中西医结合治疗慢性阻塞性肺疾病急性加重合并呼吸衰竭的效果

Effect of integrative Chinese and western medicine on acute exacerbation of chronic obstructive pulmonary disease combined with respiratory failure

目的探讨中西医结合治疗慢性阻塞性肺疾病急性加重（AECOPD）合并呼吸衰竭的临床效果。方法将深圳市龙华新区人民医院2012年1月-2014年1月收治的AECOPD合并呼吸衰竭患者90例随机分为两组,每组各45例,对照组采用西医常规治疗,观察组在西医常规治疗基础上采用自拟中药汤剂清肺化痰饮口服,比较两组治疗前后主要症状如咳嗽、咳痰、喘息、哮鸣音的积分及氧分压（Pa O2）、二氧化碳分压（Pa CO2）、白细胞计数（WBC）、血清D-二聚体（D-D）的变化情况,并比较两组治疗效果。结果两组治疗前主要症状咳嗽、咳痰、喘息、哮鸣音积分等比较差异无统计学意义（P〉0.05）,两组治疗后上述症状积分均显著下降（P〈0.05）,且观察组均低于对照组（P〈0.01）;两组治疗前Pa O2、Pa CO2、WBC及D-D比较差异无统计学意义（P〉0.05）,两组治疗后上述指标均明显改善（P〈0.05）,观察组改善情况优于对照组（P〈0.01）,观察组总有效率高于对照组,差异有统计学意义（P〈0.05）。结论中西医结合治疗AECOPD合并呼吸衰竭可有效缓解症状,改善血气分析指标,提高临床疗效,安全性好,有临床推广应用价值。

Objective To investigate the clinical curative effect of integrative Chinese and western medicine on chronic obstructive pulmonary disease combined with respiratory failure（AECOPD）. Methods 90 patients with acute exacerbation of chronic obstructive pulmonary disease with respiratory failure admitted to the People＇s Hospital of Longhua New District in Shenzhen City from January 2012 to January 2014 were randomly divided into two groups, with 45 cases in each group, the control group was treated with conventional western treatment, the observation group was treated with TCM Qingfei Huatan Decoction orally based on the treatment of control group. The main symptoms of cough, expectoration, gasp and wheeze integral and partial pressure of oxygen（PaO2）, carbon dioxide partial pressure（PaCO2）, white blood cell count（WBC）, serum D- two dimers（D-D） changes before and after treatment in the two groups were compared, and the clinical efficiency of the two groups was compared. Results There were no significant differences in the main symptoms of cough, sputum, wheezing, wheezing integral before treatment（P 〉0.05）, the symptom integrals mentioned above after treatment of the two groups were significantly decreased（P〈 0.05）, the observation group was lower than that of the control group, the difference was statistically significant（P 〈0.01）; there were no significant differences in PaO2, PaCO2, WBC and D-D before treatment（P〉 0.05）, the index mentioned above of two groups were significantly improved after treatment（P 〈0.05）, the observation group was better than the control group, the difference was statistically significant（P 〈0.01）, the total effective rate of the observation group was higher than that of the control group, the difference was statistically significant（P〈 0.05）. Conclusion Integrative Chinese and western medicine on acute exacerbation of chronic obstructive pulmonary disease combined with respiratory failure can effectively alleviate the symptoms, improve the blood gas index analysis, improve the clinical efficacy, it has good safety and clinical application value.