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目的:观察温肺活血汤联合常规疗法治疗慢性阻塞性肺疾病(COPD)继发性肺动脉高压的疗效及其对血清C-反应蛋白的影响。方法:将97例患者随机分为实验组47例、对照组50例,对照组给予西医常规治疗,实验组在常规治疗基础上口服温肺活血汤,疗程为1月。监测患者治疗前后的血气分析指标[pH、动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)、碳酸氢根(HCO3-)]、血清C-反应蛋白(CRP)水平,观察肺动脉收缩压和主要症状积分的变化。结果:治疗1月后,2组肺动脉收缩压、总临床症状积分均较治疗前下降(P<0.01),实验组以上2项指标值均低于对照组(P<0.01)。治疗后,2组PaCO2、HCO3-均较治疗前下降,pH、PaO2上升,差异均有显著性意义(P<0.05);实验组PaCO2、HCO3-均低于对照组,PaO2高于对照组,差异均有显著性意义(P<0.05)。2组CRP水平均较治疗前下降,实验组CRP水平低于对照组,差异均有显著性意义(P<0.05)。结论:温肺活血汤联合常规疗法治疗可改善COPD患者肺动脉高压、临床症状、缺氧及二氧化碳潴留状况,并降低患者血清CRP水平。
Objective: To observe the curative effect of Wenxuehuoxue Decoction combined with routine therapy on secondary pulmonary hypertension in patients with chronic obstructive pulmonary disease (COPD) and its effect on serum C-reactive protein. Methods: Ninety-seven patients were randomly divided into experimental group (n = 47) and control group (n = 50). The control group was given conventional western medicine. The experimental group was given Wenfeng Huoxue Decoction on the basis of routine treatment. The blood gas analysis indexes (pH, PaO2, PaCO2, HCO3-) and serum C-reactive protein (CRP) levels in patients before and after treatment were monitored to observe pulmonary arterial systolic pressure And the main symptom score changes. Results: After 1 month of treatment, systolic blood pressure and total clinical symptom scores of two groups decreased significantly compared with before treatment (P <0.01). The above two indexes in experimental group were lower than those in control group (P <0.01). After treatment, PaCO2 and HCO3- in both groups decreased compared with those before treatment, while pH and PaO2 increased significantly (P <0.05). PaCO2 and HCO3- in the experimental group were lower than those in the control group, PaO2 was higher than that in the control group, The difference was significant (P <0.05). CRP levels in both groups decreased compared with those before treatment, and CRP levels in the experimental group were significantly lower than those in the control group (P <0.05). Conclusion: Wenxuehuoxue Decoction combined with conventional therapy can improve pulmonary hypertension, clinical symptoms, hypoxia and carbon dioxide retention in patients with COPD and reduce serum CRP levels.