泄热化痰方联合无创通气治疗慢性阻塞性肺疾病急性期的临床研究

Clinical Study on Chronic Obstructive Pulmonary Disease at Acute Phase Treared with Xiere Huatan Fang (泄热化痰方) Combined with Noninvasive Ventilation Therapy

目的:分析泄热化痰方联合无创正压通气治疗慢性阻塞性肺疾病(COPD)急性期的疗效并探讨其作用机制。方法:将94例COPD患者随机分为两组,每组47例,对照组给予无创正压通气治疗,观察组在对照组治疗的基础上加用自拟泄热化痰方,1剂/d,持续治疗6周,观察两组患者症状缓解及肺功能改善情况,并检测血清炎性因子变化。结果:观察组咳喘、胸闷、肺部湿啰音缓解时间短于对照组(P<0.05);两组治疗后动脉血Pa CO2、Pa O2、Sa O2、p H值比较差异无统计学意义(P>0.05);观察组治疗前后FEV1、FEV1%比较差异有统计学意义(P<0.05),对照组无明显变化;治疗后观察组血清IL-8、TNF-α、hs-CRP浓度显著低于治疗前及对照组(P<0.05)。结论:对COPD患者在无创正压通气基础上加用泄热化痰方可缓解COPD急性期呼吸衰竭症状,促进炎症消除,改善肺功能。

Objective： To obsere the effects of Xiere Huatan Fang combined with noninvasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease（ COPD） at acute phase,explore the mechanism. Methods： 94 patients with COPD were randomly divided into two groups,47 cases in each group,the control group was given non- invasive positive pressure ventilation in the treatment,the observation group treated with Xiere Huatan Fang on the basis of control for 6 weeks,symptoms and lung function improvement,the changes of serum inflammatory factors in the two groups were observed. Results： cough,chest tightness,lung wet rales remission time in the observation group were shorter than those in control group（ P〈0. 05）; the two groups was not statistically significant after treatment on arterial blood Pa CO2,Pa O2,Sa O2,p H difference（ P〈0. 05）; there was statistical significance before and after treatment in observation group on FEV1 and FEV1%（ P〈0. 05）,the control group had no significant changes; the levels of serum IL- 8,TNF- α and hs- CRP concentrations were significantly lower in observation group than that before treatment and the control group（ P〈0. 05）. Conclusion： COPD patients with noninvasive positive pressure ventilation plus Xiere Huatan Fang can alleviate the symptoms of acute respiratory failure, promote to eliminate inflammation, improve lung function.