无创正压通气联合保金化痰利肺汤对慢阻肺急性加重期效果观察

Observation on the effect of non-invasive positive Pressure Ventilation combined with Baojin Huatan Lifei Decoction on acute Exacerbation of chronic obstructive pulmonary Disease

目的探讨无创正压通气联合保金化痰利肺汤对慢阻肺急性加重期(AECOPD)患者的治疗效果。方法选取2018年12月至2019年9月河南省驻马店地区西平县人民医院呼吸内科收治的86例AECOPD患者,根据随机数表法分为观察组(43例)和对照组(43例)。两组均采用无创正压通气治疗,观察组联合保金化痰利肺汤治疗,均治疗3周。比较两组治疗3周时的疗效,比较两组治疗前、治疗3周时的红细胞分布宽度(RDW)、中性粒细胞百分比(Neut%)、动脉血气指标[动脉二氧化碳分压(PaCO_(2))、血氧分压(PaO_(2))、酸碱值(pH)]以及两组治疗期间的不良反应发生率。结果治疗3周,观察组的治疗有效率(95.35%)高于对照组(76.74%),差异有统计学意义(P<0.05)。治疗3周时,两组RDW、Neut%均低于治疗前,且观察组RDW(14.02±0.84)、Neut%(65.50±8.42)低于对照组[(14.85±0.92)、(69.79±8.55)],差异有统计学意义(P<0.05)。治疗3周时,两组PaCO_(2)低于治疗前,且观察组PaCO_(2)[(48.72±8.20)mmHg]低于对照组[(53.14±6.09)mmHg];PaO_(2)与pH高于治疗前,且PaO_(2)[(82.24±7.95)mmHg]与pH(7.40±0.10)高于对照组[(75.20±8.01)mmHg、(7.32±0.09)],差异有统计学意义(P<0.05)。观察组不良反应发生率(9.30%)与对照组(4.65%)比较,差异无统计学意义(P>0.05)。结论无创正压通气联合保金化痰利肺汤治疗AECOPD效果显著,可有效控制患者病情及感染情况,改善动脉血气指标,且安全性较高。

Objective To explore the therapeutic effect of non-invasive positive pressure ventilation combined with Baojin Huatan Lifei decoction on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 86 AECOPD patients admitted to the respiratory department of Xiping County People's Hospital in Zhumadian,Henan Province from December 2018 to September 2019 were selected.They were randomly divided into observation group(43 cases)and control group(43 cases)using a random number table method.Both groups were treated with non-invasive positive pressure ventilation,while the observation group was treated with a combination of Baojin Huatan Lifei decoction for 3 weeks.The therapeutic effects of two groups at 3 weeks of treatment were compared,and the red blood cell distribution width(RDW),neutrophil percentage(Neutral%),arterial blood gas indicators[arterial partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),pondus hydrogen(pH)]before and at 3 weeks of treatment were compared,as well as the incidence of adverse reactions during the two groups of treatment were compared.Results After 3 weeks of treatment,the effective rate of the observation group(95.35%)was higher than that of the control group(76.74%),and the difference was statistically significant(P<0.05).At 3 weeks of treatment,the RDW and Neutral%in both groups were lower than those before treatment,and the RDW(14.02±0.84)and Neutral%(65.50±8.42)in the observation group were lower than those in the control group(14.85±0.92)and(69.79±8.55),with statistical significance(P<0.05).At 3 weeks of treatment,the PaCO_(2) levels in both groups were lower than before treatment,and the PaCO_(2) levels in the observation group[(48.72±8.20)mmHg]were lower than those in the control group[(53.14±6.09)mmHg];PaO_(2) and pH were higher than before treatment,and PaO_(2)[(82.24±7.95)mmHg]and pH(7.40±0.10)were higher than the control group[(75.20±8.01)mmHg,(7.32±0.09)mmHg],with statistical significance(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the observation group(9.30%)and the control group(4.65%)(P>0.05).Conclusion The combination of non-invasive positive pressure ventilation and Baojin Huatan Lifei decoction has a significant therapeutic effect on AECOPD,which can effectively control the patient's condition and infection,improve arterial blood gas indicators,and has high safety.