活血化瘀药治疗结核性胸腔积液疗效观察Therapeutic effect of activating blood and removing stasis drugs on tuberculous pleural effusion.pdfVIP

提 要 目的：观察活血化瘀药对于结核性胸腔积液患者胸膜肥厚、粘连及包裹的作用。 方法：将符合本研究标准的 60 例患者按照入院先后顺序、对照的原则分为试验 组30例，对照组30例。试验组在常规治疗（基本治疗+抗结核治疗+中心静脉导管引 流）的基础上加用活血化瘀中成药制剂，静滴，每日一次。对照组常规治疗。观察两 组患者体温退至正常时间，胸胁胀痛、胸闷消失时间，胸水完全引流的天数，胸水引 流总量,治疗前后胸膜厚度、粘连及包裹情况，肝功能损伤情况，临床综合疗效和不 良反应等。 结果：治疗后，试验组患者体温退至正常时间、胸胁胀痛消失时间短于对照组 （p0.01）；两组患者胸闷消失时间差异无统计学意义（P0.05）；与对照组相比，试 验组胸水完全引流时间短（P0.05），胸水引流总量少（P0.05）；治疗后两个月，两 组患者胸膜均明显变薄（P0.01），而且试验组患者胸膜厚度小于对照组患者 （P0.05）；治疗后，试验组患者胸膜粘连、包裹率低于对照组（P0.05）；临床综合 疗效试验组优于对照组（P0.05）；肝功能损伤情况无统计学意义（P0.05）；两组患 者均无不良反应发生。 结论：活血化瘀药应用于结核性胸腔积液患者可以减轻胸膜肥厚、粘连及包裹。 与西医常规药联合应用，可以提高疗效，缩短疗程。其机理可能与活血化瘀药物调节 免疫力、抗氧化、抗炎、抗血小板聚集、改善微循环等作用有关。 关键词 结核性胸腔积液；活血化瘀；胸膜肥厚；粘连；包裹 The Observation of the Clinical Efficacy of Drug for Promoting Blood Circulation and Removing Stasis in the Tuberculate Pleural Effusion Speciality: Chinese Medicine Clinical Respiratory Medicine Professional Author ：Ming Qiuhuan Tutor：Professor Zhang Weilu Abstract Objective: To observe the clinical efficacy of drug for promoting blood circulation and removing stasis to relieve the pleural thickening , adhesion and encapsulated pleurisy caused by the tuberculate pleural effusion. Methods: According to the principle of random and control, to divide the 60 patients complying with the standard of this research into two groups: 30 people in experimental group and 30 in control group. Treat the experimental group with Chinese medicines on the basis of conventional therapy with western medicine, using intravenous drip once a day. Meanwhile, treat the control group with western medicine only in conventional therap.Observing the the time of disappearance of the clinical symptoms (fever, choking sensation in chest, chest pain) , the clinical general therapeutic effect, the time of complete