Effects of rhubarb and ephedra prescription on pulmonary function and blood pressure circadian rhythm in patients with acute exacerbation of chronic obstructive pulmonary disease
10.3969/j.issn.1008-9691.2017.04.011
- VernacularTitle:大黄麻黄方对慢性阻塞性肺疾病急性加重期患者肺功能及血压昼夜节律的影响
- Author:
Lijie YU
;
Fengdan LI
;
Bingmao LI
;
Hemei XIAO
;
Xinfeng LEI
;
Weihong HAN
;
Xinxia HE
;
Li TONG
- Keywords:
Rhubarb and ephedra prescription;
Acute exacerbation of chronic obstructive pulmonary disease;
Blood gas analysis;
Pulmonary function;
Blood pressure rhythm
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2017;24(4):380-384
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of rhubarb and ephedra prescription on the pulmonary function and blood pressure circadian rhythm in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods One hundred and enghty six patients with AECOPD admitted to Department of Integrated Medicine of Harrison International Peace Hospital from December 2013 to Auguest 2016 were enrolled, and they were divided into a control group 90 cases and an experimental group 96 cases by random number talbe method. The patients in control group were treated with conventional therapy, while those in the experimental group were treated with the conventional therapy and additionally rhubarb and ephedra prescription (including rhubarb 6 g, ephedra 5 g, agrimony 15 g, licorice 15 g), taken orally 2 times a day, the therapeutic course in the two groups being 2 weeks. The diference of blood gas analysis, pulmonary function indexes, dyspnea score (mMRC) and ambulatory blood pressure monitoring were compared before and after treatment in the two groups.Results Compared with before treatment, the pH value, arterial partial pressure of oxygen (PaO2), forced vital capacity (FVC), one second forced expiratory volume (FEV1), FEV1/FVC of the two groups were significantly increased after treatment, while the arterial partial pressure of carbon dioxide (PaCO2) and mMRC score were significantly lowered, and the changes in the experimental group were more significant than those in the control group [pH: 7.40±0.04 vs. 7.37±0.03, PaO2 (mmHg, 1 mmHg = 0.133 kPa): 81.09±12.54 vs. 76.27±12.20, PaCO2 (mmHg): 48.01±8.27 vs. 51.91±8.37, FVC (L): 2.37±0.39 vs. 2.13±0.45, FEV1 (L): 2.08±0.38 vs. 1.87±0.41, FEV1/FVC: (69.01±12.04)% vs. (64.02±11.81)%, mMRC: 2.02±0.76 vs. 2.40±0.87, allP < 0.05 orP < 0.01]. Based on the percentage of blood pressure circadian value difference, the blood pressure circadian rhythm was divided into dipper type, non dipper type, super dipper type and anti dipper type, 24.2% patients were of dipper type and 75.8% patients were of non dipper, super dipper and anti dipper types. There was no significant difference in daytime systolic blood pressure (dSBP) between patients with super dipper and dipper types (P > 0.05),and the dSBP (mmHg) in patients with non dipper type was significantly higher than that in patients with dipper, super dipper and anti dipper types (131.55±5.08 vs. 117.78±4.47, 118.26±4.24, 113.37±3.97, allP < 0.05); the daytime diastolic blood pressure [dDBP (mmHg)] of anti dipper, non dipper type, dipper type, super dipper type increased in turn (respectively, 63.27±2.80, 70.24±3.82, 73.98±2.61, 82.96±4.52, allP < 0.05); the night SBP (nSBP) of anti dipper type was the highest (127.38±4.98) mmHg, and the nSBP of super dipper type was the lowest (89.07±3.81) mmHg; the night DBP (nDBP) of dipper type was lower than that of non dipper, anti dipper and super dipper types (mmHg: 63.57±1.37 vs. 68.86±2.12, 67.15±1.56, 67.89±2.04, allP < 0.05). After treatment, the proportion of patients with dipper type [66.7% (64/96) vs. 54.4% (49/90)], no dipper type [11.5% (11/96) vs. 8.9% (8/90)], and super dipper type [5.2% (5/96) vs. 2.2% (2/90)] in experimental group was significantly higher than that in the control group, the proportion of patients with anti dipper type [16.7% (16/96) vs. 34.4% (31/90)] in experimental group were significantly lower than those in the control group (allP< 0.05).Conclusion The Rhubarb and ephedra prescription can obviously improve the blood gas analysis indexes, pulmonary function and blood pressure rhythm in patients with AECOPD.