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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。
Objective To observe the clinical efficacy of Yiqi Huoxue Fang in the treatment of acute exacerbation of chronic cor pulmonale, and to explore its mechanism of protection on cardiopulmonary function. Methods Eighty patients with acute exacerbation of chronic cor pulmonale were randomly divided into experimental group (40 cases) and control group (40 cases). The experimental group was given Yiqi Huoxue Recipe on the basis of routine treatment. One dose per day for 14 days was given for one course of treatment. The control group was given conventional comprehensive treatment. The clinical symptoms, 6-minute walk distance, blood gas analysis index, blood flow Variable indicators, right ventricular pressure and mean pulmonary artery pressure, cardiac function and other improvements, evaluate the clinical efficacy and safety. Results The total effective rate of the experimental group was 82.5%, significantly higher than that of the control group (75.0%, P <0.05). The walking distance of the experimental group at 6 min was significantly longer than that of the control group (P <0.05) (P <0.05). The right ventricular pressure and mean pulmonary arterial pressure were significantly increased in the experimental group (P <0.05), and were significantly higher than those in the control group Better than the control group (P <0.05). The cardiac function of the two groups improved to some extent, and the improvement in the experimental group was obviously better than that in the control group (P <0.05). The indexes of hemorheology in the two groups were significantly lower than those before treatment (P <0.05), and the reduction in the experimental group was significantly better than that in the control group (P <0.05). No adverse reactions occurred in both groups. Conclusion Yiqihuoxue prescription combined with conventional western medicine can significantly improve the clinical symptoms of patients with acute exacerbation of chronic pulmonary heart disease, correct hypoxia and hypoxemia, improve exercise tolerance, reduce blood viscosity, and significantly improve cardiopulmonary function.