黄连温胆汤对慢性阻塞性肺疾病急性加重伴2型呼吸衰竭睡眠障碍的疗效分析

Analysis of the therapeutic effects of Huanglian Wendan Decoction on acute exacerbated chronic obstructive pulmonary disease complicated by type 2 respiratory failure sleep disorder

目的探讨黄连温胆汤对慢性阻塞性肺疾病急性加重(AECOPD)伴2型呼吸衰竭睡眠障碍患者的临床疗效。方法将56例AECOPD伴2型呼吸衰竭睡眠障碍患者随机分为安慰剂组27例和中药组29例。2组均接受相同的常规治疗,安慰剂组再口服温水,中药组再口服黄连温胆汤。治疗前及治疗第7、14天分别进行匹茨堡睡眠质量指数(PSQI)评分,评价睡眠质量改善情况,并复查动脉血气。结果中药组治疗第7、14天时PSQI评分均显著低于安慰剂组;中药组治疗后睡眠良好率显著高于安慰剂组;2组治疗第7、14天动脉血CO2分压(PCO2)均较治疗前显著下降,但2组各治疗时间段比较,差异无统计学意义。结论对于AECOPD伴2型呼吸衰竭睡眠障碍患者,在常规治疗基础上联用黄连温胆汤可显著改善睡眠质量,且安全性高,但黄连温胆汤治疗该类患者的睡眠障碍并非通过降低血清CO2而达到,其机理还需进一步探讨。

Objective To explore the clinical effects of Huanglian Wendan Decoction on the patients with acute exacerbated chronic obstructive pulmonary disease （AECK）PD） complicated by type 2 respiratory failure sleep disorder. Methods Fifty-six patients with AECOPD complicated by type 2 respiratory failure sleep disorder were randomly divided into placebo group （ n = 27） and Chi- nese medicine group （n = 29）. Both groups were administered the same conventional therapy. Be- sides, the placebo group drank warm water, while Chinese medicine group took Huanglian Wendan Decoction. Before treatment and on the 7th and 14th days of treatment, pittsburg sleeping quality index （PSQ｜） scores were respectively conducted to assess the improved condition of sleep quality, and arterial blood gas was reexamined. Results On the 7th and 14th days of treatment, all PSQI scores of Chinese medicine group were significantly lower than those of placebo group, the sleep good rate of Chinese medicine group after treatment was markedly higher than that of placebo group, and partial pressure of arterial blood CO2 （PCO2） in both groups decreased conspicuously compared the 7th and 14th days of treatment with treatment before. But the differences showed no statistical significance in comparison to each treatment time period. Conclusion The conventional therapy combined with Huanglian Wendan Decoction, with high safety, can dramatically ameliorate sleep quality of AECOPD patients complicated by type 2 respiratory failure sleep disorder, but the effect of Huanglian Wendan Decoction for sleep disorder of these patients is exerted not by decreas- ing serum CO2, its mechanism still needs to be further investigated.