通腑法对慢性阻塞性肺疾病呼吸衰竭患者胃肠激素水平的干预作用

Effect of Catharsis Method on the Gastrointestinal Hormone of Patients with Respiratory Failure Induced by Chronic Obstructive Pulmonary Disease

目的:观察通腑法对慢性阻塞性肺疾病(COPD)呼吸衰竭患者胃肠激素干预作用。方法:将符合诊断标准的COPD呼吸衰竭患者随机分为试验组(50例)和对照组(30例),试验周期为28天。两组均采用西医常规治疗(包括机械通气),试验组加用通腑平喘汤治疗。比较两组治疗前、治疗3天、治疗7天及脱机时的氧合指数(PaO2/FiO2)和肺顺应性的变化;同时,比较两组治疗前、治疗5天及脱机时血浆胃泌素和胃动素的变化。结果:试验组治疗3天后,肺顺应性较对照组迅速改善(P<0.05),氧合指数在治疗7天时较对照组也显著改善(P<0.01);试验组胃泌素水平在治疗5天时较对照组显著降低(P<0.01),而胃动素水平则在5天以后显著升高(P<0.01)。结论:胃泌素和胃动素在调节机体胃肠动力方面存在关联;通腑法能有效调整COPD呼吸衰竭患者胃动素及胃泌素的异常,从而利于呼吸力学的改善。

Objective： To evaluate the effect of catharsis method on the Gastrointestinal hormone of patients with re- spiratory failure induced by chronic obstructive pulmonary disease. Methods： Those patients were randomly divided into experiment group（ n = 50）and comparison group（ n = 30）. The experiment period is 28 days. Routine western medicine （ including mechaniea ventilation method） was used in two groups, and patients in the experiment group were added the Tongfu Pingchuan decoction for each day. Such values as Oxygenation index and pulmonary compliance were compared before therapy, on the 3rd and 7th day after therapy and after offline. Meanwhile, the Changes of motilin and Gastrin in blood plasma were compared before therapy, on the 5th and after offline. Results： Compared with the comparison group, the pulmonary compliance of the experiment group were improved rapidly 3 days later（ P 〈 0.05 ）. Oxygenation index were also improved obviously in the experiment group （ P 〈 0.01 ） at 7th day. At 5th day, the gastrin level of the experi- mental group reduced obviously （P 〈 0.01 ） ,but motilin in the same group increased markedly 5 days later（ P 〈 0.01 ）. Conclusion： In the aspect of Stomach and intestines power, the gastrin and motilin have cross - correlation. Catharsis method can adjust effectively the abnormity in the motilin and Gastrin, as in favor of the improvement of breathing dynam- ics of the patients with respiratory failure induced by chronic obstructive pulmonary disease.