宣肺化痰平喘汤治疗慢性肺源性心脏病急性加重期患者的效果

Effect of Xuanfei Huatan Pingchuan Decoction in Patients with Acute Exacerbation of Chronic Pulmonary Heart Disease

目的:探讨宣肺化痰平喘汤治疗慢性肺源性心脏病(CPHD)急性加重期患者的效果。方法:选取2020年1月-2021年6月在光泽县医院治疗的104例CPHD急性加重期患者为研究对象,应用随机数表法将其分为对照组和观察组,各52例。对照组予以常规西医治疗,观察组在对照组基础上予以宣肺化痰平喘汤治疗,两组疗程均为2周。比较两组临床疗效,比较两组治疗前后的中医症候积分、呼吸困难评分、动脉血气分析指标[动脉二氧化碳分压(PaCO_(2))、血氧分压(PaO_(2))和氧合指数(PaO_(2)/FiO_(2))]、心功能指标[左室射血分数(LVEF)、心输出量(CO)、每博输出量(SV)、N末端B型脑钠肽前体(NT-proBNP)]、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、趋化因子配体-18(CCL-18)]和T淋巴细胞亚群水平。结果:观察组治疗总有效率为92.31%,显著高于对照组的76.92%,差异有统计学意义(P<0.05)。治疗后,两组中医症候积分、呼吸困难评分、TNF-α、IL-8、CCL-18水平均低于治疗前,且观察组显著低于对照组,差异有统计学意义(P<0.05)。治疗后,两组PaCO_(2)低于治疗前,PaO_(2)和PaO_(2)/FiO_(2)高于治疗前,且观察组PaCO_(2)低于对照组,PaO_(2)和PaO_(2)/FiO_(2)高于对照组,差异有统计学意义(P<0.05)。治疗后,两组LVEF、CO和SV均高于治疗前,NT-proBNP低于治疗前,且观察组LVEF、CO和SV高于对照组,NT-proBNP低于对照组,差异有统计学意义(P<0.05)。治疗后,两组CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)均高于治疗前,而CD8^(+)低于治疗前,且观察组CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)均高于对照组,CD8^(+)低于对照组,差异有统计学意义(P<0.05)。结论:宣肺化痰平喘汤治疗CPHD急性加重期效果显著,能够有效缓解患者临床症状,改善呼吸功能,抑制炎症反应,提高免疫功能。

Objective:To explore the effect of Xuanfei Huatan Pingchuan Decoction in patients with acute exacerbation of chronic pulmonary heart disease(CPHD).Method:A total of 104 patients with acute exacerbation of CPHD treated in Guangze County Hospital from January 2020 to June 2021 were selected as the research objects.They were randomly divided into the control group and the observation group by the random number table method,with 52 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Xuanfei Huatan Pingchuan Decoction on the basis of control group.Both groups were treated for 2 weeks.The clinical efficacy of the two groups was compared.And the traditional Chinese medicine symptom scores,dyspnea scores,arterial blood gas analysis indicators[arterial partial pressure of carbon dioxide(PaCO_(2)),blood partial pressure of oxygen(PaO_(2))and oxygenation index(PaO_(2)/FiO_(2))],cardiac function indicators[left ventricular ejection fraction(LVEF),cardiac output(CO)and stroke volume(SV),N-terminal pro-brain natriuretic peptide(NT-proBNP)],inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),chemokine ligand-18(CCL-18)]and T lymphocyte subsets of the two groups before and after treatment were compared.Result:The total effective rate of the observation group was 92.31%,which was significantly higher than 76.92%of the control group,the difference was statistically significant(P<0.05).After treatment,the scores of traditional Chinese medicine symptoms,dyspnea scores and the levels of TNF-α,IL-8 and CCL-18 in both groups were lower than those before treatment,and the indexes in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,PaCO_(2) in both groups were lower than those before treatment,while PaO_(2) and PaO_(2)/FiO_(2) were higher than those before treatment,and the PaCO_(2) in the observation group was lower than that in the control group,while PaO_(2) and PaO_(2)/FiO_(2) were higher than those in the control group,the differences were statistically significant(P<0.05).After treatment,LVEF,CO,and SV in both groups were higher than those before treatment,while NT-proBNP were lower than those before treatment,and the LVEF,CO,and SV in the observation group were higher than those in the control group,and NT-proBNP levels was lower than that in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in both groups were higher than those before treatment,while CD8^(+)were lower than those before treatment,and the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,while CD8^(+)was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion:Xuanfei Huatan Pingchuan Decoction has a significant therapeutic effect on the acute exacerbation of CPHD,which can effectively alleviate clinical symptoms,improve respiratory function,inhibit inflammatory reactions,and enhance immune function.