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目的探讨川芎嗪治疗尘肺合并肺心病患者的临床效果及安全性。方法选取广西壮族自治区职业病防治研究院2013年11月—2015年11月收治的尘肺合并肺心病患者84例,随机分为对照组和治疗组,各42例。对照组患者入院后给予常规对症治疗,治疗组患者在对照组基础上给予川芎嗪注射液静脉滴注治疗,两组患者均持续治疗2周。比较两组患者的临床疗效,治疗前后血液流变学指标(全血高切黏度、全血低切黏度、血浆黏度)、血气分析指标[动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)],并比较两组患者肺心病症状消失时间、血液流变学和血气分析指标恢复正常时间、药物治疗总时间及不良反应发生情况。结果治疗组患者治疗有效率高于对照组(P<0.05)。治疗前,两组患者全血高切黏度、全血低切黏度、血浆黏度比较,差异无统计学意义(P>0.05);治疗后,治疗组患者全血高切黏度、全血低切黏度、血浆黏度低于对照组(P<0.05)。治疗前,两组患者PaO_2、PaCO_2比较,差异无统计学意义(P>0.05);治疗后,治疗组患者PaO_2高于对照组,PaCO_2低于对照组(P<0.05)。治疗组患者肺心病症状消失时间、血液流变学和血气分析恢复正常时间、药物治疗总时间短于对照组(P<0.05)。治疗组患者不良反应发生率低于对照组(P<0.05)。结论在常规治疗基础上联合川芎嗪治疗尘肺合并肺心病临床疗效确切,可有效改善患者血液流变学及血气分析指标,快速改善患者症状,且安全性高。
Objective To investigate the clinical effect and safety of ligustrazine in the treatment of patients with pneumoconiosis and pneumoconiosis. Methods Eighty-four patients with pneumoconiosis and pneumoconiosis admitted to the Institute of Occupational Disease Prevention and Control of Guangxi Zhuang Autonomous Region from November 2013 to November 2015 were randomly divided into control group and treatment group, 42 cases in each group. Patients in the control group were given conventional symptomatic treatment after admission. Patients in the treatment group were given intravenous infusion of ligustrazine injection on the basis of the control group, and patients in both groups were treated continuously for 2 weeks. The clinical curative effect was compared between the two groups. The indexes of hemorheology (such as whole blood high shear viscosity, whole blood low shear viscosity and plasma viscosity), blood gas analysis index (PaO_2, arterial carbon dioxide partial pressure (PaCO_2)]. The time of disappearance of symptoms of pulmonary heart disease, the normal time of hemorheology and blood gas analysis, the total time of drug treatment and the incidence of adverse reactions were compared between the two groups. Results The therapeutic efficiency of the treatment group was higher than that of the control group (P <0.05). Before treatment, the two groups of patients with high blood viscosity of whole blood, low blood viscosity of whole blood, plasma viscosity, the difference was not statistically significant (P> 0.05); after treatment, the treatment group patients with high blood viscosity, low blood viscosity , Plasma viscosity was lower than the control group (P <0.05). Before treatment, there was no significant difference in the PaO_2 and PaCO_2 between the two groups (P> 0.05). After treatment, the PaO_2 in the treatment group was higher than that in the control group and the PaCO_2 was lower than that in the control group (P <0.05). The disappearance time of pulmonary heart disease, hemorheology and blood gas analysis returned to normal in the treatment group, and the total duration of the drug treatment was shorter than that in the control group (P <0.05). The incidence of adverse reactions in the treatment group was lower than that in the control group (P <0.05). Conclusion The combination of tetramethylpyrazine on the basis of routine treatment is effective in treating pneumoconiosis complicated with cor pulmonale. It can effectively improve the hemorheology and blood gas analysis indexes of patients and rapidly improve the symptoms of patients with pneumoconiosis.