养心息风汤联合米力农对COPD并发肺心病急性加重患者凝血酶、脑钠肽及D-二聚体水平的影响

摘要

Objective:To observe the influence of Yangxin Xifeng Decoction combined with Milrinone on the levles of thrombin,brain natriuretic peptide (BNP) and D-dimer in acute exacerbation of patients with chronic obstructive pulmonary disease (COPD) combined with chronic pulmonary heart disease.Methods:Ninety-two cases of acute exacerbation of COPD combined with chronic pulmonary heart disease patients were divided into the control group and the study group with forty-six cases in each group according to the random number table method.The control group was given Milrinone treatment,while the study group was given Yangxin Xifeng Decoction combined with Milrinone treatment,and two groups were treated for 10d.The scores of TCM syndrome,pulmonary artery pressure (PAP),left ventricular ejection fraction (LVEF),arterial oxygen partial pressure (PaO2),thrombin time (TT) and serum BNP and D-dimer levels in two groups were observed before and after treatment,and the clinical efficacy of two groups was compared.Results:After treatment,the scores of TCM syndromes in the two groups were significantly decreased(P＜0.05),and the study group was significantly lower than the control group (P ＜ 0.05);after treatment,the PAP of two groups were significantly decreased (P ＜ 0.05);the LVEF and PaO2 were significantly increased (P＜0.05),and the study group was significantly better than the control group(P ＜ 0.05);after treatment,TT of two groups were significantly prolonged (P ＜ 0.05);the levels of serum BNP and Ddimer decreased significantly (P＜ 0.05),and the study group was significantly better than the control group (P＜0.05);the total effective rate of the study group was 93.48％,which was significantly higher than that of the control group(P＜ 0.05).Conclusion:Yangxin Xifeng Decoction combined with Milrinone has a significant effect on patients with acute exacerbation of chronic pulmonary heart disease complicated with COPD,and can prolong TT,and decrease the levels of BNP and D-dimer.%目的 观察养心息风汤联合米力农对慢性阻塞性肺疾病(COPD)并发肺心病急性加重患者凝血酶、脑钠肽(BNP)及D-二聚体水平的影响并探讨其机制.方法 将92例COPD并发肺心病急性加重患者按照随机数字表法分为对照组与研究组各46例,对照组给予米力农治疗,研究组给予养心息风汤联合米力农治疗,两组均持续治疗10 d.观察两组治疗前后中医证候积分、肺动脉压(PAP)、左室射血分数(LVEF)、动脉氧分压(Pa02)、凝血酶时间(TT)及血清BNP、D-二聚体水平,比较两组临床疗效.结果 治疗后两组中医证候积分均显著降低(P＜0.05),且研究组低于对照组(P＜0.05);治疗后两组PAP降低(P＜0.05),LVEF及PaO2升高(P＜0.05),且研究组优于对照组(P＜0.05);治疗后两组TT延长(P＜0.05),血清BNP及D-二聚体水平降低(P＜0.05),且研究组优于对照组(P＜0.05);研究组总有效率为93.48％,高于对照组76.09％(P＜0.05).结论 养心息风汤联合米力农治疗COPD并发肺心病急性加重患者效果显著,可延长TF,降低血清BNP、D-二聚体水平.