丹参川芎嗪联合综合干预对慢性阻塞性肺疾病急性加重期合并呼吸衰竭患者炎性反应及肺功能的影响

Effect of Salvia miltiorrhiza and Ligustrazine combined intervention on inflammatory response and pulmonary function in patients with AECOPD complicated with RF

目的探讨丹参川芎嗪联合综合干预对慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭(RF)患者炎性反应及肺功能的影响。方法 AECOPD合并RF患者110例,按照随机数字表法分为观察组和对照组,各55例。对照组给予抗感染、支气管扩张、祛痰止咳、平喘、营养支持等常规治疗,观察组在对照组基础上给予丹参川芎嗪静脉滴注。2组均进行综合干预,治疗10 d后进行评价。治疗前后采集晨起空腹未吸氧状态下桡动脉血,采用血气分析仪测定动脉二氧化碳分压(PaCO_2)、动脉氧分压(PaO_2)、动脉血氧饱和度(SaO_2);采集晨起空腹外周静脉血,采用免疫比浊法测定血清C反应蛋白(CRP),酶联免疫吸附法(ELISA)测定血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8);治疗前后采用肺功能仪检测用力肺活量(FVC)、第1 s用力呼气量容积(FEV1)、最大呼气流量(PEF)。结果观察组治疗后PaCO_2低于对照组,PaO_2、SaO_2高于对照组(P<0.05);观察组治疗后TNF-α、CRP、IL-6、IL-8低于对照组(P<0.05);观察组治疗后FVC、FEV1、PEF高于对照组(P<0.05)。结论综合干预可有效改善AECOPD合并RF患者的负性情绪,使其更好地配合治疗,丹参川芎嗪能够有效减轻机体炎性反应,改善血气指标,有效促进肺功能的恢复。

Objective To investigate the effect of Salvia miltiorrhiza and Ligustrazine combined intervention on inflammatory response and pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD） complicated with respiratory failure（RF）.Methods 110 patients with AECOPD combined with RF were divided into the observation group and the control group according to the random number table method,each with 55 cases,The control group was given conventional treatment,such as anti infection,bronchiectasis,expectorant,cough,asthma and nutritional support.The observation group was given Salvia miltiorrhiza and ligustrazine intravenous drip on the basis of the control group.The 2 groups were treated by comprehensive intervention after 10 d treatment.The radial artery blood was collected before and after treatment.The arterial carbon dioxide partial pressure（PaCO2）,arterial oxygen partial pressure（PaO2） and arterial oxygen saturation（SaO2） were measured by blood gas analyzer; The peripheral venous blood from the morning was collected.Serum C reactive protein（CRP） was measured by immunoturbidimetry.Serum tumor necrosis factor alpha（TNF-alpha）,interleukin-6（IL-6） and interleukin-8（IL-8） were measured by enzyme-linked immunosorbent assay（ELISA）; Before and after treatment,the lung function（FVC）,the first second forced expiratory volume（FEV1） and the maximum expiratory flow（PEF） were detected by the pulmonary function instrument.Results The PaCO2 of the observation group was lower than that of the control group after treatment.PaO2 and SaO2 were higher than those of the control group（P〈0.05）.After treatment,TNF-,CRP,IL-6 and IL-8 in the observation group were lower than those in the control group（P〈0.05）,and the FVC,FEV1 and PEF in the observation group were higher than those in the control group.Conclusion Comprehensive intervention can effectively improve the negative emotions of patients with AECOPD combined with RF,and make them better cooperate with the treatment.Salvia miltiorrhiza and Ligustrazine can effectively reduce the inflammatory response,improve blood gas index,and effectively promote the recovery of lung function.