益气固表丸配合纤支镜灌洗治疗慢性阻塞性肺疾病并呼吸衰竭临床研究

Clinical Study on Yiqi Gubiao Pills Combined with Fibronchoscope Lavage for Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure

目的:观察益气固表丸配合纤支镜灌洗治疗慢性阻塞性肺疾病(COPD)并呼吸衰竭的临床疗效。方法:选取COPD并呼吸衰竭患者132例,按随机数字表法分为观察组和对照组各66例。2组均采取常规治疗,对照组采用纤支镜灌洗治疗,观察组采用益气固表丸配合纤支镜灌洗治疗。比较2组临床疗效、临床症状(哮鸣、咳嗽、喘息)改善及住院时间,对比治疗前后血气指标[二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2)、氧分压(PaO2)]、肺功能[第1秒用力呼气容积(FEV1)、肺活量(FVC)、FEV1占预计值的百分比(FEV1%)、最大呼气流速(PEF)]、血清可溶性髓样细胞触发受体-1 (sTREM-1)及过氧化脂质(LPO)水平。结果:观察组总有效率为93.94%,高于对照组81.82%(P<0.05)。观察组哮鸣音、咳嗽、喘息等症状消失时间及住院时间短于对照组(P<0.05)。治疗后,2组PaCO2较治疗前降低,SaO2、PaO2较治疗前升高;且观察组PaCO2低于对照组,SaO2、PaO2高于对照组;差异均有统计学意义(P<0.05)。治疗后,2组FEV1、FVC、PEF、FEV1%较治疗前增高(P<0.05),且观察组FEV1、FVC、PEF、FEV1%高于对照组(P<0.05)。治疗后,2组血清sTREM-1、LPO水平较治疗前降低(P<0.05),且观察组sTREM-1、LPO水平低于对照组(P<0.05)。结论:益气固表丸配合纤支镜灌洗治疗COPD并呼吸衰竭患者疗效确切,可缓解临床症状,改善血气指标,恢复肺功能,机制可能与下调血清sTREM-1、LPO水平有关。

Objective: To observe the clinical effect of the therapy of Yiqi Gubiao pills combined with fibronchoscope lavage for chronic obstructive pulmonary disease(COPD) complicated with respiratory failure. Methods:A total of 132 COPD patients with respiratory failure were selected and divided into the observation group and the control group according to the random number table method,66 cases in each group. Both groups received conventional treatment;the control group was additionally treated with fibronchoscopy lavage, and the observation group was additionally treated with Yiqi Gubiao pills combined with fibronchoscope lavage. The clinical effect, improvement of clinical symptoms(wheezing, cough, breath),length of hospital stay, levels of blood gas indexes(PaCO2, SaO2, PaO2), lung function [forced expiratory volume in one second(FEV1) and forced vital capacity(FVC), percentage of FEV1 to predicated value(FEV1%), peak expiratory flow(PEF)],soluble triggering receptor expressed on myeloid cells-1(sTREM-1) and lipid peroxide(LPO) before and after treatment in the two groups were compared. Results: The total effective rate was 93.94% in the observation group, higher than that of 81.82% in the control group(P<0.05). The disappearance time of symptoms(wheezing, cough and breath) and length of hospital stay were shorter in the observation group than in the control group(P<0.05). After treatment,the levels of PaCO2 in the two groups were decreased when compared with those before treatment, and the levels of SaO2 and PaO2 were increased;the level of PaCO2 in the observation group was lower than that in the control group,and the levels of SaO2 and PaO2 were higher;the differences were significant(P<0.05). After treatment,the levels of FEV1,FVC,PEF and FEV1% in the two groups were increased when compared with those before treatment(P<0.05),and the above four levels in the the observation group were higher than those in the control group(P<0.05). After treatment,the levels of sTREM-1 and LPO in both groups were decreased when compared with those before treatment,and the above two levels in the observation group were lower than those in the control group(P<0.05). Conclusion: The therapy of Yiqi Gubiao pills combined with fibronchoscope lavage has a significant therapeutic effect on COPD patients with respiratory failure,which can relieve clinical symptoms,improve blood gas indexes,and restore lung function. The mechanism may be related to the downregulation of levels of sTREM-1 and LPO in serum.