clinical efficacy was evaluated.Results The total effective rate of the study group was 93.3%(56/60)and that of the control group was 78.3%(47/60).The difference between the two groups was statistically significant(χ^(2)=5.551,P=0.018).After treatment,FVE1(1.74±0.26 L vs.1.55±0.29 L,t=3.779),FVC(66.73%±7.54%vs.58.69%±6.32%,t=6.330)in the study group were significantly higher than those in the control group(P<0.01);serum FIB level(2.85±0.30 g/L vs.2.36±0.31 g/L,t=8.798),PT(15.31±0.73 s vs.11.27±0.52 s,t=34.915)were significantly higher than those in the control group(P<0.01);serum D-dimer(0.66±0.23 mg/L vs.1.18±0.32 mg/L,t=9.447),HMGB-1(3.59±0.75μg/L vs.6.14±1.28μg/L,t=13.280)and cTnI(0.62±0.26μg/L vs.1.02±0.26μg/L,t=8.896)were significantly lower than those in the control group(P<0.01).During the treatment,the incidence of adverse reactions in the control group was 13.3%(8/60)and that in the study group was 15.0%(9/60).There was no significant difference between the two groups(χ^(2)=0.069,P=0.793).Conclusion Bufei-Huayu-Tongluo Decoction combined with conventional western medicine therapy can improve lung function and coagulation function of patients with chronic PE.