中药灌肠联合无创呼吸机治疗痰热壅肺型慢性阻塞性肺疾病合并呼吸衰竭临床观察

Clinical observation of traditional Chinese medicine enema with noninvasive ventilator on AECOPD with respiratory failure of syndrome of retention of phlegm-heat in the lung

目的:观察中药灌肠联合无创呼吸机治疗痰热壅肺型慢性阻塞性肺疾病(AECOPD)合并呼吸衰竭的临床效果。方法:将55例患者随机分为两组,对照组27例,采用西医常规治疗,治疗组28例,在对照组基础上采用中药灌肠治疗,隔天1次,疗程8天,观察并比较两组治疗前后中医证候积分及心率、呼吸频率、血气分析、无创通气并发症、无创通气时间、气管插管率、死亡率等变化。结果:治疗组在中医证候积分、呼吸频率、血气分析、无创通气并发症中腹胀发生率、无创通气时间等方面优于对照组,差异有统计学意义(P<0.05)。治疗组显效5例,有效21例,无效2例,总有效率92.86%,对照组显效3例,有效15例,无效9例,总有效率67%,两组比较差异有统计学意义(P<0.05)。治疗组无创呼吸机使用时间缩短,在气管插管率、死亡率等方面无改善。结论:中药灌肠联合无创呼吸机治疗痰热壅肺型AECOPD合并呼吸衰竭临床疗效确切。

Objective:To observe the clinical effect of traditional Chinese medicine enema with noninvasive ventilator on AECOPD with respiratory failure of syndrome of retention of phlegm-heat in the lung.Methods:55cases of patients were randomly divided into two groups.The control group was treated with conventional western medicine,while the treatment group was treated with traditional Chinese medicine enema on the basis of control group,once every other day,the course of treatment was8days.The score of TCM syndrome and the changes of heart rate,respiratory frequency,blood-qi analysis,noninvasive ventilation complications,noninvasive ventilation time,endotracheal intubation rate,mortality rate etc.were observed and compared before and after treatment in two groups.Results:In score of TCM syndrome,respiratory frequency,blood-qi analysis,occurrence rate of abdominal distension in complications due to noninvasive ventilation,noninvasive ventilation time,etc.,the treatment group was better than the control group,the difference was statistically significant(P<0.05);the occurrence rate of belch reduced,but without statistical significance(P>0.05).After use of noninvasive ventilator,abdominal distension was relieved,but abdominal pain,belch,sour regurgitation,reflux,vomiting and mistake inhalation had an aggravating trend.The usetime of noninvasive ventilator shortened,endotracheal intubation rate and mortality rate etc.were not improved.Conclusion:The clinical effect of traditional Chinese medicine enema with noninvasive ventilator on AECOPD with respiratory failure of syndrome of retention of phlegm-heat in the lung is definite.