血府逐瘀汤辅助治疗对老年慢性阻塞性肺疾病急性加重期患者肺功能及血栓前状态的影响

摘要

Objective To investigate the effect of Xuefu Zhuyu Chinese Medical Therapy on the lung function and pre-thrombosis state (PTS) of chronic obstructive pulmonary disease with acute exacerbation (AECOPD). Methods Ninety old AECOPD patients were randomly divided into treatment group and control group (45 patients in each group). Control group was given conventional treatment and treatment group was given additional Xuefu Zhuyu decoc-tion for 1 week. FEV1, FVC, and Borg scores were assessed; blood gas index, arterial partial pressure of oxygen(PaO2), arterial oxygen saturation(SaO2), arterial partial pressure of carbon dioxide(PaCO2), and lactic acid (Lac) were mea-sured; coagulation related indicators, D-dimer(D-D), AT-III, fibrinogen(FIB), platelet(PLT), and activated prothrombin time(APTT)were determined before and at 1 and 2 weeks after treatment. Results After treatment, both groups had improved FEV1 and FEV1/FVC(all P<0.05), reduced Borg score(P<0.05), and improved PaO2, SaO2, PaCO2, and Lac(all P<0.05). Compared with control group, all above indicators in treatment group were better (all P<0.05). At 1 week and 2 weeks after treatment, the levels of D-D, AT-III, FIB, and PLT were reduced in both groups (P<0.05), while APTT was increased (P<0.05), but significant differences in these indicators were found between the 2 groups (all P<0.05). Conclusion Xuefu Zhuyu decoction can release PTS of AECOPD patients, improve blood gas and lung function indi-cators, which may be related to inhibiting platelet aggregation, reducing the levels of D-D, AT-III, and FIB.%目的：观察血府逐瘀汤辅助治疗对老年慢性阻塞性肺疾病急性加重期（AECOPD）患者肺功能及血栓前状态（PTS）的影响。方法90例老年AECOPD患者随机分为治疗组和对照组，各45例。对照组给予常规治疗，治疗组在常规治疗基础上加用血府逐瘀汤治疗，疗程1周；两组治疗前及治疗后1、2周测定1秒用力呼气容积（FEV1）、肺活量（FVC）及呼吸困难程度Borg评分；检测动脉血氧分压（PaO2）、血氧饱和度（SaO2）、动脉二氧化碳分压（PaCO2）、血乳酸（Lac）血气指标；检测D-二聚体（D-D）、抗凝血酶芋（AT-芋）、纤维蛋白原（FIB）、血小板（PLT）及活化部分凝血酶原时间（APTT）等凝血相关指标。结果与治疗前比较，两组治疗1、2周后肺功能指标FEV1、FEV1/FVC均显著改善（P均约0.05），呼吸困难Borg评分下降（P均约0.05）；治疗组治疗1、2周后FEV1、FEV1/FVC高于对照组（P约0.05），Borg评分低于对照组（P约0.05）；两组治疗后1、2周PaO2、SaO2、PaCO2、Lac均较治疗前有所改善（P均约0.05）；治疗组治疗后1、2周上述指标改善显著优于对照组（P均约0.05）；两组治疗后1、2周血浆D-D、AT-芋、FIB、PLT均降低（P约0.05），APTT升高（P约0.05），但治疗组上述指标改善明显优于对照组（P均约0.05）。结论血府逐瘀汤辅助治疗能够缓解AECOPD患者血栓前状态，改善血气指标及肺功能，其作用机制可能与抑制血小板聚集，降低D-二聚体、抗凝血酶芋及纤维蛋白原有关。