中药汤剂联合穴位贴敷治疗肺气亏虚型慢性肺源性心脏病及对患者BNP、ET-1、TNF‐α水平的影响

The efficiency of TCM decoction plus acupoint application on pulmonary heart disease of lung Qi deficiency type and BNP,ET-1,TNF‐α levels

目的:评估中药汤剂联合穴位贴敷治疗肺气亏虚型慢性肺源性心脏病(简称肺心病)的临床效果,并观察对患者脑钠肽(Brain Natriuretic Peptide,BNP)、内皮素-1(Endothelin-1,ET-1)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)水平的影响。方法:前瞻性地选取2020年1月-12月山东省滕州市中医医院收治的126例肺心病患者作为研究对象,按数字随机表法随机分成对照组和观察组,每组63例;比较两组患者临床疗效,评价治疗前后心肺功能及血气分析;并分析BNP、血管内皮因子、炎性因子水平。结果:临床疗效,观察组患者总有效显著高于对照组患者(P<0.05);观察组治疗后中医证候积分低于对照组(P<0.05);心肺功能及血气分析,治疗后观察组患者左心室射血分数(Left Ventricular Ejection Fraction,LVEF)、一秒率(Forced Expiratory Volume in One Second/Forced Vital Capacity,FEV_(1)/FVC)、动脉血氧分压(Arterial Blood Partial Pressure of Oxygen,PaO_(2))均显著高于对照组患者(P<0.05),而BNP、肺动脉压(Pulmonary Artery Pressure,PAP)、动脉血二氧化碳分压(Arterial Blood Partial Pressure of Carbondioxide,PaCO_(2))均显著低于对照组患者(P<0.05);生化因子分析,治疗后观察组患者ET-1、超敏C反应蛋白(Hypersensitive C-reactive Protein,hs-CRP)、TNF-α均显著低于对照组患者(P<0.05),而一氧化氮(Nitric Oxide,NO)显著高于对照组患者(P<0.05)。结论:中药汤剂联合穴位贴敷治疗肺气亏虚型肺心病可显著改善患者心肺功能、血氧能力,有效降低BNP、ET-1及TNF-α水平,最终达到提高临床治疗效果的目的。

Objective:To evaluate the clinical effect of TCM decoction combined with acupoint application in the treatment of pulmonary heart disease with lung Qi(气)deficiency,and to observe the effect on the levels of brain natriuretic peptide(BNP),endothelin-1(ET-1)and tumor necrosis factor-α(TNF-α).Methods:A total of 126 patients with pulmonary heart disease admitted to our hospital from January 2020 to December 2020 were selected as the research objects.They were randomly divided into the control group and the observation group according to the random number table method,with 63 cases in each group.The clinical efficacy in the two groups was compared,and the cardiopulmonary function and blood gas analysis before and after treatment were evaluated.The levels of BNP,vascular endothelial factors and inflammatory factors were analyzed.Results:The total effective rate in the observation group was significantly higher than that in the control group(P<0.05).After treatment,the scores of TCM syndromes in the observation group were lower than those in the control group(P<0.05).Cardiopulmonary function and blood gas analysis,after treatment,the left ventricular ejection fraction(LVEF),forced expiratory volume in one second/forced vital capacity(FEV_(1)/FVC)and arterial blood partial pressure of oxygen(PaO_(2))in the observation group were significantly higher than those in the control group(P<0.05).BNP,pulmonary artery pressure(PAP)and arterial blood partial pressure of carbon dioxide(PaCO_(2))were significantly lower than those in control group(P<0.05).After treatment,ET-1,hypersensitive C-reactive protein(hs-CRP)and TNF-α in the observation group were significantly lower than those in the control group(P<0.05),while nitric oxide(NO)was significantly higher than that in the control group(P<0.05).Conclusion:Chinese medicine decoction combined with acupoint application in the treatment of pulmonary heart disease with lung Qi deficiency can significantly improve the cardiopulmonary function and blood oxygen capacity of patients,effectively reduce the levels of BNP,ET-1 and TNF-α,and finally achieve the purpose of improving the clinical treatment effect.