中西药联合治疗慢性阻塞性肺疾病急性发作伴呼吸衰竭

Effect of combine therapy of traditional Chinese medicine on the treatment of chronic obstructive pulmonary disease in acute deteriorated stage complicated with respiratory failure

目的观察清热化痰中药抑制慢性阻塞性肺疾病急性加重（AECOPD）并呼吸衰竭患者疗效，探讨更加有效的治疗方法。方法将68例AECOPD合并呼吸衰竭患者随机分为两组，对照组常规西药治疗，治疗组在常规西药治疗基础上加用清热化痰中药。治疗前和治疗后10d分别记录两组患者的生命体征和临床表现，测定血气分析值、血浆核因子-κB（NF—κB）、肿瘤坏死因子（TNF—α）、自细胞介素8（IL-8）和C反应蛋白（CRP）含量。结果两组治疗后血浆NF—KB、TNF-α、IL-8、CRP水平以及血气分析和肺功能较治疗前明显改善（P均〈0．01），但治疗组的改善程度优于对照组（P均〈0．01）；治疗组显效率为85．3％，明显高于对照组64．7％（P〈0．05）。结论清热化痰中药可以通过抗感染、抑制炎性介质的释放，减轻AECOPD合并呼吸衰竭患者的全身炎性反应，提高疗效。

Objective To research more effective therapy strategy in chronic obstructive pulmonary disease in acute deteriorated stage complicated with respiratory failure by treatment with traditional Chinese medicine of Qingrehuatan strategy. Method 68 patients of AECOPD complicated with respiratory failure were randomly divided into two groups. The patients of treatment group were treated with Qingrehuatan Prescriptions combined with routine medicines while the patients of control group were treated with routine medicines only. Blood samples of all patients in two groups were analyzed including blood gas, NF-kb, TNF-α, IL-8 and CRP. Clinical features and life signs were also compared between two groups. Results The data in two groups including NF-KB,TNF-α,IL-8,CRP,blood gas and respiratory function were improved after treatment and the results seemed better in treatment group （ P 〈 0.01 ）. The clinical data were improved obviously in 85.3% patients of treatment group while 64.7% patients in control group （P 〈 0. 05）. Conclusion The strategy of Qingrehuatan can be used effectively in treatment of chronic obstructive pulmonary disease in acute deteriorated stage complicated with respiratory failure. It takes important role not only in infection control and inflammation mediator inhibition but also in relieving systemic inllammation reaction in the patients of AECOPD complicated with respiratory failure.