清热化痰宣肺汤治疗慢性肺源性心脏病急性加重期(痰热壅肺证)的临床观察

Clinical Observation of Qingre Huatan Xuanfei Decoction in the Treatment of Acute Exacerbation of Chronic Pulmonary Heart Disease(Sy ndrome of Phlegm-heat Obstructing Lung)

目的观察清热化痰宣肺汤治疗慢性肺源性心脏病(CPHD)急性加重期(痰热壅肺证)的临床效果。方法将68例CPHD患者按照随机数字表法分为观察组与对照组各34例。对照组患者予以西医综合治疗,观察组在对照组治疗基础上给予清热化痰宣肺汤治疗,两组均治疗10 d后评估主要症状评分,检测血液流变学指标、肺动脉压力以及N端B型脑钠肽前体(NT-proBNP)水平。结果治疗后两组咳嗽、喘促、胸闷、咯痰症状评分明显下降(P<0.05),观察组下降程度更为明显(P<0.05)。治疗后两组全血高切还原黏度、全血低切还原黏度、纤维蛋白原水平明显下降(P<0.05),观察组下降程度更为明显(P<0.05)。治疗后两组肺动脉收缩压(PASP)、肺动脉舒张压(PADP)、NT-proBNP水平明显下降(P<0.05),观察组PASP、PADP、NT-proBNP水平下降程度更为明显(P<0.05)。观察组临床总有效率为91.18%,明显高于对照组的70.59%(P<0.05)。结论清热化痰宣肺汤治疗CPHD急性加重期(痰热壅肺证)的疗效良好,有助于进一步缓解患者的临床症状,改善血液流变学指标水平和肺动脉高压。

Objective:To investigate the clinical effect of Qingre Huatan Xuanfei Decoction in the treatment of acute exacerbation of chronic pulmonary heart disease(CPHD)with syndrome of phlegm-heat obstructing lung.Methods:A total of 68 CPHD patients admitted to our hospital were divided into observation group(n=34)and control group(n=34)according to the random number table method.The patients in the control group were treated with comprehensive western medicine,while the observation group was treated with Qingre Huatan Xuanfei Decoction on the basis of the treatment in the control group.After 10 days of treatment,the main symptom scores,hemorheology indexes,pulmonary artery pressure,and precursor brain natriuretic peptide(NT-proBNP)were evaluated in both groups.Results:After treatment,the scores of cough,wheezing,chest tightness and expectoration in the two groups were significantly lower than those before treatment(P<0.05);compared with the control group,the main symptom scores of the observation group decreased more significantly after treatment(P<0.05).After treatment,the whole blood high shear reduction viscosity,whole blood low shear reduction viscosity,and fibrinogen levels in the two groups were significantly lower than those before treatment(P<0.05);compared with the control group,the levels of hemorheology indexes in the observation group decreased more significantly after treatment(P<O.05).After treatment,the levels of PASP,PADP and NT-proBNP in the two groups were significantly lower than those before treatment(P<O.05);compared with the control group,the levels of PASP,PADP and NT-proBNP in the observation group decrease more significantly after treatment(P<0.05).The total clinical effective rate in the observation group was 91.18%,which was significantly higher than 70.59%in the control group(P<0.05).Conclusion:Qingre Huatan Xuanfei Decoction has good curative effect in the treatment of acute exacerbation of CPHD(syndrome of phlegm-heat obstructing lung),which is helpful to further relieve the clinical symptoms of patients,improve the level of hemorheological indexes and pulmonary hypertension.