五苓散联合桃红四物汤加味佐治慢性阻塞性肺疾病合并肺动脉高压水瘀互结证疗效观察OA
Observation on the Efficacy of Wuling Powder Combined with Modified Taohong Siwu Decoction in the Treatment of Chronic Obstructive Pulmonary Disease with Pulmonary Arterial Hypertension with Combined Syndrome of Water and Static Blood
目的 观察五苓散联合桃红四物汤加味佐治慢性阻塞性肺疾病(COPD)合并肺动脉高压(PAH)水瘀互结证的临床疗效.方法 回顾性研究2018年5月—2024年5月南阳市第三人民医院呼吸科收治的COPD-PAH水瘀互结证患者64例,通过随机数字表法将其为对照组和观察组各32例.对照组给予氧疗、抗凝、钙通道阻滞剂和抗炎化痰治疗,观察组在此基础上给予五苓散联合桃红四物汤加味治疗.经治2周后,比较两组患者中医证候评分(咳嗽、咯痰、胸闷、气喘、气短),临床疗效,6 min步行距离(6-MWT),肺动脉收缩压(SPAP)水平.结果 治疗后,两组患者咳嗽、咯痰、胸闷、气喘、气短评分较治疗前均降低(P＜0.05),且观察组低于对照组(P＜0.05);观察组总有效率为93.8％(30/32),高于对照组的78.1％(25/32)(P＜0.05);两组患者6-MWT较治疗前均提高(P＜0.05),且观察组增幅大于对照组(P＜0.05);两组患者SPAP水平较治疗前均降低(P＜0.05),且观察组低于对照组(P＜0.05).进一步按压级分度分析,轻中度患者SPAP下降幅度优于重度患者(P＜0.05).结论 五苓散联合桃红四物汤加味佐治COPD-PAH 水瘀互结证,能显著改善患者临床症状、提高运动耐力,降低肺动脉压力,从而改善肺血管重构,减轻右心负荷,疗效良好,具有临床推广价值.
Objective To observe the clinical efficacy of Wuling Powder combined with Taohong Siwu Decoction in treating chronic obstructive pulmonary disease(COPD)complicated with pulmonary hypertension(PAH)with the syndrome of water-blood stasis.Methods A retrospective study was conducted on 64 patients with COPD-PAH and the syndrome of water-stasis interaction admitted to the respiratory department of the Third People's Hospital of Nanyang City from May 2018 to May 2024.The patients were randomly divided into a control group and an observation group,each with 32 cases using a random number table method.The control group received oxygen therapy,anticoagulation,calcium channel blockers,and anti-inflammatory expectorant treatment,while the observation group received additional treatment with Wuling Powder combined with Taohong Siwu Decoction with modifications.After two weeks of treatment,the TCM syndrome scores(cough,sputum,chest tightness,dyspnea,wheezing),clinical efficacy,6-minute walking distance(6-MWT),and pulmonary artery systolic pressure(SPAP)levels were compared between the two groups.Results After treatment,the scores for cough,sputum,chest tightness,chest pain,and dyspnea in both groups were lower than before treatment(P＜0.05),with the observation group showing lower scores than the control group(P＜0.05).The total effective rate in the observation group was 93.8％(30/32),higher than that in the control group[78.1％(25/32)](P＜0.05).The 6-MWT in both groups improved compared to before treatment(P＜0.05),with a greater increase in the observation group than in the control group(P＜0.05).The SPAP levels in both groups decreased compared to before treatment(P＜0.05),with the observation group showing lower levels than the control group(P＜0.05).Further analysis by severity classification revealed that the SPAP reduction was more pronounced in mild-to-moderate patients than in severe patients(P＜0.05).Conclusion Wuling Powder combined with Taohong Siwu Decoction with modifications can significantly improve clinical symptoms,enhance exercise tolerance,and reduce pulmonary artery pressure in patients with COPD-PAH and the syndrome of water-stasis interaction,thereby improving pulmonary vascular remodeling and alleviating right heart load,demonstrating good efficacy and clinical value for promotion.
崔付生
南阳市第三人民医院,河南南阳 473000
医药卫生
慢性阻塞性肺疾病肺动脉高压五苓散桃红四物汤临床报道
Chronic obstructive pulmonary diseasePulmonary arterial hypertensionWuling PowderTaohong Siwu DecoctionClinical report
《国医论坛》 2026 (3)
45-49,5
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