郭晓云 陈玉萍 贺燕

【摘要】 目的：探讨中西医结合治疗慢性阻塞性肺疾病（COPD）血管重塑的临床效果。方法：选择2018年9月-2019年9月于本院就诊的40例COPD患者，采用随机数字表法将其分为观察组与对照组，各20例。对照组给予常规西医治疗，观察组在对照组基础上加用玉屏风颗粒和葛根素治疗。对比两组临床疗效、血管重塑状态、改良英国医学研究学会呼吸困难指数（mMRC）及慢性阻塞性肺疾病评估测试（CAT）评分。观察两组治疗期间不良反应。结果：观察组治疗总有效率为95.00%，高于对照组的60.00%（P<0.05）。治疗6个月后，观察组%CSA 5～10 mm2与%CSA<5 mm2均高于对照组（P<0.05）。治疗6个月后，观察组mMRC与CAT评分均低于对照组（P<0.05）。两组治疗期间均未见明显不良反应。结论：中西医结合治疗能缓解COPD患者临床症状，改善呼吸困难，延缓血管重塑，是一种安全、有效的治疗方案。

【关键词】 慢性阻塞性肺疾病 玉屏风颗粒 葛根素 呼吸功能 血管重塑

Clinical Study of Integrated Traditional Chinese and Western Medicine in Treatment of COPD Vascular Remodeling/GUO Xiaoyun， CHEN Yuping， HE Yan. //Medical Innovation of China， 2021， 18（28）： 00-008

[Abstract] Objective： To investigate the clinical effect of integrated traditional Chinese and western medicine on vascular remodeling in chronic obstructive pulmonary disease （COPD）. Method： A total of 40 COPD patients admitted to our hospital from September 2018 to September 2019 were selected. They were divided into observation group and control group by random number table method， with 20 patients in each group. The control group was given conventional western medicine treatment， and the observation group was treated with Yupingfeng Granule and Puerarin in addition to the control group. Clinical efficacy， vascular remodeling status， modified British Medical Research Council （mMRC） and COPD assessment test （CAT） scores were compared between the two groups. Adverse symptoms during treatment were observed in the two groups. Result： The total effective rate of observation group was 95.00%， which was higher than 60.00% of control group （P<0.05）. After 6 months of treatment， %CSA 5-10 mm2 and %CSA<5 mm2 in the observation group were higher than those in the control group （P<0.05）. After 6 months of treatment， mMRC and CAT scores in the observation group were lower than those in the control group （P<0.05）. There were no obvious adverse reactions in both groups during treatment. Conclusion： Integrated traditional Chinese and western medicine treatment can alleviate the clinical symptoms of COPD patients， improve dyspnea， delay vascular remodeling. It is a safe and effective treatment program.

[Key words] Chronic obstructive pulmonary disease Yupingfeng Granules Puerarin Respiratory function Vascular remodeling

First-author’s address： Pingxiang Second People’s Hospital， Pingxiang 337000， China

doi：10.3969/j.issn.1674-4985.2021.28.002

慢性阻塞性肺疾病（COPD）是臨床常见的呼吸系统疾病，以气流受限为主要特征，发病后出现呼吸困难、分泌物排出困难等症状，呈进行性发展，可发展为呼吸衰竭、肺心病等，危及患者生命安全[1]。COPD病理特征包括肺实质变化、血管重塑及气道重构，其中血管重塑是形成肺心病、肺动脉高压的基础病变，是重要的病理特征[2-3]。现阶段关于COPD血管重塑的病因病机尚不明确，多认为炎症和吸烟是出现血管重塑的始动因素，而缺氧则加快了血管重塑，预防及逆转血管重塑是防治COPD的关键环节。鉴于此，本研究探讨了中西医结合治疗COPD血管重塑的临床效果，现报道如下。……