CAJ | 학술논문

目的：观察益气活血方治疗慢性肺源性心脏病急性加重期的临床疗效，探讨其对心肺功能的保护作用机制。方法80例慢性肺源性心脏病急性加重期患者随机分为试验组和对照组各40例。试验组在常规治疗的基础上给予益气活血方，每天1剂，14 d为1疗程；对照组给予常规综合治疗，观察2组患者的临床症状、6 min步行距离、血气分析指标、血液流变学指标、右室压和平均肺动脉压、心功能等改善情况，评价临床疗效及安全性。结果试验组总有效率为82.5％，显著高于对照组的75.0％（ P＜0.05）；试验组6 min步行距离显著长于对照组（ P＜0.05）；2组治疗后二氧化碳分压水平降低、血氧分压和血氧饱和度水平升高，试验组改善情况明显优于对照组（ P＜0.05）；试验组的右室压、平均肺动脉压水平均显著提高（ P＜0.05），且显著优于对照组（ P＜0.05）。2组患者心功能均不同程度改善，试验组改善情况明显优于对照组（ P＜0.05）。2组血液流变学各项指标水平较治疗前均明显降低（ P＜0.05），试验组降低程度明显优于对照组（ P＜0.05）。2组均未发生不良反应。结论益气活血方联合常规西药治疗能显著改善慢性肺心病急性加重期患者的临床症状、纠正缺氧和低氧血症、提高运动耐量、降低血液黏度，明显改善患者心肺功能。
목적：관찰익기활혈방치료만성폐원성심장병급성가중기적림상료효，탐토기대심폐공능적보호작용궤제。방법80례만성폐원성심장병급성가중기환자수궤분위시험조화대조조각40례。시험조재상규치료적기출상급여익기활혈방，매천1제，14 d위1료정；대조조급여상규종합치료，관찰2조환자적림상증상、6 min보행거리、혈기분석지표、혈액류변학지표、우실압화평균폐동맥압、심공능등개선정황，평개림상료효급안전성。결과시험조총유효솔위82.5％，현저고우대조조적75.0％（ P＜0.05）；시험조6 min보행거리현저장우대조조（ P＜0.05）；2조치료후이양화탄분압수평강저、혈양분압화혈양포화도수평승고，시험조개선정황명현우우대조조（ P＜0.05）；시험조적우실압、평균폐동맥압수평균현저제고（ P＜0.05），차현저우우대조조（ P＜0.05）。2조환자심공능균불동정도개선，시험조개선정황명현우우대조조（ P＜0.05）。2조혈액류변학각항지표수평교치료전균명현강저（ P＜0.05），시험조강저정도명현우우대조조（ P＜0.05）。2조균미발생불량반응。결론익기활혈방연합상규서약치료능현저개선만성폐심병급성가중기환자적림상증상、규정결양화저양혈증、제고운동내량、강저혈액점도，명현개선환자심폐공능。
Objective To observe the clinical efficacy of Yiqi Huoxue decoction in the treatment of chronic pulmonary heart disease in acute exa-cerbation patients, and to explore the protection mechanism of heart and lung.Methods A total of 80 chronic pulmonary heart disease with acute exacerbation patients were divided into 2 groups , 40 cases in each group.Patients in control group received conventional treatment , patients in treatment group were given Yiqi Huoxue recipe on the basis , 14 days a course.Observe the clinical symptoms , 6 min walking distance , the in-dex of blood gas analysis , hemorheology , the right ventricular pressure ( RVP) and mean pulmonary artery pressure (mPAP) values, heart func-tion, clinical efficacy and safety.Results Total efficiency of treatment group was 82.5%, significantly higher than control group 75.0%( P<0.05);6 min walking distance of treatment group was significantly longer than control group ( P<0.05 ) .The levels of PaCO 2 were signifi-cantly decreased , PaO2 and SaO2 increased after the treatment (P<0.05).The RVP and mPAP values of treatment group improved significantly ( P<0.05 ) , and was much better than control group ( P<0.05 ) .The cardiac function of the two groups were improved, and treatment group improved significantly better than control group (P<0.05).All blood rheology in-dexes were significantly lower than before treatment ( P<0.05 ) , the decrease of the treatment group was significantly better than control group(P<0.05).No adverse reaction happened in the treatment.Conclusion Yiqi Huoxue de-coction combined with conventional medicine treatment can significantly improve the chronic pulmonary heart disease in acute exacerbation in patients with clinical symptoms , correct hypoxia and hypoxia , improve exercise tolerance , reduce blood viscosity , improve heart and lung function .