基于培土生金理论治疗AECOPD伴Ⅱ型呼吸衰竭患者临床观察

Clinical observation of the treatment based on Peitushengjin theory in patients with AECOPD with Ⅱ respiratory failure

目的观察益肺健脾合剂对肺脾气虚型慢性阻塞性肺疾病急性加重期(AECOPD)伴Ⅱ型呼吸衰竭患者的中医症状积分、营养、血气等相关指标的影响。方法将符合AECOPD伴Ⅱ型呼吸衰竭需要使用无创或有创呼吸机辅助通气,且符合中医辨证分型为肺脾气虚型患者40例分为两组,对照组予常规西医治疗,中药组在西医治疗基础上加用益肺健脾合剂,口服或管喂,1周为1个疗程,观察患者治疗前后的中医症状及体征积分、APACHEⅡ评分、血清清蛋白、前清蛋白、中性粒细胞百分比、C反应蛋白(CRP)及血气分析等相关指标。结果中药组能够改善患者的中医症状及体征积分,治疗后两组间比较差异有统计学意义(P<0.05);两组患者在治疗后血清清蛋白、前清蛋白、转铁蛋白、中性粒细胞百分比、CRP及动脉血气分析等相关指标进行比较,中药组优于对照组,差异有统计学意义(P<0.05);在治疗1个星期后,APACHEⅡ的改善情况,中药组均优于对照组,差异有统计学意义(P<0.05)。结论在采用西医常规处理基础上,加用基于培土生金理论而设立的组方--益肺健脾合剂治疗AECOPD合并Ⅱ型呼吸衰竭疗效好,能够改善了患者的营养状况及动脉血气分析的各项指标。

Objective to observe the effect of lung and spleen mixture on lung spleen deficiency AECOPD withⅡrespiratory failure of TCM symptoms integral,nutrition,blood gas and related indicators.Methods in accordance with AECOPD with Ⅱtype of respiratory failure need to use the noninvasive or have a respirator assisted ventilation,and conform to the type of TCM for patients with spleen-deficiency type,40 cases were divided into two groups,control group to the conventional western medicine therapy and Chinese medicine group on the basis of western medicine treatment for reasons of Yifeijianpi mixture,oral or tube feeding,a week for a period of treatment,observation of patients before and after treatment of TCM symptoms and physical signs integral,APACHE Ⅱ score,serum albumin,pre-albumin,neutrophil percentage,CRP and blood gas analysis and related indicators was conducted.Results The results show that the TCM group can improve the patients′TCM symptoms and physical signs integral,there was significant difference between the two groups after treatment（P〈0.05）;compare the serum albumin,pre-albumin,transferrin,neutrophil percentage,CRP and arterial blood gas between two groups of patients after treatment,Chinese medicine group is superior to the control group,with statistical significance（P〈0.05）;And compared with control group,the APACHE Ⅱimprovement situation of Chinese medicine group were superior to control group after the treatment after a week,with statistical significance（P〈0.05）.Conclusion on the basis of using conventional western medicine treatment,treatment based on the theory of ridging raw gold formulae of Yifeijianpi mixture has good effect in the treatment of AECOPD combined typeⅡrespiratory failure,and can improve the nutritional status of patients and the indicators of arterial blood gas analysis.