培土生金方联合BiPAP呼吸机对慢性阻塞性肺疾病加重期合并Ⅱ型呼吸衰竭痰细胞分类、血ECP变化的影响

Effect on sputum cell classification and blood ECP changes in patients with chronic obstructive pulmonary disease exacerbation with type Ⅱ respiratory failure treated with Peitu Shengjin prescription combined with BiPAP ventilator

目的研究培土生金方联合BiPAP呼吸机治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭治疗前后诱导痰细胞分类、血中嗜酸性粒细胞阳离子蛋白(ECP)的变化。方法选择2014年1月-2017年1月期间收治的108例AECOPD合并Ⅱ型呼吸衰竭患者,采用随机数表法,分为对照组和观察组各54例。对照组患者采用AECOPD常规治疗联合BiPAP呼吸机,观察组在对照组的基础上加用培土生金方治疗,2周为1个疗程。记录比较两组患者治疗前后诱导痰细胞分类、血ECP含量和动脉血气分析指标(PaO2、PaCO2、pH),并评价疗效。结果两组患者治疗后中性粒细胞均下降,且观察组低于对照组;巨噬细胞均升高,且观察组高于对照组(P<0.05),差异有统计学意义,两组患者治疗后嗜酸性粒细胞和淋巴细胞无明显变化(P>0.05);两组患者血ECP含量均降低,且观察组低于对照组(P<0.05),差异有统计学意义;两组患者PaO2和pH均升高,且观察组高于对照组;两组患者PaCO2均降低,且观察组PaCO2低于对照组(P<0.05),差异有统计学意义;观察组治疗后总有效率高于对照组(P<0.05),差异具有统计学意义。结论采用培土生金方联合BiPAP呼吸机治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者,疗效显著,可能是通过减少中性粒细胞比例和ECP含量,增加巨噬细胞比例,从而抑制炎症反应。

Objective To observe the sputum cell classification and blood ECP changes in patients with chronic obstructive pulmonary disease(AECOPD)exacerbation with typeⅡrespiratory failure treated with Peitu Shengjin prescription combined with BiPAP ventilator.Method 108 cases of AECOPD with typeⅡrespiratory failure patients from hospital in January 2014 to 2017 year in January were divided into control group and observation group by random number table with 54 cases in each group.The control group was treated with AECOPD combined with routine treatment of BiPAP ventilator,the observation group with Peitu Shengjin prescription on the basis of the control group,2 weeks for 1 course.The sputum cell classification,blood ECP(eosinophil cationic protein)content and arterial blood gas analysis indexes(PaO2,PaCO2 and pH)were compared between the two groups before and after treatment and the curative effect was evaluated.Result Compared with before treatment,the neutrophils was decreased after treatment in both groups,and the observation group was lower than the control group;macrophages was elevated,and the observation group was higher than the control group(P<0.05).There were no significant changes in eosinophils and lymphocytes between the two groups(P>0.05).Compared with before treatment,the blood ECP levels of the two groups was decreased after treatment,and the observation group was lower than the control group(P<0.05);the PaO2 and pH of the two groups were increased after treatment,and the observation group was higher than that of the control group;the PaCO2 of the two groups was lower,and the PaCO2 of the observation group was lower than that of the control group(P<0.05).The total effective rate of the observation group after treatment was higher than that of the control group(P<0.05).Conclusion The Peitu Shengjin prescription combined with BiPAP ventilator in treatment of acute exacerbation of chronic obstructive pulmonary disease exacerbation with typeⅡrespiratory failure have obvious curative effect,which may reduce the proportion of neutrophils and the content of ECP,increase the proportion of macrophages to inhibite inflammation and alleviate disease.