无创通气联合中医辨证治疗间质性肺炎的临床疗效及安全性

Clinical effect and the safety of non-invasive ventilation coimbined with TCM differentiation in treating idiopathic interstitial pneumonias

目的探讨无创通气联合中医辨证治疗特发性间质性肺炎的临床疗效及安全性。方法选取湖北省中西医结合医院2014年6月—2016年6月收治的间质性肺炎患者120例,随机分为对照组和观察组,每组60例。对照组患者给予对症支持治疗,观察组患者在对照组基础上给予无创呼吸机辅助通气联合中药辨证治疗,两组患者均持续治疗2个月。比较两组患者治疗前后临床症状及体征(咳嗽、咳痰、呼吸困难)评分、肺功能指标[肺活量占预计值百分比(VC%pred)、第1秒用力呼气容积占预计值百分比(FEV1%pred)、用力肺活量占预计值百分比(FVC%pred)、肺总量占预计值百分比(TLC%pred)、每升肺泡容积的一氧化碳弥散量占预计值百分比(DLCO/VA%pred)]、血气分析指标[动脉血二氧化碳分压(Pa CO2)、动脉血氧分压(Pa O2)],并观察患者不良反应发生情况。结果治疗前,两组患者咳嗽、咳痰、呼吸困难评分比较,差异无统计学意义(P>0.05);治疗后,观察组患者咳嗽、咳痰、呼吸困难评分低于对照组(P<0.05)。治疗前,两组各肺功能指标比较,差异无统计学意义(P>0.05);治疗后,观察组患者VC%pred、FVC%pred、DLCO/VA%pred高于对照组(P<0.05),但两组患者FEV1%pred、TLC%pred相比,差异无统计学意义(P>0.05)。治疗前及治疗后,两组患者Pa O2与Pa CO2比较,差异无统计学意义(P>0.05)。两组患者均未发现严重不良反应。结论采用无创通气联合中医辨证施治治疗间质性肺炎的临床疗效确切,可有效改善患者的临床症状及体征,提高肺功能及生活质量,且安全性好。

Objective To study the clinical effect and the safety of non-invasive ventilation coimbined with TCM differentiation in treating idiopathic interstitial pneumonias. Methods A total of 120 cases of patients with idiopathic interstitial pneumonias were selected from June 2014 to June 2016 in Hubei Provincial Hospital of Integrated Chinese＆Western Medicine,which were randomly divided into control group and observation group,60 cases in each group. Control group was given conventional treatment,observation group was given non-invasive ventilation coimbined with TCM differentiation based on control group,both groups were treated for 2 months. The clinical symptoms（ cough,expectoration and dyspnea） scores,pulmonary function indexes（ VC% pred,FEV1% pred,FVC% pred,TLC% pred,DLCO/VA% pred）,arterial blood indexes（ PaCO2,PaO2） before and after treatment were compared between the two groups,and the incidence of adverse reactions were observed.Results Before treatment,no siginificant differences of cough,expectoration or dyspnea scores was found between the two groups（ P 〉 0. 05）; after treatment,the observation group of cough,expectoration and dyspnea scores were lower than control group（ P 〈 0. 05）. Before treatment,no siginificant differences of VC% pred,FEV1% pred,FVC% pred,TLC% pred or DLCO/VA% pred was found between the two groups（ P 〉 0. 05）; after treatment,the observation group of VC% pred,FVC%pred and DLCO/VA% pred were higher than control group（ P 〈 0. 05）,and there was no significant differences of FEV1% pred or TLC% pred was found between the two groups（ P 〉 0. 05）. Before and after treatment,no siginificant differences of PaO2 or PaCO2 was found between the two groups（ P 〉 0. 05）. There was no serious adverse reactions happened beteen the two groups.Conclusion Non-invasive ventilation coimbined with TCM differentiation have an exactly clinical effect in treating idiopathic interstitial pneumonias,it can effectively improve the clinical symptoms of patients,improve the lung function and the quality of life,and with high safety.