六字诀配合循经取穴振动排痰在急性加重期COPD患者肺康复中的效果观察

Effect observation of six character formula combined with acupoint selection along the meridian vibration sputum elimination in lung rehabilitation of acute exacerbation COPD patients

目的研究循经取穴振动排痰联合六字诀对喘证[慢性阻塞性肺疾病急性加重期(AECOPD)]患者肺康复的临床效果。方法选择2021年10月—2022年7月医院收治的AECOPD患者98例作为研究对象,按照组间基本资料具有可比性的原则分为对照组和观察组,各49例。对照组采用常规的机械排痰及呼吸肺功能锻炼,观察组采用循经取穴振动排痰和六字诀呼吸吐纳法肺功能锻炼。7 d为一个疗程,观察患者干预前、干预后血气分析指标[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))及氧合指数(OI)]、痰液量、肺部影像学检查、慢性阻塞性肺疾病评估测试(CAT)评分、ICU住院时间、机械通气时间、ICU病死率、拔管后48 h重置管率。结果干预7 d后,观察组患者PaO_(2)、OI较对照组高,PaCO_(2)较对照组低,差异具有统计学意义(P<0.05)。不同时间点两组患者痰量、痰液颜色评分比较组间、时间及交互作用差异均具有统计学意义(P<0.05)。干预7 d后,观察组痰液黏稠度优于对照组,差异具有统计学意义(P<0.05)。不同时间点两组患者CAT评分比较组间、时间及交互作用差异均具有统计学意义(P<0.05)。观察组ICU治疗时间、机械通气时间短于对照组,ICU病死率、拔管后48 h重置管率低于对照组(P<0.05)。结论循经取穴振动排痰联合六字诀应用于喘证患者肺康复中,有助于提高PaO_(2)、OI,降低PaCO_(2)水平,促进排痰,缩短ICU治疗时间,降低ICU病死率、拔管后48 h重置管率。

Objective To study the clinical effect of acupoint selection along the meridian vibration sputum elimination combined with the six character formula on lung rehabilitation in patients with asthma syndrome[acute exacerbation of chronic obstructive pulmonary disease(AECOPD)].Methods A total of 98 AECOPD patients admitted to the hospital from October 2021 to July 2022 were selected as the research subjects.They were divided into a control group and an observation group based on the principle of comparability of basic data between groups,with 49 patients in each group.The control group received routine mechanical sputum excretion and respiratory lung function exercise,while the observation group received lung function exercise using vibration sputum extraction along the meridian and the six character breathing and exhalation method.7 days is a course of treatment,and the patient's blood gas analysis indicators[partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide in artery(PaCO_(2)),oxygenation index(OI)],sputum volume,lung imaging examination,chronic obstructive pulmonary disease assessment test(CAT)score,ICU hospitalization time,mechanical ventilation time,ICU mortality rate,and 48 hours after extubation reset rate are observed before and after intervention.Results After 7 days of intervention,the PaO_(2) and OI in the observation group were higher than those in the control group,the PaCO_(2) was lower than that in the control group,the difference was statistically significant(P<0.05).At different time points,the comparison of sputum volume and sputum color scores between the two groups of patients showed statistically significant differences in inter group,time,and interaction(P<0.05).After 7 days of intervention,the sputum viscosity in the observation group was better than that in the control group,the difference was statistically significant(P<0.05).At different time points,the CAT score between the two groups of patients showed statistically significant differences in inter group,time,and interaction(P<0.05).The ICU treatment time and mechanical ventilation time in the observation group were shorter than those in the control group,the ICU mortality rate and 48 hours after extubation reset rate were lower than those in the control group(P<0.05).Conclusion The application of acupoint selection along the meridian,vibration and phlegm elimination combined with the six character formula in lung rehabilitation of patients with asthma syndrome can help increase PaO_(2) and OI,reduce PaCO_(2) levels,promote phlegm elimination,shorten ICU treatment time,reduce ICU mortality,and reset the catheter 48 hours after extubation.