本文選題：慢性阻塞性肺疾病　切入點(diǎn)：穩(wěn)定性心絞痛　出處：《中醫(yī)雜志》2017年17期 　論文類(lèi)型：期刊論文

【摘要】：目的觀(guān)察心肺同治干預(yù)慢性阻塞性肺病(COPD)穩(wěn)定期合并穩(wěn)定性心絞痛氣虛血瘀痰阻證的臨床療效。方法將96例COPD穩(wěn)定期合并穩(wěn)定性心絞痛氣虛血瘀痰阻證患者隨機(jī)分為對(duì)照組、橘紅片組、通心絡(luò)組和橘加通組,每組24例。對(duì)照組采取西醫(yī)常規(guī)治療;橘紅片組在對(duì)照組的基礎(chǔ)上加用橘紅片3.6 g口服,每日2次;通心絡(luò)組在對(duì)照組的基礎(chǔ)上加用通心絡(luò)膠囊1.04 g口服,每日3次;橘加通組在對(duì)照組的基礎(chǔ)上加用橘紅片和通心絡(luò)膠囊,服法同上。各組療程均為8周。比較治療前后咳嗽、咯痰、呼吸困難評(píng)分及圣喬治呼吸問(wèn)卷(SGRQ)評(píng)分,心絞痛發(fā)作次數(shù)、疼痛持續(xù)時(shí)間、硝酸甘油用量,肺功能[包括第一秒用力呼氣容積(FEV1)、用力肺活量(FVC)]及血清C反應(yīng)蛋白(CRP)、白細(xì)胞介素1β(IL-1β)、白細(xì)胞介素10(IL-10)水平。結(jié)果本組治療前比較,橘紅片組、通心絡(luò)組和橘加通組可不同程度降低咳嗽、咯痰、呼吸困難評(píng)分及SGRQ評(píng)分,升高FEV1、FVC,降低心絞痛發(fā)作次數(shù)、疼痛持續(xù)時(shí)間、硝酸甘油用量及血清CRP、IL-1β、IL-10水平,并且橘加通組在部分指標(biāo)上效果優(yōu)于橘紅片組和通心絡(luò)組(P0.05或P0.01)。結(jié)論心肺同治法能改善COPD穩(wěn)定期合并穩(wěn)定性心絞痛氣虛血瘀痰阻證患者臨床癥狀、肺功能,抑制慢性持續(xù)性炎癥反應(yīng)可能是其重要機(jī)制之一。
[Abstract]:Objective to observe the clinical effect of cardiopulmonary Tongzhi intervention in stable stage of chronic obstructive pulmonary disease (COPD) combined with stable angina pectoris with Qi deficiency and blood stasis and phlegm obstruction. Methods 96 COPD patients with stable angina pectoris combined with Qi deficiency and blood stasis stagnation syndrome were randomly divided into control group. Tangerine tablet group, Tongxinluo group and tangerine plus Tongtong group, 24 cases in each group. The control group was treated with routine western medicine, and the orange red tablet group was treated with 3. 6 g orange red tablet twice a day on the basis of the control group. Tongxinluo group was treated with Tongxinluo capsule 1.04 g orally three times a day on the basis of the control group, and the tangerine Jiaotong group was treated with orange red tablet and Tongxinluo capsule on the basis of the control group. The course of treatment in each group was 8 weeks, and cough was compared before and after treatment. The scores of sputum, dyspnea and SGRQ, the number of angina pectoris, the duration of pain, the dosage of nitroglycerin, Pulmonary function [including forced expiratory volume in the first second (FEV1), forced vital capacity (FVC)] and serum levels of C-reactive protein (CRP), interleukin-1 尾 (IL-1 尾), interleukin-10 (IL-10). In Tongxinluo group and tangjiaotong group, the scores of cough, sputum, dyspnea and SGRQ were decreased to some extent, and the scores of FEV1 and FVCincreased, the number of angina pectoris attacks, the duration of pain, the dosage of nitroglycerin and the level of serum CRPP-IL-1 尾 IL-10 were decreased. And the effect of tangjiatong group was better than that of tanghong tablet group and Tongxinluo group (P0.05 or P0.01) in some indexes. Conclusion the same therapy of heart and lung can improve the clinical symptoms and pulmonary function of patients with stable angina pectoris combined with Qi deficiency and blood stasis and phlegm obstruction in stable period of COPD. Inhibition of chronic persistent inflammation may be one of its important mechanisms.
【作者單位】： 河北醫(yī)科大學(xué)研究生學(xué)院;河北醫(yī)科大學(xué)附屬以嶺醫(yī)院;河北以嶺醫(yī)藥研究院;石家莊以嶺藥業(yè)股份有限公司;
【基金】：國(guó)家重點(diǎn)基礎(chǔ)研究發(fā)展計(jì)劃(973計(jì)劃)(2012CB518606)
【分類(lèi)號(hào)】：R259

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