参芪扶正注射液对慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭疗效观察

Efficacy of Shenqifuzheng Injection for Chronic Obstructive Pulmonary Disease Combined with Type Ⅱ Respiratory Failure

目的观察参芪扶正注射液治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的疗效。方法选择2010年1月至2013年12月在上海浦东新区肺科医院就诊的COPD合并Ⅱ型呼吸衰竭的患者90例为研究对象,采用随机数字表法将患者分为参芪扶正注射液组和常规治疗组,每组45例。常规治疗组予以常规治疗,参芪扶正注射液组在常规治疗组的基础上予以参芪扶正注射液治疗,每次250 m L静脉滴注,每日1次。两组患者均治疗14 d,观察两组患者的疗效、采用master screen型肺功能仪对患者的功能残气量、最大呼气流量(PEF)以及第1秒用力呼气量在预计值中的百分比(FEV1%)进行检测,采用免疫透射比浊法比较两组患者血清脑钠肽、C反应蛋白和降钙素原水平变化。结果参芪扶正注射液组患者的总有效率为93.33%(42/45),明显高于常规治疗组的75.56%(34/45),差异有统计学意义(χ2=4.145,P<0.05),且参芪扶正注射液组的疗效也显著优于常规治疗组(Z=3.908,P=0.048)。治疗后两组患者的肺功能残气量较治疗前显著降低,PEF和FEV1%较治疗前显著升高,且参芪扶正注射液组患者功能残气量低于常规治疗组[(2.6±0.6)L/s比(3.0±0.4)L/s],而PEF和FEV1%高于常规治疗组[(4.2±1.1)L比(3.8±0.4)L;(74.3±13.7)%比(66.0±11.73)%],两组患者的C反应蛋白、降钙素原及脑钠肽水平均较治疗前显著降低,且参芪扶正注射液组患者C反应蛋白、降钙素原和脑钠肽低于常规治疗组[(6.4±1.2)mg/L比(11.8±1.8)mg/L;(0.4±0.1)μg/L比(0.7±0.1)μg/L;(55.9±18.7)pg/L比(107.4±22.4)pg/L](P<0.01)。结论参芪扶正注射液治疗COPD合并Ⅱ型呼吸衰竭疗效显著,其能够改善肺功能,缓解机体的炎性反应,从而改善患者的预后。

Objective To observe the efficacy of Shenqifuzheng injection （SFI） for chronic obstructive pulmonary disease （COPD） patients with respiratory failure. Methods Total of 90 COPD patients with type Ⅱ respiratory failure in Pudong New District Pulmonary Hospital from Jan. 2010 to Dec. 2013 were included in the study, and divided into SFI group and conventional therapy group according to the random number table method,45 cases each. The conventional therapy group received conventional treatment, and the SFI group was given SFI 250 mL, intravenous infusion, once a day, on the basis of the conventional therapy, and each group was treated for 14 days. The efficacy, funetional residual capacity （ FRC ）, peak expiratory flow （PEF） ,percentage of one second expected value in forced expiratory volume （ FEV1% ） were detected by master sereen type spirometer, Brain natfiuretic peptide （BNP）, C-reactive protein （CRP） and procaieitonin （PCT） levels were detected by immune turbidimetry and the results were compared. Rults The total effective rate of the SFI group was 93.33% （42/45）, which was higher than 75.56% （ 34/45 ） of the eon- ventional therapy group,the difference was statistically significant（ z = 4. 145 ,P 〈 0. 05 ）, and efficacy of the SFI group was significantly better than the conventional therapy group （ Z = 3. 908, P = 0. 048 ）. After treatment, the FRC levels of the two groups were significantly lower than before treatment, PEF and FEV1% were significantly higher than before treatment, with statistieally significant difference （ P 〈 0. 05 ）, the FRC of the SFI group was lower than the eonventional therapy group[ （2. 6 ±0. 6） L/s vs （3.0 ±0. 4） L/s] and PEF and FEV1% were higher than the conventional therapy group [ （4. 2 ± 1.1 ） L vs （ 3.8 ± 0. 4 ） L; （ 74. 3 ± 13.7）% vs （66. 0 ±11.73）% ]. The levels of CRP,procaleitonin and brain natriuretie peptide of the two groups were significantly lower than before treatment, the levels of CRP, proealeitonin and brain natriuretic peptide of the SFI group were significantly lower than the conventional therapy group[ （6.4 ± 1. 2） mg/L vs （11.84-1.8）μg/L;（0.4 ±0.1） μg/L vs （0.7±0.1） μg/L;（55.9 ± 18.7） pg/L vs （107.4 ±22. 4） pg/L] （ P 〈 0. 01 ）. Conclusion The efficacy of Shenqifuzheng injection for the COPD patients with respiratory failure is significant, which can improve the lung function, relieve the body＇s inflammatory resoonse, thus imvrove the prognosis.