目的 探討補(bǔ)肺活血膠囊聯(lián)合坎地沙坦酯片治療慢性肺心病的臨床療效。方法 選取2019年7月—2022年6月在北京市第六醫(yī)院就診的110例慢性肺心病患者,按照隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組,每組各55例。對(duì)照組患者口服坎地沙坦酯片,1次/d,2片/次。治療組在對(duì)照組基礎(chǔ)上口服補(bǔ)肺活血膠囊,4粒/次,3次/d。兩組患者連續(xù)治療6個(gè)月。觀察兩組的臨床療效,比較兩組患者的水腫、呼吸困難、肺啰音消失時(shí)間,以及氧合指數(shù)、血氧飽和度、二氧化碳分壓、左室射血分?jǐn)?shù)(LVEF)、肺動(dòng)脈壓力(PAP)、三尖瓣反流速度(TR)、N末端B型利鈉肽前體(NT-proBNP)、和胎素(CPN)、血管緊張素Ⅱ(Ang Ⅱ)水平。結(jié)果 治療后,治療組的總有效率(92.73%)明顯高于對(duì)照組的總有效率(78.18%)(P<0.05)。治療后,治療組水腫、呼吸困難、肺啰音消失時(shí)間均短于對(duì)照組(P<0.05)。治療后,兩組的氧合指數(shù)、血氧飽和度顯著升高,二氧化碳分壓顯著降低(P<0.05);治療組的氧合指數(shù)、血氧飽和度高于對(duì)照組,二氧化碳分壓低于對(duì)照組(P<0.05)。治療后,兩組的LVEF明顯升高,PAP、TR明顯降低(P<0.05);治療組的LVEF高于對(duì)照組,PAP、TR低于對(duì)照組(P<0.05)。治療后,兩組的血清NT-proBNP、CPN、Ang Ⅱ水平明顯降低(P<0.05),且治療組血清NT-pro BNP、CPN、AngⅡ水平明顯低于對(duì)照組(P<0.05)。結(jié)論 補(bǔ)肺活血膠囊聯(lián)合坎地沙坦酯片治療慢性肺心病的療效確切,有助于減輕臨床癥狀,改善患者血?dú)庵笜?biāo)和心肺功能,減輕心肌損傷。

Objective To investigate the clinical effect of Bufei Huoxue Capsules combined with Candesartan Cilexetil Tablets in treatment of chronic pulmonary heart disease.Methods Patients(110 cases) with chronic pulmonary heart disease in Beijing Sixth Hospital from July 2019 to June 2022 were divided into control and treatment groups according to the random number table method, and each group had 55 cases. Patients in the control group were po administered with Candesartan Cilexetil Tablets, 1 tablet/time, twice daily. Patients in the treatment group were po administered with Bufei Huoxue Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and the disappearance times of edema, dyspnea, and pulmonary rales, oxygenation index, blood oxygen saturation, and partial pressure of CO₂, LVEF, PAP, TR, the serum levels of NT-pro BNP, CPN, and Ang Ⅱ in two groups were compared.Results After treatment, the total effective rate in the treatment group(92.73%) was significantly higher than that in the control group(78.18%)(P<0.05). After treatment, the disappearance time of edema, dyspnea, and lung rales in the treatment group was shorter than that in the control group(P<0.05). After treatment, the oxygenation index and blood oxygen saturation in two groups were significantly increased, while the partial pressure of CO₂ were significantly decreased(P<0.05); The oxygenation index and blood oxygen saturation in the treatment group were higher than those in the control group, while the partial pressure of CO₂ in the treatment group was lower than that in the control group(P<0.05). After treatment, LVEF in two groups were significantly increased, but PAP and TR in two groups were significantly decreased(P<0.05). LVEF in the treatment group was higher than that in the control group, while PAP and TR in the treatment group were lower than those in the control group(P<0.05). After treatment, the serum levels of NT-pro BNP, CPN, and Ang Ⅱ in two groups were significantly lower(P<0.05), and the serum levels of NT-pro BNP, CPN, and Ang Ⅱ in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion Bufei Huoxue Capsules combined with Candesartan Cilexetil Tablets is effective in treatment of chronic pulmonary heart disease, which is helpful to alleviate clinical symptoms, improve blood gas indicators and cardiopulmonary function of patients, and reduce myocardial damage.

R972

北京市東城區(qū)衛(wèi)生科技計(jì)劃項(xiàng)目(東衛(wèi)健研[2022]-7)