【摘要】 目的观察心肺同治干预慢性阻塞性肺病(COPD)稳定期合并稳定性心绞痛气虚血瘀痰阻证的临床疗效。方法将96例COPD稳定期合并稳定性心绞痛气虚血瘀痰阻证患者随机分为对照组、橘红片组、通心络组和橘加通组,每组24例。对照组采取西医常规治疗;橘红片组在对照组的基础上加用橘红片3.6 g口服,每日2次;通心络组在对照组的基础上加用通心络胶囊1.04 g口服,每日3次;橘加通组在对照组的基础上加用橘红片和通心络胶囊,服法同上。各组疗程均为8周。比较治疗前后咳嗽、咯痰、呼吸困难评分及圣乔治呼吸问卷(SGRQ)评分,心绞痛发作次数、疼痛持续时间、硝酸甘油用量,肺功能[包括第一秒用力呼气容积(FEV1)、用力肺活量(FVC)]及血清C反应蛋白(CRP)、白细胞介素1β(IL-1β)、白细胞介素10(IL-10)水平。结果本组治疗前比较,橘红片组、通心络组和橘加通组可不同程度降低咳嗽、咯痰、呼吸困难评分及SGRQ评分,升高FEV1、FVC,降低心绞痛发作次数、疼痛持续时间、硝酸甘油用量及血清CRP、IL-1β、IL-10水平,并且橘加通组在部分指标上效果优于橘红片组和通心络组(P<0.05或P<0.01)。结论心肺同治法能改善COPD稳定期合并稳定性心绞痛气虚血瘀痰阻证患者临床症状、肺功能,抑制慢性持续性炎症反应可能是其重要机制之一。更多还原

【Abstract】 Objective To examine the clinical effect of simultaneous intervention for heart and lung on chronic obstructive pulmonary disease( COPD) of stationary phase combined with stable angina pectoris with Qi deficiencyblood stasis-phlegm blockade syndrome. Methods Ninety-six COPD stationary phase combined with stable angina pectoris patients with Qi deficiency-blood stasis-phlegm blockade syndrome were randomized into control group,Juhong [Exocarpium Citri Rubrum]tablet group,the Tongxinluo( 通心络) group and the Ju&Tong group,24 cases in each group. The control group was given western medicine routine therapy. In addition to the treatment of the control group,Juhong tablet 3. 6 g was given to the Juhong tablet group orally,twice each day; Tongxinluo capsule 1. 04 g was given to the Tongxinluo group orally,three times each day; Juhong tablet and Tongxinluo capsule were given to the Ju&Tong group. Each group was treated for 8 weeks. The following intems were compared before and after treatment including the scores of cough, cough up phlegm, dyspnea and St. George’ s Respiratory Questionnaire( SGRQ),anginal attacks,durante dolors,nitroglycerin consumption,pulmonary function [including forced expiratory volume in one second( FEV1) and forced vital capacity( FVC) ],as well as the levels of serum C reactive protein( CRP),interleukin 1β( IL-1β) and interleukin 10( IL-10). Results After treatment,the scores of cough,cough up phlegm,dyspnea and SGRQ decreased in the Juhong tablet group,the Tongxinluo group and the Ju&Tong group. FEV1 and FVC increased. Anginal attacks,durante dolors,nitroglycerin consumption,as well as the levels of serum CRP,IL-1βand IL-10 decreased. Moreover,the effect of certain indexes in the Ju&Tong group was superior to those in the Juhong tablet group and the Tongxinluo group( P < 0. 05 or P < 0. 01). Conclusion Simultaneous intervention for heart and lung might improve clinical symptoms and pulmonary function of COPD stationary phase combined with stable angina pectoris with Qi deficiency-blood stasis-phlegm blockade syndrome patients. Inhibiting chronic persistent inflammation might be one of the important mechanisms.更多还原