清化活血汤治疗慢性阻塞性肺疾病急性加重期的临床研究

Clinical research on treating AECOPD with the Qinghua Huoxue decoction

目的:观察清化活血汤治疗慢性阻塞性肺疾病急性加重期的临床疗效。方法:60例纳入观察的患者随机分为观察组和对照组各30例,观察组给予氧疗、抗生素、支气管舒张剂、糖皮质激素、维持液体和电解质平衡、气管插管和有创机械通气,并在接受有创机械通气后即刻鼻饲中药清化活血汤,而对照组仅采用西医治疗方法;观察两组患者接受有创机械通气前、机械通气后24h、48h的动脉血pH值、氧合指数和PaCO2,并统计拔除气管导管的时间和死亡率。结果:观察组患者治疗后总有效率达96.7%,明显高于对照组的80.0%,差异具有统计学意义(P<0.05);对照组患者的死亡率高于对照组,但差异不具有统计学意义(P>0.05);机械通气后48h观察组的pH值和氧合指数高于对照组,而PaCO2低于对照组,拔出气管导管的时间亦短于对照组,差异均具有统计学意义(P<0.05)。结论:AECOPD患者在机械通气时鼻饲清化活血汤能提高临床疗效,缓解临床症状,且安全可靠。

Objective： To observe the effect of the Qinghua Huoxue decoction on treating acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods： 60 patients were randomly divided into observation group and control group, 30 in each. The observation group was given oxygen therapy, antibiotics, bronchodilators, corticosteroids, maintaining fluid and electrolyte balance, endotracheal intubation and invasive mechanical ventilation, and after receiving invasive mechanical ventilation immediately given nasal feeding Qinghua Huoxue decoction. The control group was given modem medicine treatment only. Observe in patients receiving invasive mechanical ventilation before and after 24h, 48h arterial pH, oxygenation index and PaCO2, and statistical extubation time and mortality. Results： After treatment, the observation group total efficiency was 96.7%, significantly higher than 80.0% in control group, the difference was statistically significant （P〈0.05）; control group mortality was higher, but the difference was not statistically significant （P〉0.05）; After mechanical ventilation 48h observation group pH and oxygenation index was higher than the control group, while PaCO2, After mechanical ventilation 48h observation group pH and oxygenation index was higher than the control group, while PaCO2 was lower than control group, pull out the endotracheal tube time will be shorter than control group, the differences were statistically significant （P〈0.05）. Conclusion： Treated AECOPD patients with nasal feeding Qinghua Huoxue decoction in mechanical ventilation can improve the clinical efficacy, improve the clinical symptoms, safe and reliable.