宣肺汤联合中药穴位贴敷治疗慢性阻塞性肺疾病急性加重合并呼吸衰竭临床研究

Clinical Study on Xuanfei Decoction Combined with Point Application with Chinese Herbal Medicine for AECOPD Complicated with Respiratory Failure

目的:观察宣肺汤联合中药穴位贴敷治疗慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭的临床疗效。方法:选择AECOPD合并呼吸衰竭患者100例,按随机数字表法分为观察组与对照组各50例。对照组采用常规西医治疗,观察组在对照组基础上联合宣肺汤、中药穴位贴敷治疗。2组均持续治疗7 d,比较2组临床疗效及不良反应情况,以及治疗前后改良版英国医学研究委员会呼吸问卷(mMRC)评分、最大呼气第1秒用力呼气容积(FEV_(1))、FEV_(1)/用力肺活量(FEV_(1)/FVC)、动脉血氧分压(PaO_(2))、动脉血二氧化氮分压(PaCO_(2))、临床症状评分变化。结果:观察组总有效率为92.00%,对照组为74.00%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组mMRC评分均较治疗前降低(P<0.05),FEV_(1)、FEV_(1)/FVC水平均较治疗前升高(P<0.05);且观察组mMRC评分低于对照组(P<0.05),FEV_(1)、FEV_(1)/FVC水平高于对照组(P<0.05)。治疗后,2组PaO_(2)水平均较治疗前升高(P<0.05),PaCO_(2)水平均较治疗前降低(P<0.05);且观察组PaO_(2)水平高于对照组(P<0.05),PaCO_(2)水平低于对照组(P<0.05)。治疗后,2组咳嗽、咳痰、喘息等症状评分均较治疗前降低(P<0.05),且观察组上述各项评分均低于对照组(P<0.05)。治疗期间2组均无严重不良事件发生。结论:宣肺汤联合中药穴位贴敷治疗AECOPD合并呼吸衰竭疗效显著,可有效改善临床症状、肺功能及血气指标,且安全可靠。

Objective:To observe the clinical effect of Xuanfei Decoction combined with point application with Chinese herbal medicine for acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with respiratory failure.Methods:A total of 100 cases of AECOPD complicated with respiratory failure were selected and divided into the observation group and the control group according to the random number table method,with 50 cases in each group.The control group was treated with routine western medicine group,and the observation group was treated with Xuanfei Decoction and point application with Chinese herbal medicine based on the treatment of the control group.Both groups were treated for seven days.The clinical effects and incidence of adverse reactions were compared between the two groups.The changes in scores of modified Medical Research Council(mMRC)questionnaire,forced expiratory volume in one second(FEV_(1)),ratio of forced expiratory volume in one second to forced vital capacity(FEV_(1)/FVC),partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),and scores of clinical symptoms were compared before and after treatment.Results:The total effective effect was 92.00%in the observation group and 74.00%in the control group,the difference being significant(P<0.05).After treatment,the mMRC scores in the two groups were decreased when compared with those before treatment(P<0.05),and FEV_(1)and FEV_(1)/FVC levels were increased when compared with those during treatment(P<0.05);mMRC score in the observation group was lower than that in the control group(P<0.05),and FEV_(1)and FEV_(1)/FVC levels were higher than those in the control group(P<0.05).After treatment,PaO_(2)levels in the two groups were increased when compared with those before treatment(P<0.05),and PaCO_(2)level was decreased when compared with that before treatment(P<0.05).After treatment,the symptom scores of cough,expectoration,and wheezing in the two groups were decreased when compared with those before treatment(P<0.05),and the above scores in the observation group were lower than those in the control group(P<0.05).During treatment,there was no serious adverse reaction in the two groups.Conclusion:Xuanfei Decoction combined with point application with Chinese herbal medicine has a significant effect on patients with AECOPD complicated with respiratory failure,which can effectively improve clinical symptoms,lung function and blood gas indexes,and is safe and reliable.