益气活血化痰方联合小剂量阿托伐他汀对高危性COPD患者动脉僵硬度、血液黏度及预后的影响研究

目的 探讨益气活血化痰方联合小剂量阿托伐他汀对高危性慢性阻塞性肺疾病(COPD)患者动脉僵硬度、血液黏度及预后的影响.方法 随机数字表法将240例存在心血管病变危险因素的高危性COPD患者分成他汀组(A组)、益气活血化痰组(B组)、联合组(C组)和对照组(D组),每组60例.4组均予以常规治疗方案,A组联合小剂量阿托伐他汀,B组联合益气活血化痰方,C组在A组基础上联合益气活血化痰方,均持续治疗6个月.观察4组治疗前后中医证候积分、动脉僵硬度指标及血液流变学指标变化差异,记录其不良反应发生情况及预后情况.结果 治疗6个月后,4组患者中医证候积分及颈动脉-股动脉脉搏波传导速度(PWV)水平均较治疗前明显降低,且C组、A组、B组、D组逐渐升高(P＜0.05).治疗6个月后,除D组患者全血黏度、红细胞压积未见明显改变(P＞0.05),其余3组患者均较治疗前明显降低,C组明显低于A组和B组(P＜0.05),A组和B组比较差异无统计学意义(P＞0.05).4组患者不良反应发生率比较差异无统计学意义(P＞0.05),C组、A组、B组、D组患者BODE指数逐渐升高(P＜0.05).结论 益气活血化痰方联合小剂量阿托伐他汀对调节有心血管病变危险因素的高危性COPD患者血液流变学状态、促进患者预后恢复等具有积极作用.

Effect of Yiqi Huoxue Huatan Formula combined with low-dose atorvastatin on arterial stiffness,blood viscosity and prognosis in patients with high-risk COPD

Objective To investigate the effect of Yiqi Huoxue Huatan Formula combined with low-dose atorvastatin on arterial stiffness,blood viscosity and prognosis in the patients with high-risk chronic obstructive pulmonary disease (COPD).Methods A total of 240 patients with high-risk COPD and risk factors of cardiovascular disease were divided into the statin group(A),Yiqi H uoxue H uatan group(B),combined group(C) and control group(D),60 cases in each group.All groups were treated with routine therapy.On this basis,the group A was combined with low-dose atorvastatin,the group B was combined with Yiqi Huoxue Huatan Formula.On the basis of the group A,the group C was combined with Yiqi Huoxue Huatan Formula.All groups were treated for 6 months.The changes of TCM syndrome scores,arterial stiffness index and blood rheological indexes in 4 groups were observed and compared between before and after treatment.The situation of adverse reactions occurrence and prognosis were recorded.Results After 6 months of treatment,the TCM syndrome scores and carotid artery-femoral artery pulse wave velocity (PWV)in 4 groups were significantly decreased compared with those before treatment,which in the group C,A,B and D was gradually increased (P＜ 0.05).After 6 months of treatment,there was no significant change of whole blood viscosity and hematocrit in the group D (P＞ 0.05),which in the other 3 groups were significantly decreased compared with those before treatment,moreover the group C was significantlylower than the group A and B (P＜0.05),while there was no statistically significant difference between the group A and B (P＞0.05).The incidence rate of adverse reactions had no statistically significant difference among the four groups (P＞ 0.05).The BODE index showed gradual increase ih the group C,A,B and D (P＜0.05).Conclusion Yiqi Huoxue Huatan Formula combined with low-dose atorvastatin has an positive effect in regulating the blood rheological state and promoting the prognostic recovery in the patients with high-risk COPD and risk factors of cardiovascular disease.