【摘要】 目的:观察泻肺宁心汤对慢性肺源性心脏病(CPHD)急性期血管内皮功能和炎性因子的影响。方法:96例CPHD急性期患者随机按住院前后顺序分为观察组和对照组各48例。均给予抗感染、止咳、平喘、祛痰、利尿、抗心衰等对症治疗。观察组加服泻肺宁心汤,1剂/d,疗程均为14 d。监测动脉二氧化碳分压(PaCO2)、氧分压(PaO2)和血氧饱和度(SaO2)等血气指标,测量肺动脉压(mPAP)和心肌做功指数(Tei指数),检测血浆内皮素-1(ET-1)、一氧化氮(NO)、肿瘤坏死因子-α(TNF-α)和白介素-8(IL-8)水平,记录主要症状、体征评分。结果:观察组总有效率为93.75%,优于对照组的77.08%(P<0.05);治疗后观察组PaO2,SaO2高于对照组,PaCO2低于对照组(P<0.01);治疗后观察组mPAP,Tei指数及主要症状、体征评分均低于对照组(P<0.01);治疗后观察组ET-1低于对照组,NO水平高于对照组(P<0.01);治疗后观察组TNF-α和IL-8水平低于对照组(P<0.01)。结论:泻肺宁心汤能改善CPHD急性期患者临床症状、体征,改善通气/换气功能,并降低mPAP,改善心功能,其作用机制可能与调节血管内皮功能,降低炎性反应有关。更多还原

【Abstract】 Objective: The purpose is to observe the influence of Xiefei Ningxin decoction on vascular endothelial function and inflammatory factor in acute stage of chronic cor pulmonary heart disease(CPHD).Method: Ninety-six cases of CPHD patients were randomly divided into control group(48 cases) and observation group(48 cases) according to digital method. The patients in both groups took supportive treatment,aiming at anti-infection,relieving cough and asthma,eliminating phlegm,diuresis,heart failure,etc. The patients in observation group took Xiefei Ningxin soup,1 dose / day,course treatment 14 days. The blood gas indexes,such as Arterial carbon dioxide partial pressure(PaCO2),oxygen partial pressure(PaO2) and the blood oxygen saturation(SaO2) were monitored. Pulmonary artery pressure(mPAP) and Tei index were measured,detecting plasma endothelin 1(ET-1),nitric oxide(NO),tumor necrosis factor α(TNF-α) and interleukin 8(IL-8) level. The cardinal symptom and physical sign score were recorded. Result: The total curative effect of the observation group was 93. 75%,superior to 77. 08% of the control group(P < 0. 05). After treatment,PaO2and SaO2of patients in observation group were higher than the control group,while PaCO 2 is lower than the control group(P < 0. 01). The mPAP,myocardial performance index,cardinal symptom and physical sign score were lower than control group(P <0. 01). ET-1 of observation group was lower than the control group,while the NO level was higher than the control group(P < 0. 01). The levels of TNF-α and IL-8 of observation group were lower than the control group(P < 0. 01). Conclusion: Xiefei Ningxin decoction can improve clinical symptoms and physical signs of CPHD patients in acute stage,improving ventilation / air change function and heart function and reducing mPAP. The mechanism may be related to regulating endothelial function,reducing the inflammatory reaction.更多还原