中西醫(yī)結(jié)合治療結(jié)核性肺源性心臟病的效果觀察(1)
[摘要] 目的 探討中西醫(yī)結(jié)合治療結(jié)核性肺源性心臟病(肺心病)的臨床效果。 方法 選取本院2013年1月～2014年1月收治的60例結(jié)核性肺心病急性發(fā)作期患者為研究的對象。根據(jù)隨機(jī)數(shù)字表法將患者分為治療組和對照組，每組30例。對照組實(shí)施常規(guī)西醫(yī)治療，治療組在對照組基礎(chǔ)上加用痰熱清注射液，比較兩組的臨床效果。 結(jié)果 兩組治療前的各項(xiàng)癥狀積分及總積分比較，差異無統(tǒng)計(jì)學(xué)意義(P>0.05)；治療后，兩組的各項(xiàng)癥狀評分均有所下降，治療組的各項(xiàng)癥狀積分及總積分均顯著低于對照組(P<0.05)。治療組的總有效率為90.0%，顯著高于對照組的70.0%(P<0.05)。 結(jié)論 中西醫(yī)結(jié)合治療結(jié)核性肺心病可顯著改善臨床癥狀，有效提高臨床效果，值得推廣應(yīng)用。
[關(guān)鍵詞] 痰熱清注射液；肺結(jié)核；肺源性心臟��；急性發(fā)作期
[中圖分類號] R541.5 [文獻(xiàn)標(biāo)識碼] A [文章編號] 1674-4721(2015)05(b)-0139-03
Effect observation of intrgrated traditional Chinese and western medicine treating tuberculo-pulmonary heart disease
XU Xiu-zhen
Disease Control and Prevention Center of Leping City in Jiangxi Province，Leping 333300，China
[Abstract] Objective To explore the clinical effect of integrated traditional Chinese and western medicine treating tuberculo-pulmonary heart disease. Methods 60 patients with tuberculo-pulmonary heart disease at acute attack stage admitted into our hospital from January 2013 to January 2014 were selected as research objects.They were evenly divided into treatment group and control group according to random number table method.In the group，regular western medicine treatment was applied，while in treatment group，on the basis of control group，Tanreqing injection was added.The clinical efficacy between two groups was compared. Results There was no statistical difference in symptom score of each item or total score before treatment (P>0.05).After treatment，symptom score of each item in two groups both decreased.The symptom score of each item and total score in treatment group were much higher than that in control group with statistical differences (P<0.05).The total effective rate in treatment group (90.0%) was obviously higher than that of control group (70.0%) (P<0.05). Conclusion In the treatment of tuberculo-pulmonary heart disease， integrated of traditional Chinese and western medicine can significantly improve the clinical symptoms and effect，and it is worthy of promotion and application.
[Key words] Tanreqing injection；Pulmonary tuberculosis；Pulmonary heart disease；Acute attack stage
結(jié)核病是因結(jié)核桿菌引起的慢性傳染病，其已經(jīng)成為人類健康的一大殺手。肺部真菌感染為機(jī)會性感染，是臨床常見疾病，在所有深部真菌感染中，肺部感染率最高[1]。在肺結(jié)核病情的持續(xù)進(jìn)展下，其廣泛破壞性病變會引起支氣管擴(kuò)張、肺氣腫、肺纖維化、肺空洞、肺不張、肺空洞、胸膜增厚等嚴(yán)重毀損性病變，胸膜的廣泛性鈣化、纖維化會增加肺循環(huán)阻力，導(dǎo)致肺動脈高壓，從而導(dǎo)致右心室擴(kuò)大、肥厚甚至功能衰竭，引發(fā)肺源性心臟病(肺心病)[2]。目前，臨床治療結(jié)核性肺心病的效果還不甚理想，本院為提高結(jié)核性肺心病的治療效果，在常規(guī)西醫(yī)治療基礎(chǔ)上加用中藥痰熱清注射液，現(xiàn)報(bào)道如下。
1 資料與方法
1.1 一般資料
選取本院2013年1月～2014年1月收治的60例結(jié)核性肺心病急性發(fā)作期患者作為研究對象，所有患者均符合全國肺心病專業(yè)會議(第2次)[3]制訂的肺心病診斷標(biāo)準(zhǔn)，其中男性39例，女性21例，年齡54～84歲，平均(62.5±3.4)歲，病程1～26年，平均(11.5±2.5)年，NYHA心功能分級：Ⅲ級33例，Ⅳ級27例。所有患者均有程度不一的右心衰竭和肺結(jié)核癥狀、體征，包括氣短、咳痰、咳嗽、發(fā)熱、心悸、無法平臥、下肢水腫、肺部啰音、肺氣腫征、胸腹水、肝大等，結(jié)核性肺心病的病因主要是結(jié)核桿菌引起肺部感染。本研究通過了倫理委員會的相關(guān)審查，所有患者均簽署知情同意書。根據(jù)隨機(jī)數(shù)字表法將患者分為治療組和對照組，每組30例。治療組：男性20例，女性10例；年齡53～85歲，平均(63.4±3.6)歲；心功能分級：Ⅲ級17例、Ⅳ13例；病程1～26年，平均(1.3±2.2)年，合并營養(yǎng)不良者5例。對照組：男性19例，女性11例；年齡55～83歲，平均(61.3±2.9)歲；心功能分級：Ⅲ級16例、Ⅳ14例；病程1～26年，平均(11.7±2.6)年，合并營養(yǎng)不良者4例。兩組患者的一般資料比較，差異無統(tǒng)計(jì)學(xué)意義(P>0.05)，具有可比性。 (徐秀珍)
[關(guān)鍵詞] 痰熱清注射液；肺結(jié)核；肺源性心臟��；急性發(fā)作期
[中圖分類號] R541.5 [文獻(xiàn)標(biāo)識碼] A [文章編號] 1674-4721(2015)05(b)-0139-03
Effect observation of intrgrated traditional Chinese and western medicine treating tuberculo-pulmonary heart disease
XU Xiu-zhen
Disease Control and Prevention Center of Leping City in Jiangxi Province，Leping 333300，China
[Abstract] Objective To explore the clinical effect of integrated traditional Chinese and western medicine treating tuberculo-pulmonary heart disease. Methods 60 patients with tuberculo-pulmonary heart disease at acute attack stage admitted into our hospital from January 2013 to January 2014 were selected as research objects.They were evenly divided into treatment group and control group according to random number table method.In the group，regular western medicine treatment was applied，while in treatment group，on the basis of control group，Tanreqing injection was added.The clinical efficacy between two groups was compared. Results There was no statistical difference in symptom score of each item or total score before treatment (P>0.05).After treatment，symptom score of each item in two groups both decreased.The symptom score of each item and total score in treatment group were much higher than that in control group with statistical differences (P<0.05).The total effective rate in treatment group (90.0%) was obviously higher than that of control group (70.0%) (P<0.05). Conclusion In the treatment of tuberculo-pulmonary heart disease， integrated of traditional Chinese and western medicine can significantly improve the clinical symptoms and effect，and it is worthy of promotion and application.
[Key words] Tanreqing injection；Pulmonary tuberculosis；Pulmonary heart disease；Acute attack stage
結(jié)核病是因結(jié)核桿菌引起的慢性傳染病，其已經(jīng)成為人類健康的一大殺手。肺部真菌感染為機(jī)會性感染，是臨床常見疾病，在所有深部真菌感染中，肺部感染率最高[1]。在肺結(jié)核病情的持續(xù)進(jìn)展下，其廣泛破壞性病變會引起支氣管擴(kuò)張、肺氣腫、肺纖維化、肺空洞、肺不張、肺空洞、胸膜增厚等嚴(yán)重毀損性病變，胸膜的廣泛性鈣化、纖維化會增加肺循環(huán)阻力，導(dǎo)致肺動脈高壓，從而導(dǎo)致右心室擴(kuò)大、肥厚甚至功能衰竭，引發(fā)肺源性心臟病(肺心病)[2]。目前，臨床治療結(jié)核性肺心病的效果還不甚理想，本院為提高結(jié)核性肺心病的治療效果，在常規(guī)西醫(yī)治療基礎(chǔ)上加用中藥痰熱清注射液，現(xiàn)報(bào)道如下。
1 資料與方法
1.1 一般資料
選取本院2013年1月～2014年1月收治的60例結(jié)核性肺心病急性發(fā)作期患者作為研究對象，所有患者均符合全國肺心病專業(yè)會議(第2次)[3]制訂的肺心病診斷標(biāo)準(zhǔn)，其中男性39例，女性21例，年齡54～84歲，平均(62.5±3.4)歲，病程1～26年，平均(11.5±2.5)年，NYHA心功能分級：Ⅲ級33例，Ⅳ級27例。所有患者均有程度不一的右心衰竭和肺結(jié)核癥狀、體征，包括氣短、咳痰、咳嗽、發(fā)熱、心悸、無法平臥、下肢水腫、肺部啰音、肺氣腫征、胸腹水、肝大等，結(jié)核性肺心病的病因主要是結(jié)核桿菌引起肺部感染。本研究通過了倫理委員會的相關(guān)審查，所有患者均簽署知情同意書。根據(jù)隨機(jī)數(shù)字表法將患者分為治療組和對照組，每組30例。治療組：男性20例，女性10例；年齡53～85歲，平均(63.4±3.6)歲；心功能分級：Ⅲ級17例、Ⅳ13例；病程1～26年，平均(1.3±2.2)年，合并營養(yǎng)不良者5例。對照組：男性19例，女性11例；年齡55～83歲，平均(61.3±2.9)歲；心功能分級：Ⅲ級16例、Ⅳ14例；病程1～26年，平均(11.7±2.6)年，合并營養(yǎng)不良者4例。兩組患者的一般資料比較，差異無統(tǒng)計(jì)學(xué)意義(P>0.05)，具有可比性。 (徐秀珍)