摘要
目的:探讨藏药脑神宝丸方中应用培育牛黄与天然牛黄对高原性心脏病(HAHD)患者症状表现、心功能、凝血功能及血清氧化应激水平的影响。方法:按照单盲随机数字表法将2019年9月至2022年8月该院收治的80例HAHD患者分为天然组、培育组,各40例。两组患者在常规治疗基础上给予藏药脑神宝丸方治疗,天然组患者方中应用天然牛黄,培育组患者方中应用培育牛黄。比较两组患者治疗前后临床症状变化、心率、心功能[右心室射血分数(RVEF)、右心房收缩波(As)和肺动脉收缩压(SPAP)]、凝血功能[活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、纤维蛋白原降解产物(FDP)和凝血酶原时间(PT)]、氧化应激指标[超氧化物歧化酶(SOD)、脂质过氧化物(LPO)、谷胱甘肽过氧化物酶(GSH-Px)和丙二醛(MDA)]及安全性。结果:治疗后,两组患者疲乏、呼吸困难、胸闷、头晕/头痛和烦躁不安评分均显著低于治疗前,差异均有统计学意义(P<0.05);治疗后,天然组患者临床症状各维度评分与培育组比较,差异无统计学意义(P>0.05)。治疗后,两组患者心率、SPAP和As水平较治疗前降低,RVEF水平较治疗前升高,差异均有统计学意义(P<0.05);治疗后,天然组患者心功能指标、心率与培育组比较,差异均无统计学意义(P>0.05)。治疗后,两组患者PT、APTT均长于治疗前,FDP、FIB水平均低于治疗前,差异均有统计学意义(P<0.05);治疗后,两组患者凝血功能指标比较,差异无统计学意义(P>0.05)。与治疗前比较,两组患者治疗后SOD、GSH-Px水平升高,LPO、MDA水平降低,差异均有统计学意义(P<0.05);治疗后,两组患者血清氧化应激指标水平比较,差异无统计学意义(P>0.05)。天然组患者的不良反应发生率为7.50%(3/40),与培育组(2.50%,1/40)比较,差异无统计学意义(P>0.05)。结论:藏药脑神宝丸方中应用天然牛黄与培育牛黄效果一致,联合常规治疗均可缓解HAHD患者的氧化应激损伤,改善凝血指标,促进临床病症好转,且安全性高。
OBJECTIVE:To probe into the effects of cultivated and natural calculus bovis in the formula of Xizang drugs Naoshenbao pills on manifestations of plateau heart disease,cardiac function,coagulation function and serum oxidative stress levels in patients with high altitude heart disease(HAHD).METHODS:Eighty patients with HAHD admitted into the hospital from Sept.2019 to Aug.2022 were divided into the natural group and cultivated group via the random number table method,with 40 patients in each group.Both groups were given Xizang drugs Naoshenbao pills formula on the basis of conventional treatment,with the application of natural calculus bovis in the natural group and cultivated calculus bovis in the cultivated group.Changes of clinical symptoms,heart rate,cardiac function [right ventricular ejection fraction(RVEF),right atrial systolic wave(As),systolic pressure of pulmonary artery(SPAP)],coagulation function [activated partial thromboplastin time(APTT),fibrinogen(FIB),fibrinogen degradation product(FDP),prothrombin time(PT)],oxidative stress [superoxide dismutase(SOD),lipid peroxidation(LPO),glutathione peroxidase(GSH-Px),malondialdehyde(MDA)] and safety of two groups were compared.RESULTS:The scores of fatigue,dyspnea,chest tightness,dizziness/headache,and irritability were significantly lower in both groups after treatment than before treatment,with statistically significant differences(P<0.05).There was no significant difference in clinical symptom scores of each dimension between natural group and cultivated group after treatment(P>0.05).After treatment,heart rate,SPAP and As were lower in both groups than before treatment,and RVEF was higher than before treatment,with statistically significant differences(P<0.05),and there was no statistically significant difference in cardiac function indicators and heart rate between natural group and cultivated group after treatment(P>0.05).After treatment,PT and APTT were higher in both groups than before treatment,FDP and FIB were lower in both groups than before treatment,with statistically significant differences(P<0.05).There was no significant difference in coagulation function indicators between two groups after treatment(P>0.05).Compared with before treatment,SOD and GSH-Px increased and LPO and MDA decreased in both groups after treatment,the differences were statistically significant(P<0.05).After treatment,there was no statistical significance in serum oxidative stress indicator between two groups(P>0.05).The incidence of adverse drug reactions in the natural group was 7.50%(3/40),higher than 2.50%(1/40) in the cultivated group,with no significant difference(P>0.05).CONCLUSIONS:The application of natural and cultivated calculus bovis in the formula of Xizang drugs Naoshenbao pills has the same effect,and the combination with conventional treatment can alleviate the oxidative stress injury of patients with HAHD,improve the coagulation indicator,and promote the improvement of the patients' clinical conditions with higher safety.
作者
桑德才让
拉毛措
华青加
CAIRANG Sande;Lamaocuo;HUA Qingjia(Dept.of High Altitude Cardiology,Golog Xizang Autonomous Prefecture Xizang Hospital,Qinghai Guoluo 814000,China;Dept.of Gynecology and Pediatrics,Golog Xizang Autonomous Prefecture Xizang Hospital,Qinghai Guoluo 814000,China;Dept.of Preparation Management,Golog Xizang Autonomous Prefecture Xizang Hospital,Qinghai Guoluo 814000,China)
出处
《中国医院用药评价与分析》
2024年第1期42-46,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
青海省科技支撑计划项目(No.090NKCA155)。
关键词
藏药
脑神宝丸
培育
天然
牛黄
高原性心脏病
Xizang drugs
Naoshenbao pills
Cultivated
Natural
Calculus bovis
High altitude heart disease
