清金化痰颗粒干预痰热壅肺型慢性肺源性心脏病患者的临床观察

发布时间：2018-01-21 02:08

本文关键词： 慢性肺源性心脏病痰热壅肺证清金化痰汤　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察在西医常规治疗基础上加用清金化痰颗粒治疗痰热壅肺型肺源性心脏病患者的疗效,为清金化痰颗粒治疗痰热壅肺型慢性肺源性心脏病提供依据。方法:观察病例均来自时间为2015年1月至2016年1月广西中医药大学第一附属医院肺病科痰热壅肺型慢性肺源性心脏病住院患者64例,将64例患者随机分为对照组和治疗组,两组均给予西医常规治疗,治疗组加用清金化痰汤颗粒剂,观察两组治疗前后症状、体征、肺动脉平均压、心输出量、血常规、血气分析、凝血功能、血液流变学和脑钠肽(brain natriuretic peptide,BNP)等变化以及治疗后的有效率,并统计分析两组之间的差别。结果:(1)经统计分析,治疗组总有效率为87.50%;对照组总有效率为71.88%;治疗组的临床疗效优于对照组,差异有统计学意义(P0.05)。(2)在症状和体征方面,治疗组的症状总积分和体征总积分低于对照组,治疗组改善症状和体征方面优于对照组(P0.05)。(3)在肺动脉平均压方面,治疗组的肺动脉平均压低于对照组,但治疗组改善肺动脉平均压优于对照组(P0.05)。(4)在心输出量方面,治疗组的心输出量高于对照组,治疗组改善心输出量优于对照组(P0.05)。(5)在白细胞方面,治疗组的白细胞和中性粒细胞百分比低于对照组,治疗组改善白细胞方面优于对照组(P0.05)。(6)治疗组的动脉血二氧化碳分压(partial pres-sure of carbon dioxide in artery,PaCO2)、血氧分压(partial pressure of oxygen,PaO2)和动脉血氧饱和度(arterial oxygen saturation,SaO2)与对照组相比,治疗组改善优于对照组(P0.05)。(7)在凝血功能方面,治疗组的凝血酶原时间、活化部分凝血活酶时间和凝血酶时间与对照组相比,治疗组改善凝血优于对照组(P0.05)。(8)在血液流变学方面,治疗组的全血高切粘度、全血低切粘度、血浆粘度、红细胞聚集指数与对照组相比,治疗组改善血液流变学方面优于对照组(P0.05)。(9)在BNP检测方面,治疗组的BNP与对照组相比,治疗组改善心功能方面优于对照组(P0.05)。结论:清金化痰颗粒结合西药治疗能提高痰热壅肺型慢性肺源性心脏病患者治疗疗效,改善患者症状、体征。清金化痰颗粒可以作为痰热壅肺型慢性肺源性心脏病的重要的辅助治疗方法。
[Abstract]:Objective: to observe the curative effect of Qingjin Huatan granule (QJHuatan) on the treatment of pulmonary pulmonary heart disease with phlegm and heat obstruction on the basis of routine western medicine treatment. To provide the basis for Qingjin Huatan granule in treating chronic pulmonary heart disease with phlegm and heat obstruction. Methods:. From January 2015 to January 2016, 64 cases of chronic pulmonary heart disease with chronic pulmonary heart disease with phlegm-heat obstruction in the Department of Pulmonary Diseases, first affiliated Hospital of Guangxi University of traditional Chinese Medicine were observed. 64 patients were randomly divided into control group and treatment group, both groups were treated with routine western medicine, the treatment group was treated with Qingjinhuatan decoction granule, the symptoms, signs, mean pulmonary artery pressure, cardiac output were observed before and after treatment. The changes of blood routine, blood gas analysis, coagulation function, hemorheology, brain natriuretic peptide (BNP), and the effective rate after treatment were observed. The results showed that the total effective rate of the treatment group was 87.50; The total effective rate of the control group was 71.88; The clinical curative effect of the treatment group was better than that of the control group, the difference was statistically significant (P 0.05. 05. 2) in terms of symptoms and signs, the total score of symptoms and signs in the treatment group was lower than that in the control group. The improvement of symptoms and signs in the treatment group was better than that in the control group (P0.05. 3) the mean pulmonary artery pressure in the treatment group was lower than that in the control group. But the improvement of the mean pulmonary artery pressure in the treatment group was better than that in the control group (P 0.05). The cardiac output in the treatment group was higher than that in the control group. The percentage of leukocytes and neutrophils in the treatment group was lower than that in the control group. The improvement of leukocyte in the treatment group was better than that in the control group (P0.05. 0. 0. 6) the partial pressure of arterial blood carbon dioxide in the treatment group (. Partial pres-sure of carbon dioxide in artery. PaCO2, partial pressure of oxygen. PaO2) and arterial oxygen saturation (Pao 2) and arterial oxygen saturation (SaO2) were compared with those in the control group. Compared with the control group, the prothrombin time, activated partial thromboplastin time and thrombin time in the treatment group were better than those in the control group. In hemorheology, the whole blood viscosity, low shear viscosity, plasma viscosity and erythrocyte aggregation index of the treatment group were higher than those of the control group. The improvement of hemorheology in the treatment group was better than that in the control group (P0.05. 9) in BNP detection, the BNP in the treatment group was compared with the control group. Conclusion: Qingjin Huatan granule combined with western medicine can improve the therapeutic effect of phlegm-heat blockage pulmonary chronic pulmonary heart disease patients and improve the symptoms of patients. Physical signs. Qingjin Huatan granule can be used as an important adjuvant therapy for chronic pulmonary heart disease with phlegm and heat obstruction.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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