中西医结合治疗结核性肺源性心脏病的效果观察(1)
[摘要] 目的 探讨中西医结合治疗结核性肺源性心脏病(肺心病)的临床效果。 方法 选取本院2013年1月～2014年1月收治的60例结核性肺心病急性发作期患者为研究的对象。根据随机数字表法将患者分为治疗组和对照组，每组30例。对照组实施常规西医治疗，治疗组在对照组基础上加用痰热清注射液，比较两组的临床效果。 结果 两组治疗前的各项症状积分及总积分比较，差异无统计学意义(P>0.05)；治疗后，两组的各项症状评分均有所下降，治疗组的各项症状积分及总积分均显著低于对照组(P<0.05)。治疗组的总有效率为90.0%，显著高于对照组的70.0%(P<0.05)。 结论 中西医结合治疗结核性肺心病可显著改善临床症状，有效提高临床效果，值得推广应用。
[关键词] 痰热清注射液；肺结核；肺源性心脏病；急性发作期
[中图分类号] R541.5 [文献标识码] A [文章编号] 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
结核病是因结核杆菌引起的慢性传染病，其已经成为人类健康的一大杀手。肺部真菌感染为机会性感染，是临床常见疾病，在所有深部真菌感染中，肺部感染率最高[1]。在肺结核病情的持续进展下，其广泛破坏性病变会引起支气管扩张、肺气肿、肺纤维化、肺空洞、肺不张、肺空洞、胸膜增厚等严重毁损性病变，胸膜的广泛性钙化、纤维化会增加肺循环阻力，导致肺动脉高压，从而导致右心室扩大、肥厚甚至功能衰竭，引发肺源性心脏病(肺心病)[2]。目前，临床治疗结核性肺心病的效果还不甚理想，本院为提高结核性肺心病的治疗效果，在常规西医治疗基础上加用中药痰热清注射液，现报道如下。
1 资料与方法
1.1 一般资料
选取本院2013年1月～2014年1月收治的60例结核性肺心病急性发作期患者作为研究对象，所有患者均符合全国肺心病专业会议(第2次)[3]制订的肺心病诊断标准，其中男性39例，女性21例，年龄54～84岁，平均(62.5±3.4)岁，病程1～26年，平均(11.5±2.5)年，NYHA心功能分级：Ⅲ级33例，Ⅳ级27例。所有患者均有程度不一的右心衰竭和肺结核症状、体征，包括气短、咳痰、咳嗽、发热、心悸、无法平卧、下肢水肿、肺部啰音、肺气肿征、胸腹水、肝大等，结核性肺心病的病因主要是结核杆菌引起肺部感染。本研究通过了伦理委员会的相关审查，所有患者均签署知情同意书。根据随机数字表法将患者分为治疗组和对照组，每组30例。治疗组：男性20例，女性10例；年龄53～85岁，平均(63.4±3.6)岁；心功能分级：Ⅲ级17例、Ⅳ13例；病程1～26年，平均(1.3±2.2)年，合并营养不良者5例。对照组：男性19例，女性11例；年龄55～83岁，平均(61.3±2.9)岁；心功能分级：Ⅲ级16例、Ⅳ14例；病程1～26年，平均(11.7±2.6)年，合并营养不良者4例。两组患者的一般资料比较，差异无统计学意义(P>0.05)，具有可比性。 (徐秀珍)
[关键词] 痰热清注射液；肺结核；肺源性心脏病；急性发作期
[中图分类号] R541.5 [文献标识码] A [文章编号] 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
结核病是因结核杆菌引起的慢性传染病，其已经成为人类健康的一大杀手。肺部真菌感染为机会性感染，是临床常见疾病，在所有深部真菌感染中，肺部感染率最高[1]。在肺结核病情的持续进展下，其广泛破坏性病变会引起支气管扩张、肺气肿、肺纤维化、肺空洞、肺不张、肺空洞、胸膜增厚等严重毁损性病变，胸膜的广泛性钙化、纤维化会增加肺循环阻力，导致肺动脉高压，从而导致右心室扩大、肥厚甚至功能衰竭，引发肺源性心脏病(肺心病)[2]。目前，临床治疗结核性肺心病的效果还不甚理想，本院为提高结核性肺心病的治疗效果，在常规西医治疗基础上加用中药痰热清注射液，现报道如下。
1 资料与方法
1.1 一般资料
选取本院2013年1月～2014年1月收治的60例结核性肺心病急性发作期患者作为研究对象，所有患者均符合全国肺心病专业会议(第2次)[3]制订的肺心病诊断标准，其中男性39例，女性21例，年龄54～84岁，平均(62.5±3.4)岁，病程1～26年，平均(11.5±2.5)年，NYHA心功能分级：Ⅲ级33例，Ⅳ级27例。所有患者均有程度不一的右心衰竭和肺结核症状、体征，包括气短、咳痰、咳嗽、发热、心悸、无法平卧、下肢水肿、肺部啰音、肺气肿征、胸腹水、肝大等，结核性肺心病的病因主要是结核杆菌引起肺部感染。本研究通过了伦理委员会的相关审查，所有患者均签署知情同意书。根据随机数字表法将患者分为治疗组和对照组，每组30例。治疗组：男性20例，女性10例；年龄53～85岁，平均(63.4±3.6)岁；心功能分级：Ⅲ级17例、Ⅳ13例；病程1～26年，平均(1.3±2.2)年，合并营养不良者5例。对照组：男性19例，女性11例；年龄55～83岁，平均(61.3±2.9)岁；心功能分级：Ⅲ级16例、Ⅳ14例；病程1～26年，平均(11.7±2.6)年，合并营养不良者4例。两组患者的一般资料比较，差异无统计学意义(P>0.05)，具有可比性。 (徐秀珍)