益气活血化痰法联合无创辅助通气治疗慢阻肺急性加重期呼吸衰竭

Yiqi Huoxue Huatan Method with Noninvasive Assisted Ventilation Therapy Acute Exacerbations of Copd Curative Effect Observation of Respiratory Failure

目的:观察益气活血化痰法配合无创机械通气治疗慢性阻塞性肺疾病急性加重期(AECOPD)呼吸衰竭的疗效。方法:将符合纳入标准的72例(其中包含20%的脱落病例)AECOPD呼吸衰竭证属肺脾肾虚痰瘀阻肺型患者随机分配为两组:对照组治疗予抗生素、支气管解痉剂、化痰药等常规和无创机械通气治疗,治疗组在对照组治疗基础上服用益气活血化痰中药,每日1剂,每天3次。比较两组的治疗效果,以动脉血气[pH、二氧化碳分压(PaCO2)、氧分压(PaO2)]的改善情况;观察咳嗽、胸闷、肺部干湿啰音等临床症状及住院天数。结果:两组比较,治疗组34例,显效19例,有效12例,无效3例,总有效率为91.18%;对照组32例,显效11例,有效16例,无效5例,总有效率84.38%。两组治疗前后的pH无明显变化,两组治疗后PaCO2,PaO2指标皆较治疗前有明显改善(P<0.05),但治疗组较对照组治疗前后改善更明显。治疗组住院天数较对照组明显缩短(P<0.05)。结论:益气活血化痰法配合无创机械通气治疗AECOPD呼吸衰竭患者,明显改善血气指标,缩短病人住院天数,减少患者经济负担,充分发挥中医优势,取得中西医互补作用,提高AECOPD呼吸衰竭治疗的临床疗效。

Objective：To observe the Yiqi Huoxue Huatan expectorant noninvasive method with mechanical ventilation treatment of stage acute exacerbations of chronic obstructive pulmonary disease （AECOPD） the curative effect of respiratory failure.Method：Will conform to the criteria of 72 cases of fall off （including 20％ of cases） AECOPD respiratory failure syndrome of lung and kidney phlegm and blood stasis resistance type lung patients were randomly assigned to two groups：control group treated with antibiotics,bronchial spasm,expectorant drugs and other conventional and noninvasive mechanical ventilation treatment,treatment group in the control group on the basis of taking the yuan tonga blood phlegm of traditional Chinese medicine,every day a dose,three times a day.Compared two groups of curative effect,with arterial blood gas （pH value,carbon dioxide pressure （PaCO2）,and oxygen partial pressure （PaO2） the improvement of the situation ; Cough,chest tightness,and sound and other clinical symptoms and lung wet days in hospital.Result：Two groups,the treatment group （34 cases,19 cases were markedly effective,effective 12 cases,3 cases,the total effective rate of 91.18％ ; 16 in 32 cases,11 cases were markedly effective,efficient,invalid in 5 cases,the total effective rate 84.38％.Two groups before and after treatment of the pH value has no obvious change,two groups after treatment carbon dioxide pressure （PaCO2）,and oxygen partial pressure index （PaO2） is a treatment before have significantly improved （P ＜ 0.05）,but the treatment group than the control group before and after treatment to improve the more obvious.Treatment group hospitalization days was significantly reduced （P ＜ 0.05）.Conclusion：This study suggests Yiqi Huoxue Huatan method with phlegm AECOPD respiratory failure patients noninvasive mechanical ventilation treatment,can improve the clinical curative effect,improve blood gas index,shorten the patient in hospital days,reduce the economic burden in patients,give full play to the advantages of traditional Chinese medicine,and achieve complementary effect of Chinese and western medicine,improve AECOPD respiratory failure clinical curative effect of treatment.