活血化瘀导痰汤辅助治疗COPD合并肺心病心功能衰竭的效果和安全性

Efficacy and safety of Huoxue Huayu Daotan Decoction in the Treatment of COPD Complicated with Cor Pulmonale and Heart Failure

目的探讨活血化瘀导痰汤中西医结合治疗COPD合并肺心病心功能衰竭的效果和安全性。方法选取2020年7月至2022年6月我院收治的110例COPD合并肺心病心功能衰竭患者,分为对照组和观察组各55例。对照组给予常规西医治疗,观察组加用活血化瘀导痰汤辅助治疗,对比两组凝血功能、心肺功能、临床指标、疗效和不良反应。结果治疗2周后,观察组的血清组织型纤溶酶原激活物抑制剂(PAI-1)、D-二聚体(D-D)水平低于对照组,差异有统计学意义(P<0.05);治疗后,观察组第一秒用力呼气容积(FEV_(1))、心脏指数(CI)评分、中医证候和美国纽约心脏病协会(NYHA)分级均低于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率高于对照组,心血管不良事件率低于对照组,差异有统计学意义(P<0.05);两组药物不良反应发生率比较,无显著差异(P>0.05)。结论活血化瘀导痰汤能降低COPD合并肺心病心功能衰竭患者的血液黏度,提高心肺功能,改善临床症状和疾病预后,安全性较高。

Objectives To investigate the efficacy and safety of Huoxue Huayu Daotan Decoction combined with Traditional Chinese and Western Medicine in the treatment of chronic obstructive pulmonary disease(COPD)complicated with pulmonary heart disease and heart failure.Methods A total of 110 COPD patients complicated with pulmonary heart disease and heart failure admitted to our hospital from July 2020 to June 2022 were selected and divided into control group and observation group,with 55 cases in each group.The control group received routine Western medicine treatment,while the observation group received auxiliary treatment with Huoxue Huayu Daotan Decoction.The changes in coagulation function,cardiopulmonary function,clinical indicators,curative effect,and adverse reactions were observed.Results After 2 weeks of treatment,the serum levels of tissue plasminogen activator inhibitor(PAI-1)and D-dimer(D-D)in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the forced expiratory volume in one second(FEV_(1)),cardiac index(CI)score,Traditional Chinese Medicine syndrome,and New York Heart Association(NYHA)grading in the observation group were significantly lower than those in the control group(P<0.05).The total effective rate of treatment in the observation group was significantly higher than that in the control group,and the incidence of cardiovascular adverse events was significantly lower than that in the control group(P<0.05);There was no statistically significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusions Huoxue Huayu Daotan Decoction can reduce the blood viscosity of COPD patients complicated with pulmonary heart disease and heart failure,improve cardiopulmonary function,improve clinical symptoms and disease prognosis,and has high safety.