The Effect Of Polygonum Oral Liquid For Chronic Obstructive Pulmonary Disease With Pulmonary Hypertension

BackgroundChronic obstructive pulmonary disease (COPD) is a chronic respiratory disease ofglobal concern, due to the prolonged course of recurrent disease, and eventuallyevolved into the respiratory disability, it poses a major burden on individuals, familiesand society, that has become an important public health problem. Pulmonaryhypertension (PH), frequently observed in patients with advanced COPD, is the centrallink of COPD development of chronic cor pulmonale (CCP), which is considered as apredictor of worse outcome. PH in COPD is mainly the result of hypoxic pulmonaryvasoconstriction, pulmonary vascular endothelial dysfunction and pulmonary arterialwalls remodeling. In addition, CCP patients with long-term hypoxia and the blood in ahypercoagulable state, are often accompanied by micro thrombosis of smallpulmonary arteries, and further aggravate PH. To this day, Treatment of Westernmedicine for COPD with pulmonary hypertension is still lack of effective measure.Conventional vasodilators are not recommended because of their potential detrimentaleffects on gas exchange, produced by the inhibition of hypoxic pulmonaryvasoconstriction and their lack of effectiveness after long-term treatment. Therefore,finding a small adverse reactions and a clear clinical efficacy of drugs which canprevent and treat COPD with PH, becomes the research focus of many pharmaceuticalworkers. Polygonum cuspidatum oral solution is processed from Polygonumcuspidatum rhizome. Its main component is the Polydatin (PD). It has the role of stasisand pain, cough and phlegm, expelling wind and dampness, and heat detoxification, etc. Many studies had confirmed that Polygonum cuspidatum could reduce pulmonarypressure, increase cardiac output, while no change in the systemic circulation, andoxygenation less affected. However, these studies were only experimented in animalexperiments, no oral agents had been used in clinical to treat COPD patients with PH.ObjectiveTo investigate the effect of Poligonum Cuspidatum on hemodynamics, bloodrheology, and blood gas analysis in COPD with pulmonary hypertension.MethodsSixty acute exacerbation of chronic obstructive pulmonary disease(AECOPD) patientswith pulmonary hypertension were randomized into two groups,the control(32patients)and the HuzhangHZ(28patients). The controls received ordinary therapy, and the HZreceived extra Poligonum Cuspidatum. The pulmonary artery pressure, heart rate,mean systemic artery pressure, blood rheology, plasma fibrinogen, and blood gasanalysis were measured before and after treatments, and symptoms and signs scorewere recorded every day.ResultsThe HZ group in improving clinical symptoms, reducing mPAP, reducing plasma FIBlevels, and improving blood rheology was superior to the control group, and thedifferences were statistically significance (P <0.05). The gas analysis in both groupswas improved, but no significant differences between the two groups.ConclusionThe results suggest that Polygonum Cuspidatum can significantly decline pulmonaryartery pressure of COPD with PH, and can improve clinical symptoms, reduce the generation of fibrinogen, and lower blood viscosity, thereby inhibiting plateletaggregation and thrombosis formation.