升陷汤加减辅助治疗慢性肺源性心脏病急性发作期的临床观察

摘要

OBJECTIVE:To explore the clinical efficacy and safety of modified Shengxian decoction in adjunctive treatment of acute episode of chronic pulmonary heart disease(CHPD). METHODS:208 patients with acute episode of CHPD were divided into observation group and control group with 104 cases in each group according to random number table method. Control group was given comprehensive treatment of western medicine,including oxygen inhalation,anti-infective therapy,eliminating phlegm, relieving asthma,correcting respiratory and heart failure,etc. Observation group was additionally given modified Shengxian decoc-tion,one dose a day,for 7 d,on the basis of control group. The cardiac and pulmonary function,clinical symptoms,sign score and total score were observed in 2 groups before treatment and after treatment. Clinical efficacy and the occurrence of ADR were compared between 2 groups. RESULTS:There was no statistical significance in FEV1/predictive value and FEV1/FVC between 2 groups before treatment (P>0.05);7 d after treatment,cardiac functional grading of 2 groups were improved significantly,and FEV1/predictive value and FEV1/FVC were increased significantly;the observation group was significantly better than the control group,with statistical significance(P<0.05). There was no statistical significance in clinical symptoms and signs,total score be-tween 2 groups before treatment and 3 d after treatment(P>0.05);7 d after treatment,above score of observation group were sig-nificantly lower than that of control group, with statistical significance (P<0.05). Total effective rate of observation group (98.1%) was significantly higher than that of control group (90.4%),with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:The adjunctive therapy with modified Shengxian decoction is significantly effective for acute episode of CHPD,and can improve the cardiac and pulmonary function and clinical manifestations with good safety.%目的：探讨升陷汤加减辅助治疗慢性肺源性心脏病（CHPD）急性发作期的临床疗效及安全性。方法：将208例CHPD急性发作期患者按随机数字表法分为观察组和对照组，各104例。对照组患者给予西医综合治疗，包括吸氧、抗感染、祛痰、平喘、纠正呼吸及心力衰竭等。观察组患者在对照组基础上辅以升陷汤加减治疗，每日1剂，水煎服，连服7d。观察两组患者治疗前后心肺功能情况、临床症状、体征积分、总积分，并比较两组患者临床疗效及不良反应发生情况。结果：两组患者治疗前心功能分级及一秒用力呼气容积（FEV1）/预测值、FEV1/用力肺活量（FVC）比较，差异无统计学意义（P＞0.05）；治疗7 d后，两组患者心功能分级均显著好转，FEV1/预测值、FEV1/FVC明显升高，且观察组显著优于对照组，差异均有统计学意义（P＜0.05）。两组患者治疗前及治疗3 d后临床症状、体征及总积分组间比较，差异均无统计学意义（P＞0.05）；治疗7 d后，观察组患者上述积分显著低于对照组，差异有统计学意义（P＜0.05）。观察组总有效率（98.1％）显著高于对照组（90.4％），差异有统计学意义（P＜0.05）。两组患者均未见明显不良反应发生。结论：升陷汤加减辅助治疗CHPD急性发作期疗效显著，能明显改善患者心肺功能及临床症状，且安全性较好。