中药苇茎汤加味配合纤维支气管镜支气管肺泡灌洗治疗老年支气管扩张合并感染急性加重的临床效果

Clinical effect of modified Phragmites Stem Decoction of TCM plusing bronchoalveolar lavage with fiberoptic bronchoscope treating acute exacerbation of bronchiectasis complicated with infection in the elderly

目的探讨中药苇茎汤加味配合纤维支气管镜支气管肺泡灌洗治疗老年支气管扩张合并感染急性加重的临床效果。方法选取我院2017年3月～2018年4月收治的62例老年支气管扩张并发感染急性加重患者作为研究对象,按入院先后顺序分组,每组31例。对照组应用纤维支气管镜支气管肺泡灌洗治疗法,观察组应用中药苇茎汤加味配合纤维支气管镜支气管肺泡灌洗治疗法。观察两组的血气分析指标变化,对比两组的症状改善时间,评估两组的治疗效果。结果治疗前,两组的动脉血氧分压(PaO_2)、动脉血氧饱和度(SaO_2)以及氧合指数(PaO_2/FiO_2)指标比较,差异无统计学意义(P>0.05),治疗后,观察组的PaO_2、SaO_2、PaO_2/FiO_2指标水平均高于对照组,差异有统计学意义(P<0.05)。观察组的感染控制时间、发热、咳嗽、咳痰以及肺部湿罗音症状改善时间均短于对照组,差异有统计学意义(P<0.05)。观察组的总有效率为93.55%,高于对照组的77.42%,差异有统计学意义(P<0.05)。结论老年支气管扩张并发感染急性加重患者应用中药苇茎汤加味配合纤维支气管镜支气管肺泡灌洗治疗时能有效提升动脉血气指标,控制感染、改善临床症状用时更短,治疗有效率更高,患者恢复更快。

Objective To discuss the clinical effect of modified Phragmites Stem Decoction of TCM plusing bronchoalveolar lavage with fiberoptic bronchoscope treating acute exacerbation of bronchiectasis (BE) complicated with infection in the elderly. Methods All of 62 elderly patients with acute exacerbation of bronchiectasis complicated with infection treated in our hospital from March 2017 to April 2018 were selected as objects and they were grouped according to the order of admission,and there were 31 cases in each group. The control group was treated with the bronchoalveolar lavage with fiberoptic bronchoscope,while the observation group was treated with modified Phragmites Stem Decoction of TCM plusing bronchoalveolar lavage with fiberoptic bronchoscope. The blood gas analysis indicators changes were observed,symptom improvement time was compared and therapeutic effect were evaluated between the two groups. Results Before treatment,the partial pressure of oxygen (PaO2),oxygen saturation (SaO2) and PaO2/fraction of inspiration oxygen (PaO2/FiO2) showed no statistical differences between the two groups (P>0.05). After treatment,the values of PaO2,SaO2 and PaO2/FiO2 in the observation group were higher than those of the control group,with statistical differences (P<0.05). The symptom improvement time of pulmonary infection,fever,cough,expectoration and moist rale in the observation group were shorter than those of the control group,with statistical differences (P<0.05). The total effective rate in the observation group (93.55%) was higher than that of the control group (77.42%),with statistical difference (P<0.05). Conclusion The modified Phragmites Stem Decoction of TCM plusing bronchoalveolar lavage with fiberoptic bronchoscope can efficiently improve the arterial blood analysis indicators,and it takes shorter time to control infection and improve clinical symptoms,with higher treatment effective rate and faster recovery of patients.