通腑平喘汤辅助无创正压机械通气治疗老年COPD合并呼吸衰竭的临床疗效及对肺功能的影响

Effectiveness of Applying Tongfu Pingchuan Decoction Assisted by Noninvasive Positive Pressure Ventilation in Treating Elderly Chronic Obstructive Pulmonary Disease with Respiratory Failure and Its Influence on Lung Function

目的:探讨通腑平喘汤联合无创正压机械通气(NIPPV)治疗老年慢性阻塞性肺疾病(COPD)合并呼吸衰竭的临床疗效,并观察其对肺功能的影响。方法:选择2017年10月~2019年9月我院重症医学科收治并进行NIPPV的COPD急性加重期老年患者136例,随机数字表法将其分为观察组和对照组,各68例。对照组给予西药联合无创呼吸机治疗,观察组在对照组基础上加用通腑平喘汤治疗。比较两组患者治疗前后实验室指标、肺功能、动脉血气及临床症状评分间的差异。结果:治疗后观察组C反应蛋白(C-reactive Protein,CRP)、呼吸频率、PaCO_(2)、PaO_(2)、FEV1、FEV1/FVC(%)、临床症状评分等指标均较对照组明显改善(P<0.05),观察组治疗后腹胀发生率(χ^(2)=3.969,P=0.046)、平均住院时间(χ^(2)=2.467,P=0.015)低于对照组。结论:老年COPD合并呼吸衰竭患者采取通腑平喘汤联合NIPPV治疗可促使感染指标恢复,且能有效改善患者呼吸功能及血气分析指标,可显著减轻患者临床症状。

Objective:To investigate the clinical efficacy of applying Tongfu Pingchuan Decoction combined with noninvasive positive pressure ventilation in treating acute exacerbation of chronic obstructive pulmonary disease in elderly patients.Methods:136 elderly COPD patients with respiratory failure in our hospital from October 2017 to September 2019,were randomly divided into a controlled group and an observation group,68 cases in each group.The controlled group received western medicine combined with NIPPV therapy,and the patients in the observation group additionally received Tongfu Pingchuan Decoction on the basis of the treatment in the controlled group.The differences in laboratory examination,lung function,arterial blood gas and clinical symptom scores between the two groups before and after treatment were observed.Results:After treatment,compared with the controlled group,the observation group had improved significantly in C-reactive protein,respiratory frequency,PaCO_(2),PaO_(2),FEV1,FEV1/FVC(%),and clinical symptom score(P<0.05).The incidence of abdominal distension(χ^(2)=3.969,P=0.046)and the average length of stay(χ^(2)=2.467,P=0.015)in the observation group were lower than those in the controlled group.Conclusion:Tongfu Pingchuan Decoction combined with NIPPV can significantly reduce the infectious indicator,effectively improve the respiratory function and blood gas analysis indexes,and significantly reduce the clinical symptoms in COPD patients.