真武汤合麻杏石甘汤治疗AECOPD合并Ⅱ型呼吸衰竭临床疗效及对炎性因子及肺功能的影响

Effect of Zhenwu Decoction Combined with Maxing Shigan Decoction on Clinical Efficacy,Inflammatory Factors and Lung Function for Patients with AECOPD Combined with Type Ⅱ Respiratory Failure

目的:探讨真武汤和麻杏石甘汤治疗对慢性阻塞性肺疾病急性加重(Chronic Obstructive Pulmonary Diseases Acute Exacerbation,AECOPD)合并Ⅱ型呼吸衰竭患者临床疗效、炎性因子及肺功能的影响。方法:回顾性分析2017年6月~2020年6月我院收治的87例AECOPD合并Ⅱ型呼吸衰竭患者的临床资料,按照治疗方式的差异分为研究组(n=44)和对照组(n=43)。对照组给予西医常规治疗,研究组在对照组的基础上予以真武汤合麻杏石甘汤治疗。比较两组患者的临床疗效、炎性因子[可溶性髓系细胞触发受体-1(Soluble Myeloid Cell Trigger Receptor-1,sTREM-1)、高迁移率族蛋白1(High Mobility Group Protein-1,HMGB-1)]、肺功能[第一秒用力呼气容积(Forced Expiratory Volume in First Second,FEV1)、第一秒用力呼气容积占用力肺活量的比率(The First Second Forced Expiratory Volum,FEV1%)及第一秒用力呼气量/用力肺活量(FEV1/FVC)]、血气分析指标[动脉血氧饱和度(Arterial Oxygen Saturation,SaO_(2))、动脉血二氧化碳分压(Arterial Partial Pressure of Carbon Dioxide,PaCO_(2))、血氧分压(Arterial Blood Partial pressure of Oxygen,PaO_(2))]、不良反应。结果:研究组临床总有效率为90.91%,对照组临床总有效率为72.09%,研究组总有效率高于对照组(P<0.05)。与治疗前相比,两组sTREM-1、HMGB-1水平均降低(P<0.05),其中以研究组最为显著(P<0.05);治疗后,两组FEV1、FVC、FEV1/FVC水平均明显上升(P<0.05),其中研究组指标水平更高(P<0.05);与治疗前相比,两组SaO_(2)、PaCO_(2)、PaO_(2)均显著改善(P<0.05),治疗后研究组SaO_(2)、PaO_(2)水平较对照组高,PaCO_(2)水平较对照组低(P<0.05)。两组患者治疗过程中均未出现严重不良反应。结论:真武汤合麻杏石甘汤治疗AECOPD合并Ⅱ型呼吸衰竭患者疗效显著,可有效改善患者肺功能及血气指标水平,降低sTREM-1、HMGB-1水平,安全性高,值得临床应用推广。

Objective:To investigate the effect of Zhenwu Decoction combined with Maxing Shigan Decoction on the clinical efficacy,inflammatory factors and lung function for patients with acute exacerbation of chronic obstructive pulmonary diseases(AECOPD)combined with type II respiratory failure.Methods:The clinical data of 87 patients with AECOPD combined with type II respiratory failure admitted to this hospital from June 2017 to June 2020 were retrospectively analyzed.According to the difference in treatment,they were divided into a study group(n=44)and a controlled group(n=43).The controlled group was given conventional western medicine treatment,and the study group was supplemented with Zhenwu Decoction combined with Maxing Shigan Decoction.The clinical efficacy,inflammatory factors[Soluble Myeloid Cell Trigger Receptor-1(sTREM-1),High Mobility Group Protein-1(HMGB-1)],lung function[forced expiratory volume in first second(FEV1%)and the first second forced expiratory volume/forced vital capacity(FEV1/FVC)],blood gas analysis indicators[Arterial Oxygen Saturation(SaO_(2)),Arterial Partial Pressure of Carbon Dioxide(PaCO_(2)),Arterial Blood Partial Pressure of Oxygen(PaO_(2))]and adverse reactions of patients between the two groups were compared.Results:The total clinical effective rate of the study group was 90.91%,and the total clinical effective rate of the controlled group was 72.09%.The total effective rate of the study group was higher than that of the controlled group(P<0.05).Compared with those before treatment,the levels of sTREM-1 and HMGB-1 in the two groups decreased(P<0.05),and the study group was the most significant(P<0.05).After treatment,the levels of FEV1,FVC,FEV1/FVC in the two groups increased significantly(P<0.05),and the index levels of the study group were lower(P<0.05).Compared with those before treatment,the SaO_(2),PaCO_(2)and PaO_(2)of the two groups significantly improved(P<0.05).After treatment,the levels of SaO_(2)and PaO_(2)in the study group were higher than those in the controlled group,and the level of PaCO_(2)was lower than that in the controlled group(P<0.05).There were no serious adverse reactions during the treatment in the two groups.Conclusion:Zhenwu Decoction combined with Maxing Shigan Decoction has a significant effect in the treatment of patients with AECOPD combined with typeⅡrespiratory failure.It can effectively improve the patient’s lung function and blood gas index levels,reduce the levels of sTREM-1 and HMGB-1,and has high safety.It is worthy of clinical application and promotion.