“肺肠同治”法辅助治疗慢性阻塞性肺疾病急性加重期肺热腑实证机械通气患者临床研究

Clinical Efficacy of“Lung-intestinal Treatment”Method for Adjuvant Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Mechanical Ventilation Patients with Syndrome of Lung Heat and Fu-viscera Excess

[目的]观察肺肠同治法辅助治疗慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)肺热腑实证机械通气患者的临床疗效。[方法]选取62例浙江中医药大学附属第三医院呼吸与危重症医学科及重症医学科AECOPD并接受有创机械通气的患者,按随机数字表法分为常规治疗组和治疗组,每组31例。常规治疗组予西医治疗,治疗组在西医基础上加用肺肠同治方,观察并比较两组患者中医症候积分、血气指标、呼吸机参数、机械通气时间、并发症和临床疗效。[结果]与本组治疗前比较,常规治疗组血气,呼吸机参数,中医症候(咳喘、咳痰、腹胀便秘、发热、胸闷)积分及总分均改善(P<0.05);治疗组血气,呼吸机参数,中医症候(咳喘、咳痰、腹胀便秘、发热、胸闷、食欲减退)积分及总分均改善(P<0.05)。组间比较,治疗组血气,呼吸机参数,中医症候(胸闷、咳喘、腹胀便秘、食欲减退)积分及总分,临床疗效较常规治疗组改善明显(P<0.05);机械通气时间较常规治疗组缩短,并发症减少(P<0.05)。[结论]肺肠同治法治疗AECOPD机械通气患者疗效明确,能改善临床症状,缩短机械通气时间,疗效优于纯西医治疗。

[Objective]To observe the clinical effect of“lung-intestinal treatment”method for adjuvant treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)mechanical ventilation patients with syndrome of lung heat and Fu-viscera excess.[Methods]Sixty-two patients with AECOPD in Pulmonary and Critical Care Medicine(PCCM)and Intensive Care Unit(ICU)of the Third Affiliated Hospital of Zhejiang Chinese Medical University were selected and divided into conventional treatment group and treatment group by random number table,31 cases in each group.The conventional treatment group was treated with western medicine,and the treatment group was added with lung-intestinal treatment on the basis of the conventional treatment group.The traditional Chinese medicine(TCM)syndrome points,blood gas index,ventilator parameters,mechanical ventilation time,complications and clinical effects were observed.[Results]Compared with before treatment,the conventional treatment group had improvement in the blood gas index,ventilator parameters,TCM syndrome(cough and asthma,sputum,abdominal distension and constipation,fever,chest tightness)and total points after treatment(P<0.05);after treatment,the blood gas index,ventilator parameters,TCM syndrome(cough and asthma,sputum,abdominal distension and constipation,fever,chest tightness,loss of appetite)were relieved and total scores were all improved in the treatment group(P<0.05).Compared with the conventional treatment group,the treatment group had significantly improved blood gas index,ventilator parameters and clinical effects,the TCM symptoms(chest tightness,cough and asthma,abdominal distension and constipation,loss of appetite)were relieved and total scores were improved(P<0.05),and the time of mechanical ventilation and complications were reduced compared with the conventional treatment group(P<0.05).[Conclusion]The treatment of AECOPD mechanical ventilation patients with“lung-intestinal treatment”method has clear cu rative effect,which can relieve clinical symptoms,shorten the time of mechanical ventilation,and the efficacy is better than that of western medicine alone.