楊麗麗,張正義,姜 華,關(guān)曉麗,安虹瑾
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·中醫(yī)·中西醫(yī)結(jié)合研究·
苓桂術(shù)甘湯治療低氧性肺動(dòng)脈高壓的臨床療效研究
楊麗麗,張正義,姜 華,關(guān)曉麗,安虹瑾
目的探討苓桂術(shù)甘湯治療低氧性肺動(dòng)脈高壓(HPH)的臨床療效。方法選取2013年5月—2015年8月到蘭州大學(xué)第二醫(yī)院就診的HPH患者96例,采用隨機(jī)數(shù)字表法分為對(duì)照組(n=44)和試驗(yàn)組(n=52)。對(duì)照組患者采用常規(guī)治療,試驗(yàn)組患者在常規(guī)治療的基礎(chǔ)上服用苓桂術(shù)甘湯,兩組患者平均治療時(shí)間為(12±2) d。比較兩組患者治療前后的血清N端腦利鈉肽前體(NT-proBNP)水平、心肺功能指標(biāo)、血?dú)夥治鲋笜?biāo)、中醫(yī)證候積分,以及中醫(yī)證候療效和不良反應(yīng)發(fā)生情況。結(jié)果治療前兩組患者血清NT-proBNP水平比較,差異無統(tǒng)計(jì)學(xué)意義(P>0.05);治療后試驗(yàn)組患者血清NT-proBNP水平低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05);治療后兩組患者血清NT-proBNP水平均低于治療前,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療前兩組患者心排血量(CO)、左心室射血分?jǐn)?shù)(LVEF)、肺動(dòng)脈壓比較,差異無統(tǒng)計(jì)學(xué)意義(P>0.05);治療后試驗(yàn)組患者CO、LVEF高于對(duì)照組,肺動(dòng)脈壓低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05);治療后兩組患者CO、LVEF均高于治療前,肺動(dòng)脈壓均低于治療前,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療前兩組患者pH、血氧分壓(PaO2)、動(dòng)脈血二氧化碳分壓(PaCO2)比較,差異無統(tǒng)計(jì)學(xué)意義(P>0.05)。治療后兩組患者pH比較,差異無統(tǒng)計(jì)學(xué)意義(P>0.05);試驗(yàn)組患者PaO2高于對(duì)照組,PaCO2低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后兩組患者pH與治療前比較,差異均無統(tǒng)計(jì)學(xué)意義(P>0.05);PaO2均高于治療前,PaCO2均低于治療前,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療前兩組患者中醫(yī)證候積分比較,差異無統(tǒng)計(jì)學(xué)意義(P>0.05);治療后試驗(yàn)組患者中醫(yī)證候積分低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05);治療后兩組患者中醫(yī)證候積分均低于治療前,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。試驗(yàn)組患者中醫(yī)證候療效優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組患者均無明顯不良反應(yīng)發(fā)生。結(jié)論苓桂術(shù)甘湯治療HPH的臨床療效確切,可緩解患者低氧狀態(tài),利于患者預(yù)后。
高血壓,肺性;苓桂術(shù)甘湯;治療結(jié)果
楊麗麗,張正義,姜華,等.苓桂術(shù)甘湯治療低氧性肺動(dòng)脈高壓的臨床療效研究[J].中國(guó)全科醫(yī)學(xué),2016,19(28):3495-3499.[www.chinagp.net]
YANG L L,ZHANG Z Y,JIANG H,et al.Clinical effects of Lingguizhugan decoction in the treatment of hypoxic pulmonary hypertension[J].Chinese General Practice,2016,19(28):3495-3499.
低氧性肺動(dòng)脈高壓(HPH)是發(fā)展為慢性肺源性心臟病(肺心病)的中心環(huán)節(jié),??捎捎诜窝軆?nèi)阻力進(jìn)行性升高致右心室擴(kuò)張,嚴(yán)重者可引發(fā)右側(cè)心力衰竭,進(jìn)而致殘或致死[1]。盡管前列環(huán)素類和內(nèi)皮素-1受體拮抗劑等藥物可以明顯改善患者的生存質(zhì)量,但患者多預(yù)后較差[2-3]。中醫(yī)藥對(duì)降低肺動(dòng)脈壓、改善患者預(yù)后、提高患者生活質(zhì)量有獨(dú)特的治療效果。臨床上HPH患者多屬陽(yáng)虛水泛證,本研究采用張仲景《傷寒論》治痰飲名方苓桂術(shù)甘湯對(duì)HPH患者進(jìn)行治療,觀察其治療前后各項(xiàng)臨床指標(biāo)變化,評(píng)價(jià)其中醫(yī)證候療效,從而為HPH患者的臨床治療提供依據(jù)。
1.1研究對(duì)象選取2013年5月—2015年8月到蘭州大學(xué)第二醫(yī)院就診的HPH患者96例。HPH診斷標(biāo)準(zhǔn):彩色超聲檢查示,靜息狀態(tài)下肺動(dòng)脈收縮壓>30 mm Hg(1 mm Hg=0.133 kPa)和/或肺動(dòng)脈平均壓>25 mm Hg[4]。納入標(biāo)準(zhǔn):(1)年齡≤80歲;(2)美國(guó)紐約心臟病學(xué)會(huì)(NYHA)心功能分級(jí)為Ⅱ~Ⅲ級(jí)[5];(3)根據(jù)《中藥新藥臨床研究指導(dǎo)原則》,中醫(yī)辨證為脾腎陽(yáng)虛水泛證[6]286。排除標(biāo)準(zhǔn):(1)合并肺結(jié)核、肺癌等呼吸系統(tǒng)疾病,或冠心病、原發(fā)性心肌病等心血管疾?。?2)伴嚴(yán)重肝腎功能損害,或治療依從性差。研究通過了蘭州大學(xué)第二醫(yī)院倫理委員會(huì)的批準(zhǔn),納入患者均知情同意。
1.2研究方法采用隨機(jī)數(shù)字表法,將納入患者分為對(duì)照組(n=44)和試驗(yàn)組(n=52)。對(duì)照組患者采用常規(guī)治療,試驗(yàn)組患者在常規(guī)治療的基礎(chǔ)上服用苓桂術(shù)甘湯,兩組患者平均治療時(shí)間為(12±2) d。比較兩組患者治療前后的血清N端腦利鈉肽前體(NT-proBNP)水平、心肺功能指標(biāo)、血?dú)夥治鲋笜?biāo)、中醫(yī)證候積分,以及中醫(yī)證候療效和不良反應(yīng)發(fā)生情況。
本文要點(diǎn):
低氧性肺動(dòng)脈高壓(HPH)屬中醫(yī)“喘癥”“肺脹”等范疇,臨床多屬陽(yáng)虛水泛證,主要治則為“補(bǔ)益腎肺”“活血消淤”“疏通肺絡(luò)”。苓桂術(shù)甘湯源于漢代張仲景《傷寒論》,是治痰飲的經(jīng)典名方,方藥組成包括茯苓、白術(shù)、桂枝、甘草,重用茯苓。本研究探討了加減苓桂術(shù)甘湯治療HPH的臨床療效,結(jié)果顯示,苓桂術(shù)甘湯可以改善HPH患者的低氧狀態(tài),緩解其肺動(dòng)脈高壓狀況,符合從中醫(yī)辨證角度治療HPH的臨床要求。但需要注意的是,該方不可長(zhǎng)期應(yīng)用于高血壓患者的臨床治療,或者應(yīng)在長(zhǎng)期使用該方治療的患者中酌情去除甘草。
1.2.1治療方法(1)對(duì)照組患者采用常規(guī)治療,包括積極治療原發(fā)病,消除誘發(fā)因素與合并癥,合理使用利尿劑、β-受體阻滯劑、洋地黃制劑、血管擴(kuò)張劑等。必要時(shí)給予患者抗生素、吸氧等治療。(2)試驗(yàn)組患者在常規(guī)治療的基礎(chǔ)上,根據(jù)中醫(yī)辨證加減服用中藥苓桂術(shù)甘湯。苓桂術(shù)甘湯的藥物組成包括茯苓20 g、白術(shù)15 g、桂枝10 g、炙甘草10 g。水煎,1劑/d,復(fù)渣再煎,分早晚2次服用,2周為1個(gè)療程。
1.2.2血清NT-proBNP水平檢測(cè)采用美國(guó)Bio-Tek ELx800型全自動(dòng)酶標(biāo)儀和奧地利Biomedica公司生產(chǎn)的ELISA試劑盒檢測(cè)兩組患者血清NT-proBNP水平,操作嚴(yán)格按照說明書進(jìn)行。測(cè)定范圍為5~35 000 ng/L,分析靈敏度為5 ng/L,批內(nèi)變異系數(shù)(CV)<5%,批間CV<10%,檢測(cè)方法的各項(xiàng)質(zhì)量指標(biāo)及質(zhì)控參數(shù)均在允許范圍內(nèi)。
1.2.3心肺功能及血?dú)夥治鰴z查由超聲科醫(yī)生在患者入組時(shí)采用2.0~2.5 MHz探頭對(duì)其進(jìn)行心臟多普勒超聲檢查,記錄指標(biāo)包括心排血量(CO)、左心室射血分?jǐn)?shù)(LVEF)、肺動(dòng)脈壓,以右房室瓣反流壓加右心房壓估算肺動(dòng)脈收縮壓[7]。采用丹麥Radiometer公司生產(chǎn)的ABLS型血?dú)夥治鰞x進(jìn)行動(dòng)脈血?dú)夥治?,主要記錄指?biāo)包括pH、血氧分壓(PaO2)、動(dòng)脈血二氧化碳分壓(PaCO2)。
1.2.4中醫(yī)證候積分采用中醫(yī)證候積分法對(duì)患者治療前后的臨床癥狀/體征進(jìn)行評(píng)分,主要包括氣促、乏力、心悸、胸悶、喘促、下肢水腫等。0分代表無明顯癥狀,1分代表存在輕微癥狀或癥狀偶爾出現(xiàn),2分代表癥狀時(shí)輕時(shí)重或間斷出現(xiàn),3分代表癥狀明顯或持續(xù)出現(xiàn)[8]。
1.3中醫(yī)證候療效評(píng)價(jià)根據(jù)《中藥新藥臨床研究指導(dǎo)原則》中關(guān)于“中醫(yī)新藥治療心力衰竭的臨床指導(dǎo)原則”[6]287,制定中醫(yī)癥候療效評(píng)價(jià)標(biāo)準(zhǔn)。(1)顯效:患者治療后中醫(yī)證候積分為0分或減少>70.0%,主要癥狀與次要癥狀基本消失;(2)有效:患者治療后中醫(yī)證候積分減少30.0%~70.0%;(3)無效:患者治療后中醫(yī)證候積分減少<30.0%;(4)加重:患者治療后中醫(yī)證候積分高于治療前。
2.1兩組患者基本情況比較兩組患者性別、平均年齡、平均病程及心功能分級(jí)比較,差異無統(tǒng)計(jì)學(xué)意義(P>0.05,見表1)。
表1 兩組患者基本情況比較
注:a為t值
2.2兩組患者治療前后血清NT-proBNP水平比較治療前對(duì)照組和試驗(yàn)組患者血清NT-proBNP水平分別為(1 046±587)、(1 053±628)ng/L,兩組比較,差異無統(tǒng)計(jì)學(xué)意義(t=0.055,P>0.05);治療后兩組患者血清NT-proBNP水平分別為(728±74)、(687±78) ng/L,兩組比較,差異有統(tǒng)計(jì)學(xué)意義(t=2.625,P<0.05)。治療后兩組患者血清NT-proBNP水平與治療前比較,差異均有統(tǒng)計(jì)學(xué)意義(t′值分別為3.565、4.171,P<0.05)。
2.3兩組患者治療前后心肺功能指標(biāo)比較治療前兩組患者CO、LVEF、肺動(dòng)脈壓比較,差異無統(tǒng)計(jì)學(xué)意義(P>0.05);治療后兩組患者CO、LVEF、肺動(dòng)脈壓比較,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后兩組患者CO、LVEF、肺動(dòng)脈壓與治療前比較,差異均有統(tǒng)計(jì)學(xué)意義(P<0.05,見表2)。
Table 2Comparison of hearts and lung function indices of patients in two groups before and after treatment
組別例數(shù)CO(L/min)治療前 治療后LVEF(%)治療前 治療后肺動(dòng)脈壓(mmHg)治療前治療后對(duì)照組444.37±0.444.56±0.36a50.0±0.653.2±0.4a55±849±7a試驗(yàn)組524.35±0.475.67±0.31a50.2±0.561.5±0.6a55±945±7at(t')值0.21416.2341.78280.771b0.4722.312P值0.831<0.0010.078<0.0010.6380.023
注:CO=心排血量,LVEF=左心室射血分?jǐn)?shù);與治療前比較,aP<0.05;b為t′值;1 mm Hg=0.133 kPa
2.4兩組患者治療前后血?dú)夥治鲋笜?biāo)比較治療前兩組患者pH、PaO2、PaCO2比較,差異無統(tǒng)計(jì)學(xué)意義(P>0.05)。治療后兩組患者pH比較,差異無統(tǒng)計(jì)學(xué)意義(P>0.05);PaO2、PaCO2比較,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后兩組患者pH與治療前比較,差異均無統(tǒng)計(jì)學(xué)意義(P>0.05);PaO2、PaCO2與治療前比較,差異均有統(tǒng)計(jì)學(xué)意義(P<0.05,見表3)。
Table 3Comparison of blood gas analysis of patients in two groups before and after treatment
組別例數(shù)pH治療前 治療后PaO2(mmHg)治療前 治療后PaCO2(mmHg)治療前 治療后對(duì)照組447.35±0.097.36±0.1756±869±11a76±1153±13a試驗(yàn)組527.36±0.117.36±0.1357±874±11a77±1244±11at值0.4820.0000.0602.2930.3613.391P值0.6311.0000.9530.0240.7190.001
注:PaO2=血氧分壓,PaCO2=動(dòng)脈血二氧化碳分壓;與治療前比較,aP<0.05
2.5兩組患者中醫(yī)癥候積分及療效、不良反應(yīng)發(fā)生情況比較治療前對(duì)照組和試驗(yàn)組患者中醫(yī)證候積分分別為(2.11±0.67)、(2.31±0.74)分,兩組比較,差異無統(tǒng)計(jì)學(xué)意義(t=0.192,P>0.05);治療后兩組患者中醫(yī)證候積分分別為(1.61±0.56)、(1.21±0.63)分,兩組比較,差異有統(tǒng)計(jì)學(xué)意義(t=4.506,P<0.05)。治療后兩組患者中醫(yī)證候積分與治療前比較,差異均有統(tǒng)計(jì)學(xué)意義(t值分別為3.463、8.330,P<0.05)。兩組患者中醫(yī)證候療效比較,差異有統(tǒng)計(jì)學(xué)意義(Z=-2.463,P<0.05,見表4)。兩組患者均無明顯不良反應(yīng)發(fā)生。
表4 兩組患者中醫(yī)癥候療效比較(例)
HPH的主要臨床表現(xiàn)為呼吸困難逐漸加重,屬中醫(yī)“喘癥”“肺脹”等范疇,為“本虛標(biāo)實(shí)、虛實(shí)夾雜”的病證?!皩?shí)”表明夾有“外寒”“血淤”“水飲”“痰熱”等,“虛”表明存在“肺腎虛”“氣虛”等。由“氣虛”而致“血瘀”,由“痰阻”而致局部“肺絡(luò)不通”[9]?!皻馓摗笔荋PH發(fā)生的使動(dòng)因素,“痰阻”是繼發(fā)性病理改變,局部“肺絡(luò)不通”是病理結(jié)果,同時(shí)“氣虛”又貫穿整個(gè)病程,故臨床治療應(yīng)“補(bǔ)益腎肺”“活血消淤”“疏通肺絡(luò)”。
苓桂術(shù)甘湯源于漢代張仲景《傷寒論》,是一劑經(jīng)典古方,由茯苓、白術(shù)、桂枝、甘草組成,全方重用茯苓。茯苓性平甘淡,歸于心、肺、脾、腎經(jīng),淡能利竅,甘以助陽(yáng),有除濕之功效[10],可治療各種水腫。現(xiàn)代醫(yī)學(xué)研究表明,茯苓中含有的茯苓素是一種新型醛固酮受體拮抗劑,具有利尿的功效[11]。桂枝屬性甘溫,歸于肺、心、膀胱經(jīng),為下氣降逆、溫陽(yáng)化氣行水藥,可發(fā)汗解肌、溫通經(jīng)脈、溫助陽(yáng)氣,常與補(bǔ)肝腎、補(bǔ)氣血藥配伍。桂枝與茯苓相配伍,具有溫陽(yáng)化飲的作用[12]53-55。白術(shù)性溫甘苦,歸于脾、胃經(jīng),具有健脾益氣、燥濕利水的功效[12]503-504?,F(xiàn)代醫(yī)學(xué)研究表明,白術(shù)具有明顯而持久的利尿作用,不僅可以增加水排泄,還可以增加電解質(zhì)排泄[13]。茯苓、桂枝、白術(shù)配伍,有助于振奮脾陽(yáng),同時(shí)借肺陽(yáng)之溫化,去除痰飲。甘草性味干平,歸于脾、胃、心、肺經(jīng),具有益氣補(bǔ)中、止咳祛痰、調(diào)和諸藥等作用[14]。茯苓、桂枝、白術(shù)配伍甘草,可達(dá)“補(bǔ)益腎肺”“活血消淤”“疏通肺絡(luò)”的目的。
心力衰竭是各種心臟疾病的終末階段,而NT-proBNP不僅是反映心力衰竭的關(guān)鍵指標(biāo),也是評(píng)價(jià)患者預(yù)后的指標(biāo)[12]507-508。HPH是一種長(zhǎng)期暴露在低氧環(huán)境中所導(dǎo)致的復(fù)雜性病變,最終會(huì)引發(fā)不可逆的右側(cè)心力衰竭。有研究結(jié)果顯示,NT-proBNP水平較低患者的1年內(nèi)隨訪死亡率低于NT-proBNP水平較高患者[15]。本研究結(jié)果顯示,治療后兩組患者血清NT-proBNP水平均有所降低,且試驗(yàn)組低于對(duì)照組。提示在常規(guī)治療基礎(chǔ)上應(yīng)用苓桂術(shù)甘湯治療HPH,可以改善患者預(yù)后。血?dú)夥治鍪桥袛嗷颊呤欠翊嬖隗w液酸堿失衡及是否存在低氧和低氧程度的檢查方法[16]。本研究結(jié)果顯示,治療前后兩組患者的pH均無差異,提示患者在治療前后不存在體液酸堿失衡現(xiàn)象。另外,治療后兩組患者PaO2均有所升高,且試驗(yàn)組高于對(duì)照組,提示試驗(yàn)組患者血液氧溶解程度較高,苓桂術(shù)甘湯可改善HPH患者的低氧狀態(tài);治療后兩組患者PaCO2均有所下降,且試驗(yàn)組低于對(duì)照組,提示苓桂術(shù)甘湯可以在一定程度上緩解HPH患者的呼吸性酸中毒程度。CO可以反映每分鐘一側(cè)心室射出的總血量,可用于判斷患者心功能,診斷心力衰竭[17]。本研究結(jié)果顯示,治療后兩組患者CO均升高,且試驗(yàn)組高于對(duì)照組,同樣提示苓桂術(shù)甘湯可以緩解患者的低氧狀態(tài)。LVEF是反映心肌收縮能力的指標(biāo),水平越高表明心肌收縮力越強(qiáng)[18]。本研究中,兩組患者經(jīng)過治療后LVEF均有所提高,且試驗(yàn)組患者高于對(duì)照組,提示苓桂術(shù)甘湯可以提高患者的心肌收縮力,增加心臟每搏輸出量,進(jìn)而緩解低氧狀態(tài)。肺動(dòng)脈壓可以反映左心房的充盈程度[19]。本研究中兩組患者經(jīng)過治療后肺動(dòng)脈壓均下降,且試驗(yàn)組低于對(duì)照組,提示苓桂術(shù)甘湯具有降低肺動(dòng)脈壓效果。另外,本研究結(jié)果還顯示,試驗(yàn)組患者的中醫(yī)證候療效優(yōu)于對(duì)照組,兩組均無明顯不良反應(yīng)發(fā)生,提示苓桂術(shù)甘湯具有較好的中醫(yī)治療效果,且安全性較高。
綜上所述,苓桂術(shù)甘湯治療HPH的臨床療效確切,可以增加患者的血液氧溶量,降低PaCO2,從而改善患者低氧狀態(tài);增加患者心臟每搏心輸出量,提高LVEF,降低肺動(dòng)脈壓,緩解患者肺動(dòng)脈高壓狀況。同時(shí),苓桂術(shù)甘湯也滿足從中醫(yī)辨證角度治療HPH的要求。但需要注意的是,苓桂術(shù)甘湯中的甘草具有抑制皮質(zhì)醇轉(zhuǎn)化的作用[20],故該方不可長(zhǎng)期應(yīng)用于高血壓患者的臨床治療,或者應(yīng)在長(zhǎng)期使用該方治療的患者中酌情去除甘草。
作者貢獻(xiàn):楊麗麗進(jìn)行試驗(yàn)設(shè)計(jì)與實(shí)施、撰寫論文、成文,并對(duì)文章負(fù)責(zé);張正義、姜華、關(guān)曉麗、安虹謹(jǐn)進(jìn)行試驗(yàn)實(shí)施、評(píng)估、資料收集;楊麗麗、張正義進(jìn)行質(zhì)量控制與審校。
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(本文編輯:王鳳微)
Clinical Effects of Lingguizhugan Decoction in the Treatment of Hypoxic Pulmonary Hypertension
YANGLi-li,ZHANGZheng-yi,JIANGHua,GUANXiao-li,ANHong-jin.
DepartmentofGeneralMedicine,LanzhouUniversitySecondHospital,Lanzhou730030,China
Correspondingauthor:YANGLi-li,DepartmentofGeneralMedicine,LanzhouUniversitySecondHospital,Lanzhou730030,China;E-mail:yanglili2004058@163.com
ObjectiveTo investigate the clinical effects of Lingguizhugan decoction in the treatment of hypoxic pulmonary hypertension(HPH).Methods96 HPH patients who received treatment in Lanzhou University Second Hospital from May 2013 to August 2015 were selected and divided into control group(n=44) and experimental group(n=52) by using random number table method.The control group was treated with conventional therapy,based on which the experimental group took Lingguizhugan decoction.The average time of therapy of patients in two groups was(12±2) d.Serum N-terminal pro brain natriuretic peptide(NT-proBNP) level,hearts and lungs function indices,blood gas analysis,TCM symptom scores,and efficacy of TCM syndrome and occurrence of adverse reactions among patients in two groups before and after treatment were compared.ResultsSerum NT-proBNP levels of patients in two groups before treatment were not significantly different(P>0.05);after treatment,serum NT-proBNP level of patients in experimental group was significantly lower than that in control group(P<0.05);serum NT-proBNP levels of patients in two groups after treatment were significantly lower than those before treatment(P<0.05).There was no significant difference in cardiac output(CO),left ventricular ejection fraction(LVEF) and pulmonary artery pressure of patients in two groups before treatment(P>0.05);after treatment,CO and LVEF of patients in experimental group were significantly higher than those in control group,while pulmonary artery pressure in experimental group was lower than that in control group(P<0.05);both CO and LVEF of patients in two groups after treatment were significantly lower than those before treatment,while pulmonary artery pressure after treatment was lower than that before treatment(P<0.05).pH,partial pressure of blood oxygen(PaO2) and arterial partial pressure of carbon dioxide(PaCO2) of patients in two groups before treatment were not significantly different(P>0.05).pH of patients in two groups was not significantly different(P>0.05);PaO2of patients in experimental group was significantly higher than that in control group,while PaCO2was lower than that in control group(P<0.05).pH of patients in two groups after treatment and before treatment was not significantly different(P>0.05);PaO2in two groups was significantly higher than that before treatment,PaCO2was significantly lower than that before treatment(P<0.05).There was no significant difference in TCM symptom scores of patients in two groups before treatment(P>0.05);after treatment,TCM symptom scores of patients in experiment group were significantly lower than those in control group(P<0.05);TCM symptom scores of patients in two groups after treatment were significantly lower than those before treatment(P<0.05).Efficacy of TCM syndrome of patients in experiment group was better than that in control group(P<0.05).Patients in two groups had no obvious adverse reaction.ConclusionConclusion Lingguizhugan decoction has precise clinical effects on the treatment of HPH,and can remit patients′ hypoxic condition.It benefits prognosis of patients.
Hypertension,pulmonary;Lingguizhugan decoction;Treatment outcome
甘肅省青年科技研究基金資助項(xiàng)目(1308RJYA063)
730030 甘肅省蘭州市,蘭州大學(xué)第二醫(yī)院綜合內(nèi)科
楊麗麗,730030 甘肅省蘭州市,蘭州大學(xué)第二醫(yī)院綜合內(nèi)科;E-mail:yanglili2004058@163.com
R 544
ADOI:10.3969/j.issn.1007-9572.2016.28.023
2016-04-27;
2016-08-23)