Clinical Observation Of Modified Buyang Huanwu Decoction In Treating AECOPD Patients With Qi Deficiency And Blood Stasis Syndrome

Objective: To observe the effects of modified Buyang Huanwu Decoction on plasma D-dimer,fibrinogen,arterial blood gas analysis and clinical symptoms of AECOPD patients with Qi-deficiency and blood-stasis syndrome,and to evaluate the clinical efficacy of modified Buyang Huanwu Decoction in treating AECOPD patients with Qi-deficiency and blood-stasis syndrome,providing new ideas for clinical treatment of such diseases.Methods: According to the case inclusion criteria,96 AECOPD patients with qi deficiency and blood stasis syndrome hospitalized in our department from February 2021 to February 2022 were collected.They were randomly divided into control group,treatment group Ⅰ and treatment group Ⅱ,with 32 patients in each group.All the patients in the three groups were treated with Controlled oxygen therapy,anti-infection,phlegm,spasmolysis,asthma and other conventional western treatment.The treatment group Ⅰ was treated with low molecular weight heparin,and the treatment group Ⅱ was treated with modified Buyang Huanwu Decoction.The course of treatment was 14 days.Analysis all of the patients before treatment generally(gender,age,course of the disease,smoking,classification of lung function)and the changes of total TCM symptom score,plasma D-dimer,fibrinogen,arterial blood gas index(Pa O2,Pa CO2)before and after treatment.Results:1.General conditions: Statistical analysis was conducted on gender,age,course of disease,smoking status and classification of lung function of patients in the three groups before treatment,and the differences were not statistically significant and were comparable(P>0.05).2.Clinical efficacy: After treatment,the total effective rate of treatment group Ⅱ was88.46%,the total effective rate of treatment group Ⅰ was 65.38%,and the total effective rate of control group was 62.96%.The total effective rate of TCM syndromes in treatment groupⅡ was higher than that in control group and treatment group Ⅰ,and the difference between groups was statistically significant(P<0.05).There was no statistical difference in the total effective rate of TCM syndromes between the control group and the treatment groupⅠ(P>0.05).3.In terms of symptoms: Compared with before treatment,the total score of TCM syndromes of patients in the three groups decreased after treatment,with statistical significance(P<0.05).Comparison between groups:After treatment,the total score of TCM syndromes in treatment group Ⅱ were lower than those in treatment group Ⅰ and control group with statistical significance(P<0.05).There was no significant difference in the total score of TCM syndromes between the treatment group Ⅰ and the control group(P>0.05).4.Coagulation indicators: Plasma D-dimer and fibrinogen in the three groups were decreased after treatment compared with before treatment(P<0.05).Comparison between groups: After treatment,plasma D-dimer and fibrinogen in treatment group Ⅰ and treatment group Ⅱ were lower than those in control group(P<0.05),and there was no significant difference in plasma D-dimer and fibrinogen levels between the two groups(P>0.05).5.Blood gas: After treatment,Pa O2 was increased and Pa CO2 was decreased in the three groups compared with before treatment(P<0.05).Comparison between groups: The Pa O2 of treatment group Ⅰ and treatment group Ⅱ after treatment was higher than that of control group(P<0.05),and there was no significant difference in Pa O2 between the two groups after treatment(P>0.05).Pa CO2 in treatment group Ⅰ and treatment group Ⅱ was lower than that in control group(P<0.05),and there was no significant difference in Pa CO2 between the two groups(P>0.05).6.There were no serious adverse reactions in the three groups during treatment.Conclusion: The modified Buyang Huanwu Decoction can effectively improve clinical picture of AECOPD patients with qi deficiency and blood stasis syndrome,such as cough,expectoration,asthma,shortness of breath,spontaneous sweating,laziness to speak,fatigue,mental fatigue,cyanotic lips,scaly dry skin,and so on,improve oxygen partial pressure,reduce carbon dioxide storage,and reduce plasma D-dimer and fibrinogen levels.It can improve the hypercoagulable state of AECOPD patients,and the effect degree is close to low molecular weight heparin.No obvious adverse reactions were observed in clinical application,indicating that the treatment is safe and effective.