复方葶苈子胶囊联合依诺肝素治疗CCP合并HF的临床研究

Clinical Study on the treatment of CCP complicated with HF with compound Tinglizi capsule combined with enoxaparin

目的探讨复方葶苈子胶囊联合依诺肝素治疗慢性肺源性心脏病(CCP)合并心力衰竭(HF)的临床疗效。方法选取2020年12月至2021年11月在湖南省中医药研究院附属医院肺病科住院的CCP合并HF患者68例,按照随机数字表法分为联合组与对照组,各34例。对照组采用常规治疗方案,联合组在对照组基础上使用复方葶苈子胶囊联合依诺肝素治疗。比较2组治疗前后左室射血分数(LVEF)、左室舒张末期直径(LVIDd)、心排血量(CO)、肌钙蛋白T(cTnT)、D-二聚体(D-D)、6 min步行距离(6MWT)及血气分析[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、肺功能[第1秒用力呼气容积(FEV_(1))、FEV_(1)/用力肺活量(FVC)]指标,同时对2组临床疗效及不良反应进行分析。结果2组临床疗效比较,差异有统计学意义(P<0.05)。2组治疗前LVEF、CO、LVIDd、cTnT、D-D、6MWT、PaO_(2)、PaCO_(2)、FEV_(1)、FEV_(1)/FVC水平比较,差异无统计学意义(P>0.05)。2组治疗后LVEF、CO、LVIDd、cTnT、D-D、6MWT、PaO_(2)、PaCO_(2)、FEV_(1)、FEV_(1)/FVC水平优于治疗前,且联合组各指标优于对照组,差异有统计学意义(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P=0.367)。结论复方葶苈子胶囊联合依诺肝素治疗CCP合并HF,可有效改善患者临床症状及心肺功能,并具有较好的安全性。

Objective To explore the clinical efficacy of compound Tinglizi capsule combined with enoxaparin in the treatment of chronic pulmonary heart disease(CCP)complicated with heart failure(HF).Methods From December 2020 to November 2021,68 CCP complicated with HF patients hospitalized in the Pulmonary Disease Department of the Affiliated Hospital of Hunan Academy of Traditional Chinese Medicine were selected and divided into combined group and control group according to the random number table method,with 34 patients in each group.The control group was treated with conventional treatment scheme,while the combined group was treated with compound Tinglizi capsule and enoxaparin on the basis of the control group.The indexes of left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVIDd),cardiac output(CO),cardiac troponin T(cTnT),D-dimer(D-D),6-min walking distance(6MWT),blood gas analysis[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))]and pulmonary function[forced expiratory volume in the first second(FEV_(1)),FEV_(1)/forced vital capacity(FVC)]were compared between the two groups before and after treatment.At the same time,the clinical efficacy and adverse reactions of the two groups were analyzed.Results There was significant difference in the clinical efficacy between the two groups(P<0.05).There were no significant differences in the levels of LVEF,CO,LVIDd,cTnT,D-D,6MWT,PaO_(2),PaCO_(2),FEV_(1),FEV_(1)/FVC before treatment between the two groups(P>0.05).After treatment,the levels of LVEF,CO,LVIDd,cTnT,D-D,6MWT,PaO_(2),PaCO_(2),FEV_(1),FEV_(1)/FVC in the two groups were better than those before treatment,and the indexes in the combined group were better than those in the control group,with statistically significant differences(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.367).Conclusion Compound Tinglizi capsule combined with enoxaparin can effectively improve the clinical symptoms and cardiopulmonary function of CCP complicated with HF patients and has good safety.