目的 探讨补肺活血胶囊联合坎地沙坦酯片治疗慢性肺心病的临床疗效。方法 选取2019年7月—2022年6月在北京市第六医院就诊的110例慢性肺心病患者,按照随机数字表法将所有患者分为对照组和治疗组,每组各55例。对照组患者口服坎地沙坦酯片,1次/d,2片/次。治疗组在对照组基础上口服补肺活血胶囊,4粒/次,3次/d。两组患者连续治疗6个月。观察两组的临床疗效,比较两组患者的水肿、呼吸困难、肺啰音消失时间,以及氧合指数、血氧饱和度、二氧化碳分压、左室射血分数(LVEF)、肺动脉压力(PAP)、三尖瓣反流速度(TR)、N末端B型利钠肽前体(NT-proBNP)、和胎素(CPN)、血管紧张素Ⅱ(Ang Ⅱ)水平。结果 治疗后,治疗组的总有效率(92.73%)明显高于对照组的总有效率(78.18%)(P<0.05)。治疗后,治疗组水肿、呼吸困难、肺啰音消失时间均短于对照组(P<0.05)。治疗后,两组的氧合指数、血氧饱和度显著升高,二氧化碳分压显著降低(P<0.05);治疗组的氧合指数、血氧饱和度高于对照组,二氧化碳分压低于对照组(P<0.05)。治疗后,两组的LVEF明显升高,PAP、TR明显降低(P<0.05);治疗组的LVEF高于对照组,PAP、TR低于对照组(P<0.05)。治疗后,两组的血清NT-proBNP、CPN、Ang Ⅱ水平明显降低(P<0.05),且治疗组血清NT-pro BNP、CPN、AngⅡ水平明显低于对照组(P<0.05)。结论 补肺活血胶囊联合坎地沙坦酯片治疗慢性肺心病的疗效确切,有助于减轻临床症状,改善患者血气指标和心肺功能,减轻心肌损伤。

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

北京市东城区卫生科技计划项目(东卫健研[2022]-7)