温肾健脾、化痰活血法对慢性阻塞性肺疾病急性加重期困难撤机的临床研究

Clinical research of Wenshenjianpi Huatanhuoxue Mode in AECOPD difficult weaning

目的:研究温肾健脾、化痰活血法对慢性阻塞性肺疾病急性加重期(AECOPD)困难撤机的应用价值。方法:采用前瞻性研究方法,将望京医院ICU自2010年5月-2012年10月AECOPD困难撤机48例患者随机分为观察组和对照组,对照组采用常规机械通气撤机策略,观察组加用温肾健脾、化痰活血中药汤剂治疗,对比两组治疗后的中医主症变化、血气分析结果、白蛋白(ALB)及血红蛋白(HGB)水平,有创机械通气时间、总机械通气时间、撤机成功率。结果:两组中医主症评价指标、有创机械通气时间有显著性差异(P<0.01,P<0.05),两组治疗后血气分析、ALB及HGB水平无显著性差异,但部分指标同组治疗前后比较有显著性差异(P<0.01,P<0.05)。结论:温肾健脾、化痰活血法在AECOPD困难撤机中具有一定的应用前景,为解决临床撤机难题开辟了新思路。

Objective： To investigate the applied value of Wenshenjianpi Huatanhuoxue Mode in difficult weaning with AECOPD. Methods： Prospectively observed 48 patients of difficult weaning with AECOPD in ICU from May, 2010 to October, 2012, and randomly divided them into observation group and control group. Using conventional mechanical ventilation weaning strategy in two groups, the observation group was additionally treated with Wenshenjianpi Huatanhuoxue Mode. The two groups were compared in TCM main symptoms, blood gas analysis, ALB and HGB level, invasive mechanical ventilation time, total duration of mechanical ventilation, weaning success rate after treatment. Results： There were significant differences between two groups in TCM main symptoms and invasive mechanical ventilation time （P〈0.01, P〈0.05） and no significant differences in blood gas analysis, ALB and HGB level, but there were significant differences in the same group before and after treatment （P〈0.01, P〈0.05）. Conclusion： Wenshenjianpi Huatanhuoxue Mode has a good application prospects in AECOPD difficult weaning, which may be a new method to resolve the problem of clinical difficulty weaning.