Clinical Study On Treatment Of Acute Gastrointestinal Dysfunction With Acute Exacerbation Of Pulmonary Heart Disease By Integrated Traditional Chinese And Western Medicine

Objective:To observe the therapeutic effect and safety of the combined treatment of Traditional Chinese and Western Medicine for acute exacerbation of chronic pulmonary heart disease(CPHD) accompany gastrointestinal dysfunction(GD) by a prospective, multi-center, randomized controlled, paralleled chinical trail. Try to establish the standardization program of the combined treatment of Traditional Chinese and Western Medicine for acute exacerbation of CPHD accompany GD and improve the clinical effect.Methods:(1)Review the general research situation of Traditional Chinese Medicine (TCM) about CPHD, including the relevant expositions of ancient literature and modern researches, to make an understanding of recognition, diagnosis and treatment of TCM about CPHD.(2)Summarize the mechanisms and treatments of Western Medicine about CPHD and GD caused by it in the latest twenty years, to grasp the overall situation of Western Medicine researches about CPHD.(3)Summarize the academic thought of professor Chen shaohong and clinical experiences of professor Chen shaohong about the combined treatment of Traditional Chinese and Western Medicine for CPHD.(4)Totally120cases of acute exacerbation of CPHD accompany GD were randomized into the treatment group and control group, with60cases in each. Both groups were given the basic treatments of Western medicine, the control group was added with the treatment of GD, the treatment group was added with the Chinese herb decoctions according to syndrome differentiations, if it is spleen deficiency and Qi stagnation added with Bian Xiao Hou Pu Decoction and Xiang Sha Liu Jun Zi Decoction, if intermixing of cold and heat added with Bian Xiao Hou Pu Decoction and Bian Xiao Xie Xin Decoction, one dose daily, both groups were treated for14days. The scores of Chinese Medicine symptom, the scores of Chinese Medicine syndrome, bowel sound, total white blood cells, percentage of neutrophile granulocyte, blood gas analysis, lung function, nutrition index, the total effective rates, mortality rate, personal living ability,readmission rate were observed. Blood routine, liver and kidney function, glucose, etc. and adverse reactions were observed, too.Results:(1) The relevant expositions of ancient literature of TCM about CPHD is more abundant. Modern researches clearly put forward the syndrome differentiations and treatments of CPHD. There are many scholars take the based on differentiations of disease. Although achieved certain effects, but the common problems are the lack of uniform standards of syndrome differentiations and curative effect and insufficience in the aspect of system standardization study.(2)Western Medicine has good curative effect in the treatment of CPHD, but the treatment of acute exacerbation of CPHD accompany GD has no uniform standard, although achieved certain effects, but some problems can not be ignored.(3)The total effective rate, improving of digestive tract symptoms of stomachache, decreased food intake, epigastric upset in stomach and abnormal defecation, the scores of Chinese Medicine syndrome, personal living ability three months after the end of the treatment of the treatment group were significantly better than the control group (P<0.01). The improving of digestive tract symptoms of stomach or abdominal distention, belching and acid regurgitation, fatigue without strength, bitter taste and dry mouth, nausea and vomiting, bowel sound, prealbumin, lung function, total white blood cells, percentage of neutrophile granulocyte, partial pressure of oxygen and carbon dioxide, personal living ability one month after the end of the treatment of the treatment group were better than the control group (P<0.05).Although mortality rate and readmission rate in the following three months after the end of the treatment had no statistical significance between the two groups (P>0.05), they showed the trend the treatment group lower than the control group. During the treatment, individual patients appeared mild adverse reactions because of Western Medicine in both groups. The mild adverse reactions reduced or disappeared after adjusting the related drugs and carrying on the related treatments. The patients in the treatment group had no obvious adverse reactions when taking Chinese herb decoctions. During the treatment, both group had no obvious adverse effects on vital signs, blood, urine and stool routine, liver and kidney function, glucose, electrocardiogram and chest x-ray.Conclusions:Modern researches of TCM should be systematized and standardized. Combined treatment of Traditional Chinese and Western Medicine is a effective way for the treatment of acute exacerbation of CPHD accompany GD. This study shows that the combined treatment of Traditional Chinese and Western Medicine is effective for acute exacerbation of CPHD accompany GD, it can obviously relieve the digestive tract symptoms and signs of GD, meanwhile improve the nutritional status of the patients, benefit infection control, improve hypoxiaand carbon dioxide retention, improve the personal living ability, it also has better security.