血必净治疗痰瘀互结型慢性阻塞性肺疾病急性加重的临床疗效观察

发布时间：2018-05-27 11:35

本文选题：血必净注射液 + 慢性阻塞性肺疾病急性加重　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：目的:通过观察血必净注射液对痰瘀互结型慢性阻塞性肺疾病急性加重治疗前后临床症状、二氧化碳分压、氧分压、炎性因子及免疫细胞的改善情况,探讨血必净的临床疗效。材料与方法:收入2015年1月至2017年2月期间于沈阳市解放军第四六三医院呼吸科住院的痰瘀互结型的慢性阻塞性肺疾病急性加重患者(肺功能诊断为慢性阻塞性肺疾病重度且加重诱因为感染引起)70人,男性36人,女性34人,将70名急性加重患者随机分为血必净组及对照组,血必净组35人,其中男性16人,女性19人,平均年龄69.23±5.29岁.对照组35人,男性20人,女性15人,平均年龄68.94±5.99岁。经χ2检验,对两组患者性别、年龄、肺功能进行统计分析,无统计学差异(P0.05),具有可比性。对照组给予常规吸氧、祛痰、解痉、抗感染治疗,血必净组在对照组的基础上加用血必净注射液,治疗时间为7天。7天后比较两组患者咳嗽、咳痰等临床症状、二氧化碳分压(Pa CO2)、氧分压(Pa O2)、外周血白细胞计数(WBC)、血清降钙素原(PCT)、超敏C反应蛋白(Hs-CRP)、血沉(ESR)、白细胞介素-6(IL-6)、辅助性T淋巴细胞(CD4+)、抑制性T淋巴细胞(CD8+)及CD4+/CD8+比率比值的变化情况。结果:1.血必净组治疗后咳嗽、咳痰等临床症状改善情况优于对照组,血必净组总有效率94.3%,对照组总有效率85.7%,具有统计学意义(P0.05)。2.血必净组治疗后Pa O2含量高于对照组,Pa CO2的含量低于对照组,血必净组疗效优于对照组,具有统计学意义(P0.05)。3.血必净组治疗后外周血WBC、血清PCT、Hs-CRP、ESR、IL-6的改善情况优于对照组,具有统计学意义(P0.05)。4.血必净组治疗后外周血T淋巴细胞CD4+较对照组升高,CD8+较对照组降低,CD4+/CD8+比值升高优于对照组,具有统计学意义(P0.05)。结论:1.常规基础治疗上加用血必净注射液可改善慢性阻塞性肺疾病急性加重患者临床症状,提高疗效。2.常规基础治疗上加用血必净注射液能提高慢性阻塞性肺疾病急性加重患者血氧含量,改善缺氧状态。3.常规基础治疗上加用血必净注射液能改善慢性阻塞性肺疾病急性加重患者外周血WBC、血清PCT、Hs-CRP、ESR、IL-6等炎性指标,提高患者治疗效果。4.常规基础治疗上加用血必净注射液能提高慢性阻塞性肺疾病急性加重患者免疫功能,提高免疫力。
[Abstract]:Objective: to observe the improvement of Xuebijing injection on clinical symptoms, partial pressure of carbon dioxide, partial pressure of oxygen, inflammatory factors and immune cells before and after treatment of acute exacerbation of chronic obstructive pulmonary disease with phlegm and blood stasis. Materials and methods: from January 2015 to February 2017, patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) who were hospitalized in respiratory department of the 463rd Hospital of the Chinese PLA in Shenyang from January 2015 to February 2017 were diagnosed as chronic obstructive pulmonary disease (COPD). The lung disease was severe and aggravated. 70 people were infected with it. Thirty-six males and 34 females were randomly divided into Xuebijing group (n = 35) and control group (n = 35). There were 16 males and 19 females with an average age of 69.23 卤5.29 years. Control group 35, male 20, female 15, average age 68.94 卤5.99 years old. The sex, age and lung function of the two groups were statistically analyzed by 蠂 2 test. There was no statistical difference between the two groups (P 0.05). The control group was given routine oxygen inhalation, expectorant, spasmolysis, anti-infection treatment, and Xuebijing group was treated with Xuebijing injection on the basis of the control group. The treatment time was 7 days, and the clinical symptoms such as cough, expectoration and phlegm were compared between the two groups. Paco _ 2, CO _ 2, CO _ 2, WBC, PCT, Hs-CRP, ESR, IL-6IL-6, helper T lymphocyte CD4, suppressive T lymphocyte CD8) and CD4 / CD8 ratio The change of the ratio. The result is 1: 1. The improvement of cough, expectoration and other clinical symptoms in Xuebijing group was better than that in control group. The total effective rate of Xuebijing group was 94.30.The total effective rate of control group was 85.7g, which had statistical significance. After treatment, the content of Pao 2 in Xuebijing group was higher than that in control group, and the content of Pa CO2 in Xuebijing group was lower than that in control group. In Xuebijing group, the improvement of peripheral blood WBCand serum PCTX Hs-CRP ESRN IL-6 was better than that of control group, which had statistical significance (P 0.05). Compared with the control group, the CD4 of peripheral blood T lymphocytes in Xuebijing group was higher than that in the control group, and the decrease of CD4 / CD8 ratio was higher than that in the control group, which had statistical significance (P 0.05). Conclusion 1. Routine basic treatment plus Xuebijing injection can improve the clinical symptoms of patients with acute exacerbation of chronic obstructive pulmonary disease. Routine basic treatment with Xuebijing injection can increase the blood oxygen content in patients with acute exacerbation of chronic obstructive pulmonary disease and improve anoxic state. 3. Routine basic therapy with Xuebijing injection can improve the peripheral blood WBCand serum PCT Hs-CRPU ESR-IL-6 in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Routine basic therapy with Xuebijing injection can improve the immune function and immunity of patients with acute exacerbation of chronic obstructive pulmonary disease.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9

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