内科

目的观察麻杏五子汤配合低分子肝素雾化吸入治疗肺源性心脏病（肺心病）急性加重期的疗效及对患者血浆N末端B型脑钠肽前体(NT-proBNP)、血浆内皮素1(ET-1)水平和心肺功能的影响。方法选取2015年1月至2017年6月我院收治的肺心病急性加重期患者134例，采用随机数字表法分为观察组与对照组，每组67例。对照组患者在常规治疗的基础上给予低分子肝素雾化吸入治疗，观察组患者在对照组治疗基础上加用麻杏五子汤治疗。比较两组患者的临床疗效、血浆NT-proBNP水平、ET-1水平以及心肺功能。结果观察组患者的治疗总有效率为94.03%，对照组为80.60%，观察组患者的临床疗效显著优于对照组，差异有统计学意义（P＜0.05）。治疗14 d后，两组患者的血浆NT-proBNP与ET-1水平均显著降低，观察组患者的血浆NT-proBNP与ET-1水平显著低于对照组，差异有统计学意义（P＜0.01）；两组患者的每搏输出量（SV）、左室射血分数（LVEF）、心输出量（CO）均显著增高，观察组患者SV、LVEF及CO均明显高于对照组，差异有统计学意义（P＜0.01）；两组患者的1秒用力呼吸容积（FEV1）、肺活量（FVC）及呼吸流量峰值（PEF）均显著提高，观察组患者FEV1、FVC及PEF均明显高于对照组（P＜0.05）。结论麻杏五子汤配合低分子肝素雾化吸入治疗肺心病急性加重期患者可有效提高临床疗效，降低血浆NT-proBNP、ET-1水平，改善心肺功能。

ObjectiveTo observe the effect of Maxing Wuzi decoction combined with low molecular weight heparin in the treatment of acute exacerbation of pulmonary heart disease (PHD) and the effect on plasma N terminal B type natriuretic peptide precursor (NT-proBNP), plasma endothelin 1 (ET-1), level and cardiopulmonary function. Methods134 patients with acute exacerbation of PHD in our hospital from January 2015 to June 2017 were selected. They were randomly divided into observation group and control group, 67 cases in each group. The control group were treated with low molecular weight heparin atomization inhalation on the basis of routine treatment, and the observation group were treated with Maxing Wuzi decoction on the basis of the control group. The clinical efficacy, plasma NT-proBNP level, ET-1 level and cardiorespiratory function were compared between the two groups. ResultThe total effective rate of treatment in the observation group was 94.03%, and the control group was 80.60%. The clinical efficacy of the observation group was significantly better than that of the control group, with a statistically significant difference (P＜0.05). After the treatment of 14d, the plasma levels of NT-proBNP and ET-1 in the two groups were significantly decreased. The plasma NT-proBNP and ET-1 levels of the patients in the observation group were significantly lower than those in the control group (P＜0.01). The stroke volume (SV), left ventricular ejection fraction (LVEF) and cardiac output (CO) were significantly higher in the two groups. The SV, LVEF and CO in the observation group were significantly higher than those in the control group, the difference was statistically significant (P＜0.01). The FEV1, FVC and PEF of the two groups were significantly improved. The FEV1, FVC and PEF of the observation group were significantly higher than those of the control group (P＜0.05). ConclusionMaxing Wuzi decoction combined with low molecular weight heparin inhalation in the treatment of acute exacerbation of PHD patients can effectively improve the clinical effect, reduce the level of plasma NT-proBNP, ET-1, improve the heart and lung function.