中西医结合治疗慢性阻塞性肺疾病并高黏血症的临床疗效分析

目的:观察银杏达莫注射液联合内服外敷中药治疗慢性阻塞性肺疾病(简称慢阻肺,COPD)合并高黏血症的临床疗效。方法:88例COPD合并高黏血症患者分为治疗组(n=44)与对照组(n=44),对照组给予西医常规治疗,治疗组在对照组治疗的基础上,给予静脉滴注银杏达莫注射液,并予以中药内服和穴位贴敷。14天后观察两组临床疗效及血液流变学指标变化。结果:连续治疗14天后,治疗组临床痊愈率明显高于对照组(45.45%vs25.00%,P0.05),无效率显著低于对照组(6.82%vs22.73%,P0.05)。治疗组高切表观黏度、低切表观黏度、红细胞压积、血浆黏度、血浆纤维蛋白原含量和红细胞聚集指数等指标均较治疗前明显改善(P0.01);治疗组与对照组治疗后比较,除红细胞聚集指数外,其它指标均显著降低,差异有统计学意义(P0.05)。结论:银杏达莫注射液联合内服外敷中药治疗COPD合并高黏血症,可明显提高临床痊愈率并显著改善血液流变状态。

The Clinical Effect Analyses of Combination Treatments of Traditional Chinese Medicine and Western Medicine in COPD combined with Blood Hyperviscosity

Objective：To analyze the clinical effect of injecting Ginkgo leaf extract and dipyridamole,together with internal and external treatment of traditional Chinese medicine in chronic obstructive pulmonary disease（COPD）combined with blood hyperviscosity.Method：Eighty-eight cases of COPD combined with blood hyperviscosity were divided into the intervention group（n=44）and the control group（n=44）.The control group received conventional western medication treatment.And the intervention group received injecting Ginkgo leaf extract and dipyridamole,and internal/external treatment of traditional Chinese medicine on the basis of the conventional medication.After 14days,clinical effects and hemodynamic changes were compared between two groups.Results：14days after treatment,the cure rate in the intervention group was significantly higher than that in the control group（45.45%vs 25.00%,respectively,P〈0.05）.The inefficiency rate in the intervention group was significantly lower than that in the control group（6.82%vs 22.73%,respectively,P〈0.05）.Within the intervention group,the indices of blood rheology,including high viscosity,low shear viscosity,hematocrit,plasma viscosity,fibrinogen and erythrocyte aggregation index,were significantly improved after treatment（P〈0.01）.All the indices of blood rheology after treatment in the intervention group,except the red cell aggregation index,decreased significantly compared with the control group（P〈0.05）.Conclusion：Injecting Ginkgo leaf extract and dipyridamole,together with internal and external treatment of traditional Chinese medicine in the treatment of high blood viscosity with COPD can significantly improve the clinical cure rate and the state of blood rheology.