中医辨证配合西医治疗慢性阻塞性肺疾病急性加重呼吸衰竭临床观察

Clinical observation of TCM syndrome differentiation combined with western medicine on acute severe respiratory failure due to chronic obstructive pulmonary disease

目的 :观察中医辨证配合西医治疗慢性阻塞性肺疾病急性加重呼吸衰竭的临床效果。方法:选取我院收治的92例慢性阻塞性肺疾病急性加重呼吸衰竭患者作为观察对象,采用随机数字表法分为2组,各46例。对照组患者给予常规治疗方法,观察组患者在此基础上,给予中医辨证治疗,对比两组患者治疗效果。结果:观察组总有效率为93.48%(95%CI=81.77%~98.58%),对照组为71.74%(95%CI=58.73%~84.75%),两组综合疗效比较(u=1.877 3,P=0.060 5),差异接近临界状态;与对照组比较,观察组可明显升高肺功能峰值呼气流速、用力呼气量、呼气量/肺活量参数(P<0.01)。结论:给予中医辨证配合西医治疗慢性阻塞性肺疾病急性加重呼吸衰竭患者的临床疗效优于单纯采取常规西医治疗方法,其收益为OR=0.18(95%CI=0.05~0.67),NNT=5(95%CI=2.69~16.00)。

Objective： To observe the clinical effect of TCM syndrome differentiation combined with western medicine on acute severe respiratory failure due to chronic obstructive pulmonary disease. Methods： 92 cases of patients with acute severe respiratory failure due to chronic obstructive pulmonary disease selected and treated in our hospital were taken as observed object,and divided randomly into two groups,46 cases in each group. The control group was treated conventionally,while the observation group was treated with TCM syndrome differentiation on the basis of control group. The therapeutic effects of patients in two groups were compared. Results： The total effective rate of observation group was 93. 48%（ 95% CI = 81. 77%- 98. 58%）,while while the control group was71. 74%（ 95% CI = 58. 73%- 84. 75%）. Compared the comprehensive efficacy in two groups（ U = 1. 877 3,P =0. 060 5）,the difference was close to the critical state. Compared with the control group,the observation group could increase significantly the parameters of peak expiratory flow rate,forced expiratory volume and expiratory volume / vital capacity of lung function（ P〈0. 01）. Conclusion： The clinical effect of TCM syndrome differentiation combined with western medicine on acute severe respiratory failure due to chronic obstructive pulmonary disease is better than that of pure conventional western medicine,its benefit is OR = 0. 18（ 95% CI = 0. 05- 0. 67）and NNT = 5（ 95% CI = 2. 69- 16. 00）.