自拟顺气活血汤治疗肺源性心脏病气滞血瘀证的疗效及对血清APN、CPN水平的影响

Efficacy of Shunqi Huoxue Decoction(顺气活血汤) on Pulmonary Heart Disease with Syndrome of Qi Stagnation and Blood Stasis and Its Effect on Serum Levels of APN and CPN

目的探讨自拟顺气活血汤治疗肺源性心脏病(pulmonary heart disease,PHD)气滞血瘀证的疗效及对血清脂联素(adiponectin,APN)与和肽素(copeptin,CPN)水平的影响。方法纳入2019年1月—2022年1月该院收治的62例PHD气滞血瘀证患者,按照随机数字表法分为治疗组与对照组,每组31例。对照组根据指南进行常规干预措施;治疗组的常规干预措施同对照组,并且采取自拟顺气活血汤内服。两组连续治疗4周。比较两组心功能、肺功能、血气相关指标、临床疗效以及血清APN与和CPN水平。结果治疗4周后,两组患者左室射血分数(left ventricular ejection fraction,LVEF)、每搏输出量(stroke volume,SV)、心输出量(cardiac output,CO)以及第1秒用力呼气容积占预计值百分比(forced expiratory volume in one second/predicted value ratio,FEV1%pred)、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)/用力肺活量(forced vital capacity,FVC)显著上调,并且治疗组上调更加明显(P<0.01);治疗4周后,两组患者动脉血氧分压(arterial partial pressure of oxygen,PaO_(2))显著上调及二氧化碳分压(partial pressure of carbon dioxide,PaCO_(2))明显减低,并且治疗组以上指标改善更加明显(P<0.01);治疗组患者的总有效率(93.55%,29/31)显著高于对照组(67.74%,21/31)(P<0.05)。治疗4周后,两组患者血清APN水平明显增加及CPN水平明显降低,并且治疗组以上指标改善更加明显(P<0.01)。结论于常规治疗措施的基础上加用自拟顺气活血汤治疗PHD气滞血瘀证疗效更佳,有助于患者的心肺功能、血气指标的改善以及调节血清APN与CPN的水平。

Objective To investigate the clinical efficacy of Shunqi Huoxue Decoction(顺气活血汤)on pulmonary heart disease(PHD)with syndrome of Qi stagnation and blood stasis and its effect on serum levels of adiponectin(APN)and copeptin(CPN).Methods Sixty-two PHD patients with syndrome of Qi stagnation and blood stasis admitted in the hospital from January 2019 to January 2022 were enrolled and divided into treatment group and control group according to the random number table method with 31 cases in each group.The control group received routine intervention according to the guidelines and the routine intervention measures of the treatment grouPwere the same as those of the control grouPand Shunqi Huoxue Decoction was used for internal administration.The two groups were treated for 4 weeks.The cardiac function,pulmonary function,blood gas related indexes,the clinical efficacy and serum levels of APN and CPN were compared between the two groups.Results After 4 weeks treatment in two groups,the values of left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac output(CO),the forced expiratory volume in 1 second/predicted value ratio(FEV1%)and the forced expiratory volume in 1 second(FEV1)/forced vital capacity(FVC)were obviously increased,and those of the treatment group increased more obviously(P<0.01).After 4 weeks treatment,the values of the arterial partial pressure of oxygen(PaO_(2))were significantly increased and the values of the partial pressure of carbon dioxide(PaCO_(2))were significantly decreased in the two groups,and the above indexes were improved more obviously in the treatment group(P<0.01).The total effective rate of the treatment group(93.55%,29/31)was significantly higher than that of the control group(67.74%,21/31)(P<0.05).After 4 weeks treatment,the serum level of APN was significantly increased and CPN level was significantly decreased in the two groups,and the above indexes were improved more obviously in the treatment group(P<0.01).Conclusion On the basis of conventional treatment measures,the clinical efficacy of Shunqi Huoxue Decoction on PHD with syndrome of Qi stagnation and blood stasis is better,which is helpful to improve the cardiopulmonary function and blood gas indexes of patients and can regulate serum levels of APN and CPN.