【作者】 荆丰德；

【导师】 于忠学；

【作者基本信息】 黑龙江中医药大学 ， 中医内科学， 2003， 硕士

【摘要】 慢性肺源性心脏病(Chronic cor pulmonale,ccp)是由肺组织、肺动脉血管或胸廊的慢性病变引起肺组织结构和功能异常，产生肺血管阻力增加，肺动脉压力增高，使右心扩大，肥大，伴或不伴右心衰竭的心脏病，是呼吸系统的一种常见病。肺心病的患病率存在地区的差异，北方患病率高于南方地区，随着年龄增高而患病率增高。本病占住院心脏病的38.5％～46％。是严重威胁人类生命的重要疾病之一。加强缓解期间的防治是阻止慢性肺源性心脏病发展的关键，中医药对CCP缓解期的治疗较西医有很大优势。本研究旨在观察补肺益肾汤治疗CCP缓解期肺肾气虚型的临床疗效。 本研究将100例CCP缓解期肺肾气虚型患者随机分为对照组和治疗组，治疗组50例，采用补肺益肾汤治疗，对照组50例采用西医综合治疗，30天为一疗程，共观察2个疗程。观察两组治疗前后症状体征变化。结果表明：治疗组疗效显效率为40％，总有效率为96％；对照组疗效显效率为20％，总有效率为72％，两组总有效率有显著性差异。在改善病人主要临床症状方面，治疗组优于对照组(P＜O.05)，补肺益肾汤在增强机体免疫能力，减少患者感冒次数及CCP急性发作次数的作用优于对照组。 我们认为，CCP缓解期以肺肾气虚为主要发病机制。治疗上应以补肺益肾，纳气平喘为主要治法。补肺益肾汤对CCP缓解期肺肾气虚型有较好的疗效。更多还原

【Abstract】 The abnormality of lung structure and lung function induced by the extensive chronic pathological changes of pulmonary artery, pulmonary organization and thorax led up to the increase of pulmonary vascular resistences,which caused pulmonary hypertension, pulmonary hypertension was in duced to enlarge the right ventricle, with or without right ventricular failure. This kind of disease above is called chronic cor pulmonale, which is one kind of common ailment in the respiratory system. The falling ill rate of pulmonary heart disease is area divergence. In Northern area the falling ill rate is more than the southern area, the higher age gets, the higher fallng ill rate is. CCP threatens human life seriously. The key to preventing the development of CCP lies in prophylaxis and treatment of catabasis. Traditional Chinese medicine is superior to western medicine in treating CCP of catabasis. This study was conducted to observe the clinical effect of treatment of deficiency of pulmonary and renal Qi of catabasis of CCP with Bu fei Yi shen decoction.We dividied 100 pationts into two groups randomly. The 50 cases of the treated group were treated with "Bu fei Yi shen decoction", while only routine treatment for control group. Symptoms, signs were observed before and after the treatment. The results indicated that the obvious effective rate(40%) was signiticantly higher than that in control group (20%). Thetotal response rate in treated group (96%) was significantly higher than that in control group(54%). There was significant difference in the total effective rate between both groups (p < 0.05). The Improvement of symptoms in treated group were much better than those of the control group (p < 0.05). Bu fei Yi shen decoction also can build up immunity ability of human body, and decrease acute breakout of CCP without side effect.We think the main mechainism of CCP relieving course is deficiency of pulmonary and renal Qi. Invigorating the lung, nourishing the kidney and preventing asthma were the main ways to CCP. The was very effective of Bu fei Yi shen decoction to the deficiency of pulmonary and renal Qi of relieving course of CCP.Bu fei Yi shen decoction is an effective medicine to the prophylaxis and treatment of CCP.更多还原