RESUMEN
Objective To investigate the effect of Chinese rhubarb and ephedra prescription on the pulmonary function and blood pressure rhythm in patients with chronic obstructive pulmonary disease (COPD) in remission stage. Methods One hundred and fifty-two patients with COPD were admitted to Harrison International Peace Hospital from March 2014 to December 2016, and they were divided into a western medicine control group (72 cases) and a rhubarb and ephedra prescription group (80 cases) by random number table method, the conventional therapy was given to both groups, and in the rhubarb and ephedra group, additionally Chinese rhubarb and ephedra prescription (rhubarb 6 g, ephedra 5 g, agrimony 15 g, licorice 15 g) was applied, one dose orally taken daily, once 1/2 dose, 2 times a day, the therapeutic course being 3 months. The blood gas analysis, pulmonary function, 6-minute walking distance (6MWD) were detected, and modify medical research committee (mMRC) questionnaire for dyspnea score, the change of ambulatory blood pressure level monitoring and clinical effect were observed before and after treatment for 1, 2, 3 months. Results Compared with those before treatment, the blood gas indexes, the arterial partial pressure of oxygen (PaO2), arterial blood oxygen saturation (SaO2), and pulmonary function indexes, the percentage of one second forced expiratory volume (FEV1) in predictive value (FEV1%), the ratio of FEV1/forced vital capacity (FEV1/FVC) and 6MWD levels in both groups were continuously increased after treatment, while the arterial partial pressure of carbon dioxide (PaCO2) and mMRC score were persistently decreased after treatment in the two groups. After treatment for 2 months, compared with before treatment, the statistical differences appeared in the western medicine control group, while in the rhubarb and ephedra group, the statistical differences turned up after 1 month of treatment. After 3 months of treatment,the PaO2, SaO2, FEV1%, FEV1/FVC and 6MWD in the rhubarb and ephedra group were significantly higher than those in the western medicine control group [PaO2(mmHg, 1 mmHg = 0.133 kPa): 95.42±14.88 vs. 88.28±13.38, SaO2:0.97±0.02 vs. 0.96±0.02, FEV1%: 77.35±11.57 vs. 72.63±10.66, FEV1/FVC (%): 71.01±9.47 vs. 69.28±10.04, 6MWD (m): 318.0±40.1 vs. 306.6±35.7], PaCO2and mMRC were obviously lower in the rhubarb and ephedra group than those in the western medicine control group [PaCO2(mmHg): 40.35±7.58 vs. 43.57±7.85, mMRC score: 1.09±0.65 vs. 1.23±0.69], the differences of the two groups were statistically significant (all P < 0.05). After 3 months of treatment, in the western medicine control group, the percentage of patients with abnormal blood pressure rhythm was reduced to 44.4% (32/72), while in the rhubarb and ephedra group, was decreased to 32.5% (26/72), and the decrease amplitude of the rhubarb and ephedra group was greater than that of the western medicine control group (P > 0.05). The ratio of blood pressure morning peak in the rhubarb and ephedra group was significantly lower than that in the western medicine control group [23.8% (19/80) vs. 31.9% (23/72), P < 0.05], and the total effective rate in rhubarb and ephedra group was significantly higher than that in the western medicine control group [92.5% (74/80) vs. 73.6% (53/72), P < 0.05]. Conclusion Chinese rhubarb and ephedra prescription can improve indexes of blood gas analysis, pulmonary function and blood pressure rhythm in COPD patients in remission phase, and its clinical efficacy is significant.
RESUMEN
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),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.