丹参川芎嗪在慢阻肺急性加重合并呼衰治疗中的作用

Effect of salvia miltiorrhiza ligustrazine injection in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease complicated by respiratory failure

目的分析丹参川芎嗪在慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭患者临床治疗中的作用。方法选取老年AECOPD合并呼吸衰竭患者81例,随机分为研究组40例和对照组41例。对照组予以基础治疗和有创/无创机械通气,研究组在此基础上加用丹参川芎嗪,观察两组临床疗效及治疗前后血气指标、炎性因子水平、肺功能指标的变化。结果研究组总有效率为95. 0%,略高于对照组的90. 2%,但差异无统计学意义(P> 0. 05)。两组治疗后动脉二氧化碳分压(Pa CO2)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)水平较治疗前明显降低(P <0. 01),动脉氧分压(Pa O2)、动脉血氧饱和度(Sa O2)明显升高(P <0. 01),但研究组降低及升高幅度均显著大于对照组(P <0. 01)。两组治疗后用力肺活量(FVC)、第1秒用力呼气量(FEV1)、最大呼气流量(PEF)较治疗前明显改善(P <0. 01),但研究组改善程度更为显著(P <0. 01)。结论对AECOPD合并呼吸衰竭患者加用丹参川芎嗪注射液可改善临床症状及血气指标,减轻机体炎症反应,促进肺功能恢复。

Objective To analyze the effect of salvia miltiorrhiza ligustrazine injection in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）complicated by respiratory failure. Methods Totally 81 elderly AECOPD patients complicated by respiratory failure were randomly divided into research group（ n= 40）and control group（ n= 41）.The control group was given basic treatment and invasive/non-invasive mechanical ventilation,while the research group was added salvia miltiorrhiza ligustrazine injection.The clinical efficacy and changes of blood gas indexes,inflammatory factors and lung function-related indexes before and after treatment were observed between two groups. Results The overall response rate was 95.0 % in research group,slightly higher than 90.2 % in control group（ P 〉 0.05）.After treatment,the levels of PaCO 2,tumor necrosis factor-α（TNF-α）,interlukin-6（IL-6）and C-reactive protein（CRP）went down（ P 〈 0.01）,PaO 2 and SaO 2 went up obviously in two groups when compared with pre-treatment（ P 〈 0.01）,but the decreased and increased degrees of research group were larger than those in control group（ P 〈 0.01）.After treatment,the forced vital capacity（FVC）,forced expiratory volume in the first second（FEV 1）and peak expiratory flow（PEF）in two groups were improved conspicuously when compared with pre-treatment,but the improvement degree of research group was more significant（ P 〈 0.01）. Conclusion For AECOPD patients complicated by respiratory failure,salvia miltiorrhiza ligustrazine injection can ameliorate clinical symptoms and blood gas indexes,relieve inflammatory reaction and promote recovery of lung function.