补中益气汤加减治疗急诊重症合并Ⅰ型呼吸衰竭临床研究

Clinical study on modified Buzhong Yiqi decoction in the treatment of emergency severe complicated with type Ⅰ respiratory failure

目的观察补中益气汤加减治疗急诊重症合并Ⅰ型呼吸衰竭的临床疗效。方法102例急诊重症合并Ⅰ型呼吸衰竭患者按照随机数字表法分为2组。对照组51例予常规西医治疗,治疗组51例在对照组治疗基础上予补中益气汤加减口服、鼻饲或保留灌肠治疗。2组均10 d为1个疗程,1个疗程后评估疗效。比较2组呼吸困难、纳呆乏力改善时间,并统计比较2组无创呼吸机使用时间、患者住院天数;比较2组治疗前后心率、呼吸频率、血氧饱和度、动脉血氧分压变化情况。结果治疗组总有效率96.00%,对照组总有效率86.00%,治疗组临床疗效优于对照组(P<0.05)。治疗组呼吸困难、纳呆乏力改善时间,无创呼吸机使用时间、住院天数均少于对照组(P<0.05)。2组治疗后心率、呼吸频率均较本组治疗前下降(P<0.05),血氧饱和度、动脉血氧分压升高(P<0.05),且治疗组改善均优于对照组(P<0.05)。结论补中益气汤加减治疗急诊重症合并Ⅰ型呼吸衰竭,能有效改善临床症状,缩短无创呼吸机治疗天数,减少患者住院时间,值得临床推广应用。

Objective To observe the effect of modified Buzhong Yiqi decoction in the treatment of emergency severe complicated with type Ⅰ respiratory failure. Methods 102 patients with type Ⅰ respiratory failure were randomly divided into two groups according to the random number table method. 51 cases in control group were treated by conventional western medicine. 51 cases in treatment group were treated with modified Buzhong Yiqi decoction by oral or retention enema on the basis of the control group. Both groups were treated for 10 days as a course of treatment, and the effect was evaluated after one course of treatment. The improvement time of expiratory dyspnea and fatigue in the two groups were compared. The use time of non-invasive ventilator and the days of hospitalization in the two groups were compared. The changes of heart rate, respiratory frequency, blood oxygen saturation and arterial oxygen partial pressure before and after treatment in the two groups were compared. Results The total effective rate was 96.00 % in treatment group and 86.00 % in control group. The clinical curative effect of the treatment group was better than that of the control group(P<0.05). The improvement time of expiratory dyspnea and fatigue, the use time of non-invasive ventilator and the days of hospitalization in the treatment group were less than those in the control group(P<0.05). After treatment, the heart rate and respiratory frequency of the two groups were decreased(P<0.05), blood oxygen saturation and arterial oxygen partial pressure were increased(P<0.05), and the improvement of the treatment group was better than that of the control group(P<0.05). Conclusion The modified Buzhong Yiqi decoction can effectively improve the clinical symptoms, shorten the treatment time of non-invasive ventilator, and reduce the length of hospitalization of emergency severe complicated with type Ⅰ respiratory failure patients, which is worthy of clinical popularization and application.