痰热清注射液对痰浊壅塞型慢性阻塞性肺疾病肺功能与肺血管阻力影响

目的探讨痰热清注射液对痰浊壅塞型慢性阻塞性肺疾病急性加重期(AECOPD)患者肺功能与肺血管阻力影响。方法选择痰浊壅塞型AECOPD患者150例,按照随机数字的方法将患者分为对照组与观察组,每组均为75例,对照组给予常规治疗,观察组在对照组治疗基础上给予痰热清注射液治疗,对两组治疗前后的肺功能指标[一秒用力呼气容积(FEV1),FEV1%预测值,FEV1与用力肺活量的比(FEV1/FVC)]进行比较。对两组治疗前后的动脉血气指标[动脉血氧分压(PaO2),动脉血二氧化碳分压(PaCO2),血氧饱和度(SaO2)]进行比较。对两组治疗前后的肺血管阻力和中医症候积分进行比较。结果经过治疗后,对照组的FEV1从(3.02±0.35)L升高到(3.17±0.31)L,FEV1%预测值从(65.31±8.11)%升高到(68.31±4.55)%,FEV1/FVC从(71.04±7.43)%升高到(74.66±6.29)%;观察组的FEV1从(3.06±0.34)L升高到(3.35±0.28)L,FEV1%预测值从(66.05±7.61)%升高到(72.38±4.38)%,FEV1/FVC从(72.11±6.47)%升高到(79.31±5.12)%,观察组的变化幅度大于对照组,数据差异均具有统计学意义(t=-3.732,-5.581,-4.965,P<0.05),经过治疗后,对照组的PaO2从(7.23±0.61)kPa升高到(8.31±0.51)kPa,PaCO2从(7.34±0.48)kPa降低到(5.96±0.53)kPa,SaO2从(85.12±4.35)%升高到(90.64±5.07)%;观察组的PaO2从(7.25±0.58)kPa升高到(9.43±0.64)kPa,PaCO2从(7.37±0.49)kPa降低到(5.07±0.61)kPa,SaO2从(86.16±5.01)%升高到(95.23±4.35)%,观察组的变化幅度大于对照组,数据差异均具有统计学意义(t=-11.852,9.538,-5.950,P<0.05),经过治疗后,对照组的肺血管阻力从(1435.61±298.35)dyn·s·cm^-5降低到(1110.37±287.84)dyn·s·cm^-5,"咳痰"评分从(4.35±1.07)分降低到(2.83±0.98)分,"喘息"评分从(4.43±0.85)分降低到(2.39±0.72)分,"哮鸣音"评分从(4.13±0.51)分降低到(3.02±0.32)分,观察组的肺血管阻力从(1478.61±302.57)dyn·s·cm^-5降低到(872.68±212.54)dyn·s·cm^-5,"咳痰"评分从(4.41±1.02)分降低到(1.57±0.71)分,"喘息"评分从(4.41±0.79)分降低到(1.44±0.67)分,"哮鸣音"评分从(4.17±0.57)分降低到(1.03±0.33)分,观察组的变化幅度大于对照组,数据差异均具有统计学意义(t=5.753,9.017,8.365,37.492,P<0.05)。结论使用痰热清注射液联合西医常规方法治疗痰浊壅塞型慢性阻塞性肺疾病急性加重期患者,可以明显改善患者的肺功能与血气指标,有效纠正缺氧状态,改善肺血管阻力,缓解临床症状,具有较好的临床应用价值。

Effect of Tanreqing Injection on Pulmonary Function and Pulmonary Vascular Resistance in Patients with Turbid Obstructive AECOPD

Objective To investigate the effect of Tanreqing Injection on pulmonary function and pulmonary vascular resistance in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 150 patients with phlegm and blood stasis type of AECOPD were divided into a control group and an observation group according to a random number method,and each group had 75 patients.The patients in the control group were given conventional treatment,and those in the observation group were treated with Tanreqing Injection on the basis of the treatment of the control group.Pulmonary function indicators before and after treatment,including FEV1,FEV1%predicted value,ratio of FEV1 to forced vital capacity(FEV1/FVC)were compared.The arterial blood gas indexes[arterial oxygen partial pressure(PaO2),arterial blood carbon dioxide partial pressure(PaCO2)and blood oxygen saturation(SaO2)]were compared between the two groups before and after treatment.We compared pulmonary vascular resistance and TCM syndrome scores before and after treatment in the two groups.Results After treatment,the FEV1 of the control group increased from 3.02±0.35 to 3.17±0.31,and the predicted value of FEV1%increased from(65.31±8.11)%to(68.31±4.55)%.FEV1/FVC increased from(71.04±7.43)%to(74.66±6.29)%.The FEV1 of the observation group increased from 3.06±0.34 to 3.35±0.28,and the predicted value of FEV1%increased from(66.05±7.61)%to(72.38±4.38)%,and FEV1/FVC increased from(72.11±6.47)%to(79.31±5.12)%.The change of the observation group was larger than that of the control group,and the data was statistically significant(t=-3.732,-5.581,-4.965,P<0.05).After treatment,the PaO2 of the control group increased from(7.23±0.61)kPa to(8.31±0.51)kPa,PaCO2 decreased from(7.34±0.48)kPa to(5.96±0.53)kPa,and SaO2 increased from(85.12±4.35)%to(90.64±5.07)%.PaO2 of the observation group increased from(7.25±0.58)kPa to(9.43±0.64)kPa,PaCO2 decreased from(7.37±0.49)kPa to(5.07±0.61)kPa,and SaO2 increased from(86.16±5.01)%to(95.23±4.35)%.The change of the observation group was larger than that of the control group,and the data was statistically significant(t=-11.852,9.538,-5.950,P<0.05).After treatment,the pulmonary vascular resistance of the control group was reduced from(1435.61±298.35)dyn·s·cm^-5 to(1110.37±287.84)dyn·s·cm^-5,and the cough score was decreased from(4.35±1.07)points to(2.83±0.98)points,the wheeze score decreased from(4.43±0.85)points to(2.39±0.72)points,and the wheezing sound score decreased from(4.13±0.51)points to(3.02±0.32)points.The pulmonary vascular resistance of the observation group decreased from(1478.61±302.57)dyn·s·cm^-5 to(872.68±212.54)dyn·s·cm^-5,and the cough score decreased from(4.41±1.02)points to(1.57±0.71)points.The wheeze score decreased from(4.41±0.79)points to(1.44±0.67)points,and the wheezing score decreased from(4.17±0.57)points to(1.03±0.33)points.The change of the observation group was larger than that of the control group,and the data was statistically significant(t=5.753,9.017,8.365,37.492,P<0.05).Conclusion The use of Tanreqing Injection combined with Western medicine in the treatment of patients with acute exacerbation of phlegm and blood stasis type of chronic obstructive pulmonary disease can significantly improve the lung function and blood gas index,effectively correct hypoxia,improve pulmonary vascular resistance and alleviate clinical symptoms.It has good clinical application value.