中药合机械通气治疗老年性慢性阻塞性肺疾病疗效观察

Treatment of Chronic Obstructive Pulmonary Disease with Traditional Chinese Medicine and Mechanical Ventilation

目的:观察中药辨证论治联合有创机械通气治疗老年性慢性阻塞性肺疾病的疗效。方法:60例老年性慢性阻塞性肺疾病伴机械通气治疗患者随机分成对照组(30例)和治疗组(30例),两组均给予西医抗感染、祛痰药、支气管扩张剂、有创机械通气治疗,治疗组加用中药灌服,所有患者均于治疗前及治疗后第7天检测TNF-α、IL-8、CRP、动脉血二氧化碳分压(PaCO2),并比较呼吸机相关性肺炎(VAP)发生率、机械通气时间,ICU住院时间。结果:治疗组的炎症因子TNF-α、IL-8、CRP较对照组明显好转(P<0.05),临床指标PaCO2、VAP发生率、机械通气时间及ICU住院时间等与对照组比较,差异均有统计学意义(P<0.05)。结论:中药灌服治疗较单纯西医治疗能明显改善老年性慢性阻塞性肺疾病患者的炎症因子,减少机械通气时间、VAP发生率及ICU住院时间,降低住院费用,且未见明显不良反应。

Objective ： To investigate the efficacy of traditional Chinese medicine and mechanical ventilation on patients with chronic obstructive pulmonary disease（COPD）. Methods ：60 cases of COPD with mechanical ventilation were retrospectively ana- lyzed. The patients were divided into traditional Chinese medicine treatment group （n = 30） and contol group （n = 30）. Ventilator -associated pneumonia（VAP） incidence, mechanical ventilation time,length of stay at ICU time were compared. Results：Tumor necrosis factor - α （ TNF - α）, interleukin - 8 （ IL - 8 ）, C - reactiveprotein （ CRP ） were significantly reduced in the treatment group （P 〈 0. 05 ）. The incidence of VAP, mechanical ventilation time and the stay in ICU were significantly reduced in the treat- ment group （P 〈 0. 05 ）. Conclusion ： Traditional Chinese medicine combined with conventional treatment of COPD can effectively reduce the incidence of VAP and shorten mechanical ventilation time and the stay at ICU.