摘要:
目的:观察中药内服外敷协同治疗慢性阻塞性肺疾病(简称慢阻肺,COPD)合并高黏血症患者的临床疗效.方法:100例COPD合并高黏血症患者分为观察组和对照组,每组各50例.对照组给予西药常规治疗;观察组在此基础上加用自拟豁痰化瘀中药方口服及穴位贴敷治疗.一疗程(14天)后观察两组临床疗效、肺功能水平及血液流变学指标变化.结果:观察组临床痊愈率明显高于对照组(44.00% vs 24.00%,P<0.01),无效率显著低于对照组(10.00% vs 26.00%,P<0.01).对照组治疗后肺功能指标中只有一秒呼气量(FEV1)与肺活量(FVC)比值(FEV1/FVC)较治疗前升高(P<0.05),而观察组治疗后肺功能指标FEV1、FEV1占预计值百分比和FEV1/FVC均较治疗前增加(P<0.05,P<0.01);且观察组治疗后FEV1/FVC明显大于对照组治疗后(P<0.05).对照组治疗前后血流变5项指标全血高切、低切表观黏度、红细胞压积、红细胞聚集指数、血浆黏度水平下降无统计学差异(P>0.05),观察组治疗后上述5项指标均较治疗前明显降低(P<0.05,P<0.01),且显著低于对照组治疗后水平(P<0.05,P<0.01).结论:中西医结合治疗COPD合并高黏血症,较之单纯应用西药能更明显提高临床痊愈率,更显著改善血液流变状态.%Objective:To observe the clinical effects of internal and external treatment of traditional Chinese medicine in chronic obstructive pulmonary disease (COPD) combined with blood hyperviscosity.Method:One hundred cases of COPD combined with blood hyperviscosity were divided into the observation group and the control group,50 cases in each group.The control group received conventional western medicine routine treatment.And the observation group received internal and external treatment of traditional Chinese medicine on the basis of the conventional medication.After a course of treatment,clinical effects,lung functions and hemorheology index changes were compared between two groups.Results:14 days after treatment,the cure rate in the observation group was significantly higher than that in the control group (44.00% vs 24.00%,respectively,P<0.01).The inefficiency rate in the observation group was significantly lower than that in the control group(10.00 % vs.26.00 %,respectively,P<0.01).FEV1/FVC of the control group was significantly improved after treatment(P<0.05).And FEV1,FEV1 percentage of expected value and FEV1/FVC were improvement after treatment in the observation group (P<0.05,P<0.01).After treatment in the observation group,FEV1/FVC was significantly higher than the control group(P<0.05).Before and after treatment in the control group,there was no significant difference in the level of blood rheology(P>0.05).Within the observation group,the indices of five blood rheology,including high shear rate and low shear rate apparent viscosity,hematocrit,erythrocyte aggregation index,plasma viscosity,were significantly decreased after treatment (P<0.05,P<0.01).All the indices of blood rheology after treatment in the observation group decreased significantly compared with the control group (P<0.05,P<0.01).Conclusion:The combination of traditional Chinese and western medicine in the treatment of high blood viscosity with COPD can significantly improve the clinical recovery rate and the blood rheology.