清肺化痰方联合无创正压通气治疗老年Ⅱ型呼吸衰竭临床疗效及对认知功能的影响

Clinical Effect of Therapy of Qingfei Huatan Prescription Combined with Non-Invasion Positive Pressure Ventilation on Type Ⅱ Respiratory Failure in Senile Patients and Its Effect on Cognitive Function

目的:观察清肺化痰方联合无创正压通气治疗老年Ⅱ型呼吸衰竭(RF)的临床疗效及对认知功能的影响。方法:选取80例老年RF患者,随机分为对照组和观察组各40例。对照组给予无创正压通气治疗,观察组给予清肺化痰方联合无创正压通气治疗。比较2组临床疗效、临床症状消失时间(呼吸正常、咯痰消失、咳嗽消失、体温复常及住院时间)、证候评分、血气指标[二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))、血氧分压(PaO_(2))、氧合指数(OI)]、肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、FEV_(1)/FVC]及中文版蒙特利尔认知评估量表(MoCA)评分。结果:观察组总有效率为92.50%,对照组为72.50%,2组比较,差异有统计学意义(P<0.05)。治疗后,观察组呼吸复常、咯痰消失、咳嗽消失、体温复常及住院时间均短于对照组,差异均有统计学意义(P<0.05)。治疗后,2组咯痰、咳嗽、气喘、气短、心悸等中医证候评分均较治疗前降低(P<0.05),且观察组上述各项评分均低于对照组(P<0.05)。治疗后,2组PaCO_(2)水平均较治疗前降低(P<0.05),SaO_(2)、PaO_(2)、OI水平均较治疗前升高(P<0.05);且观察组PaCO_(2)水平低于对照组(P<0.05),SaO_(2)、PaO_(2)、OI水平高于对照组(P<0.05)。治疗后,2组FVC、FEV_(1)、FEV_(1)/FVC水平均较治疗前升高(P<0.05),且观察组上述各项指标均高于对照组(P<0.05)。治疗后,2组MoCA评分均较治疗前升高(P<0.05),且观察组MoCA评分高于对照组(P<0.05)。结论:清肺化痰方联合无创正压通气治疗老年Ⅱ型RF可有效提高患者认知功能及肺功能,改善血气指标及临床症状,临床疗效良好。

Objective:To observe the clinical effect of therapy of Qingfei Huatan Prescription combined with non-invasion positive pressure ventilation on type Ⅱ respiratory failure(RF) in senile patients and its effect on the cognitive function.Methods:A total of 80 RF senile patients were selected and randomly divided into the control group and the observation group,with 40 cases in each group.The control group was given non-invasion positive pressure ventilation for treatment,and the observation group was treated with therapy of Qingfei Huatan Prescription combined with non-invasion positive pressure ventilation.The clinical effects,disappearance time of clinical symptoms,including the recovery time of normal respiration and body temperature,disappearance time of expectoration and cough and hospitalization time,syndrome scores,indexes of blood gas,including partial pressure of carbon dioxide in arterial blood(PaCO_(2)),oxygen saturation(SO_(2)),partial pressure of oxygen in arterial blood(PaO_(2)) and oxygenation index(OI),indexes of lung function,including forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1)) and FEV_(1)/FVC and scores of Montreal Cognitive Assessment(MoCA) in Chinese version were compared between the two groups.Results:The total effective rate was 92.50% in the observation group and 72.50% in the control group,the difference being significant(P<0.05).After treatment,the recovery time of normal respiration and body temperature,disappearance time of expectoration and cough and hospitalization time in the observation group were less than those in the control group,differences being significant(P<0.05).After treatment,the syndrome scores of expectoration,cough,asthma shortness of breath,palpitation in both groups were decreased when compared with those before treatment(P<0.05),and the above five scores in the observation group were lower than those in the control group(P<0.05).After treatment,the PaCO_(2) levels in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of SaO_(2),PaO_(2) and OI were increased when compared with those before treatment(P<0.05);the PaCO_(2)level in the observation group was lower than that in the control group(P<0.05),and the levels of SaO_(2),PaO_(2) and OI were higher than those in the control group(P<0.05).After treatment,the levels of FVC,FEV_(1) and FEV_(1)/FVC in the two groups were increased when compared with those before treatment(P<0.05),and the above three levels in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the MoCA scores in both groups were increased when compared with those before treatment(P<0.05),and the MoCA score in the observation group was obviously higher than that in the control group(P<0.05).Conclusion:The therapy of Qingfei Huatan Prescription combined with non-invasion positive pressure ventilation can effectively enhance the cognitive function and lung function of type Ⅱ RF senile patients,and improve the indexes of blood gas and clinical symptoms with a good curative effect.