参芪扶正注射液联合BiPAP无创通气及纳洛酮治疗COPD合并Ⅱ型呼吸衰竭疗效观察

Observation on effect of Shenqi Fuzheng injection combined with BiPAP noninvasive ventilation and naloxone on chronic obstructive pulmonary disease with type 2 respiratory failure

目的探讨参芪扶正注射液、BiPAP无创通气(双水平气道正压通气)联合纳洛酮治疗COPD合并Ⅱ型呼吸衰竭患者的临床疗效。方法将82例慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者随机分为观察组41例和对照组41例。对照组给予BiPAP无创通气联合纳洛酮治疗,观察组在对照组治疗基础上给予参芪扶正注射液治疗。统计2组治疗7 d后治疗效果,检测2组治疗前后血气指标[pH、Sa(O_2)、p(CO_2)、p(O_2)]、血清免疫球蛋白(IgG、IgA及IgM)、T淋巴细胞亚群(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)水平,观察2组治疗期间不良反应发生情况。结果观察组总有效率明显高于对照组(P<0.05);治疗后,观察组pH、Sa(O_2)、p(O_2)和血清IgG、IgA、IgM及CD3^+、CD4^+、CD4^+/CD8^+均明显高于对照组(P均<0.05),p(CO_2)和CD8^+均明显低于对照组(P均<0.05);2组不良反应发生率比较差异无统计学意义(P>0.05)。结论参芪扶正注射液联合BiPAP无创通气及纳洛酮治疗COPD合并Ⅱ型呼吸衰竭可有效改善患者肺功能,提高患者免疫力,值得研究应用。

Objective It is to observe the curative effect of Shenqi Fuzheng injection （SQFZ） combined with BiPAP non- invasive ventilation and naloxone on chronic obstructive pulmonary disease （COPD） with type 2 respiratory failure. Methods 82 cases of COPD patients with type 2 respiratory failure were divided into control group （41 cases） and treatment group （41 cases） by a randomized way. The control group was given BiPAP noninvasive ventilation combined naloxone, and the treat- ment group was given SQFZ on the basis of treatment of control group. The observation lasted for 7 days. The curative effect were observed, and the levels ofp（CO2） , Sa（O2）, p（O2）, pH, IgG, IgA, IgM, CD3＋, CD4＋ and CD8＋ were detected and compared between two groups after treatment. Results The total effective rate of the treatment group was significantly high- er than that of the control group （ P 〈 0.05 ）. After treatment, the value of Sa（ 02 ） , p（ 02 ） , pH and the levels of serum immunoglobulin IgG, IgA and IgM, and T lymphocyte subgroup CD3 ＋ , CD4 ＋ , CD4 ＋/CD8 ＋ in the treatment group were signif- icantly higher than those in the control group （all P 〈 0. 05）, but p（ CO2 ）, CD8＋ were significantly lower than those of the control group （all P 〈 0.05）. There was no significant difference between the two groups in adverse reactions （ P 〉 0.05 ）. Conclusion The treatment of SQFZ combined with BiPAP noninvasive ventilation and na]oxone in COPD with type 2 respiratory failure can effectively improve the patient＇ s lung function, enhance the patientg immunity, it is worthy of clinical application.