补肺活血胶囊联合布地奈德福莫特罗吸入粉雾剂对慢性阻塞性肺疾病急性加重期合并肺动脉高压的治疗效果研究

目的:探讨补肺活血胶囊联合布地奈德福莫特罗吸入粉雾剂治疗慢性阻塞性肺疾病急性加重期合并肺动脉高压的效果。方法:选取2019年1月至2021年1月该院收治的慢性阻塞性肺疾病急性加重期合并肺动脉高压患者80例,以随机数字表法分为对照组与研究组,每组40例。对照组患者给予常规对症治疗,研究组患者在对照组的基础上给予补肺活血胶囊联合布地奈德福莫特罗吸入粉雾剂治疗。采用慢性阻塞性肺疾病评估量表(CAT)评估患者生活质量;比较两组患者的临床疗效,治疗前后的免疫功能指标水平T淋巴细胞亚群CD3⁺、CD4⁺和CD8⁺,自然杀伤细胞(NK细胞)]、血气分析指标水平动脉血氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)和动脉血氧饱和度(SaO₂)]、肺功能指标水平第1 s用力呼吸容积(FEV₁)、FEV₁/用力肺活量(FVC)和最大呼气流量(PEF)]、肺动脉压力肺动脉舒张压(PADP)、肺动脉收缩压(PASP)和肺动脉平均压(MPAP)]和6 min步行试验(6MWT)距离。结果:研究组患者的治疗总有效率为87.50%(35/40),与对照组的65.00%(26/40)比较,明显较高,差异有统计学意义(P<0.05)。两组患者治疗14 d的CD3⁺、CD4⁺、NK细胞、PaO₂、SaO₂、FEV₁、FEV₁/FVC和PEF水平均升高,且研究组患者明显高于对照组,差异均有统计学意义(P<0.05)。两组患者治疗14 d的CD8⁺、PaCO₂、PADP、PASP和MPAP水平均降低,且研究组患者明显低于对照组,差异均有统计学意义(P<0.05)。两组患者出院后3个月的6MWT距离均延长,CAT评分均降低;且研究组患者6MWT距离明显长于对照组,CAT评分明显低于对照组,差异均有统计学意义(P<0.05)。结论:补肺活血胶囊联合布地奈德福莫特罗吸入粉雾剂治疗慢性阻塞性肺疾病急性加重期合并肺动脉高压,可有效改善患者肺功能、血气水平,降低肺动脉压力,提高免疫功能、运动耐力和生活质量,疗效显著。

Therapeutic Effect of Bufei Huoxue Capsule Combined with Budesonide/Formoterol Aerosol for Inhalation on Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Hypertension

OBJECTIVE:To probe into the therapeutic effect of Bufei Huoxue capsule combined with budesonide/formoterol aerosol for inhalation on acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with pulmonary hypertension.METHODS:Totally 80 patients with AECOPD complicated with pulmonary hypertension admitted into this hospital from Jan.2019 to Jan.2021 were selected and divided into control group and study group via the random number table,with 40 cases in each group.The control group was given conventional symptomatic treatment,while the study group was given Bufei Huoxue capsule combined with budesonide/formoterol aerosol for inhalation based on the control group.The COPD Assessment Scale(CAT)was used to assess life quality,the clinical efficacy,indicators of immunologic functionT-lymphocyte subpopulation CD3⁺,CD4⁺ and CD8⁺,natural killer cell(NK cell)],blood gas analysisarterial partial pressure of oxygen(PaO₂),arterial partial pressure of carbon dioxide(PaCO₂)and arterial oxygen saturation(SaO₂)],pulmonary functionforced expiratory volume in one second(FEV₁),FEV₁/forced vital capacity(FVC)and peak expiratory flow(PEF)],pulmonary artery pressurepulmonary artery diastolic pressure(PADP),pulmonary artery systolic pressure(PASP)and mean pulmonary artery pressure(MPAP)]and 6 min walk test(6MWT)distance were compared between two groups.RESULTS:The total effective rate was 87.50%(35/40)in the study group,which was significantly higher than 65.00%(26/40)in the control group,with statistically significant difference(P<0.05).The CD3⁺,CD4⁺,NK cell,PaO₂,SaO₂,FEV₁,FEV₁/FVC and PEF levels of both groups were increased after 14-day treatment,and those of the study group were significantly higher than the control group,with statistically significant differences(P<0.05).The CD8⁺,PaCO₂,PADP,PASP and MPAP levels of both groups decreased after treatment of 14 d,and those of the study group were significantly lower than the control group,with statistically significant differences(P<0.05).The 6MWT distance were prolonged and the CAT scores were decreased in both groups after discharge from hospital;the 6MWT distance of study group was significantly longer than that of the control group,and the CAT score of study group was significantly lower than that of the control group,with statistically significant differences(P<0.05).CONCLUSIONS:The combination of Bufei Huoxue capsule with budesonide/formoterol aerosol for inhalation in the treatment of AECOPD complicated with pulmonary hypertension can effectively improve patients’pulmonary function and blood gas level,reduce pulmonary arterial pressure,promote immunologic function,exercise tolerance and life quality,with remarkable therapeutic effect.