加味清气化痰汤配合无创正压通气治疗慢性阻塞性肺疾病急性加重期合并呼吸衰竭临床研究

Clinical Study on Modified Qingqi Huatan Decoction Combined with Non-Invasive Pos⁃itive Pressure Ventilation for Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure

目的:观察对慢性阻塞性肺疾病(COPD)急性加重期合并呼吸衰竭患者以加味清气化痰汤配合无创正压通气治疗的临床效果。方法:将130例COPD急性加重期合并呼吸衰竭患者以随机简单化法分为治疗组与对照组,各65例。对照组以无创正压通气治疗,治疗组在对照组基础上联合加味清气化痰汤治疗。治疗14 d后评估2组临床疗效,并比较2组治疗前后肺功能、动脉血气指标、血清单核细胞趋化蛋白-1(MCP-1)、可溶性髓样细胞触发受体-1(sTREM-1)水平。结果:治疗后,治疗组总有效率96.92%,高于对照组87.69%(P<0.05)。治疗后,2组用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、FEV_(1)占预计值的百分比(FEV_(1)%)均升高(P<0.05),且治疗组高于对照组(P<0.05)。治疗后,2组动脉血pH值、血氧分压(PaO_(2))均升高(P<0.05),二氧化碳分压(PaCO_(2))均降低(P<0.05),且治疗组PaO_(2)高于对照组(P<0.05),PaCO_(2)低于对照组(P<0.05)。治疗后,2组MCP-1、sTREM-1水平均降低(P<0.05),且治疗组低于对照组(P<0.05)。结论:针对COPD急性加重期合并呼吸衰竭患者采用加味清气化痰汤配合无创正压通气治疗效果显著,可改善患者肺功能、动脉血气指标,减轻炎性反应。

Objective:To observe the clinical effect of Modified Qingqi Huatan Decoction combined with non-invasive positive pressure ventilation on patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)and respiratory failure.Methods:A total of 130 patients with acute exacerbation of COPD and respiratory failure were randomly divided into a treatment group and a control group using a simplified method,with 65 cases in each group.The control group was treated with non-invasive positive pressure ventilation,while the treatment group was treated with a combination of Modified Qingqi Huatan Decoction on the basis of the control group.After 14 days of treatment,evaluate the clinical efficacy of two groups and compare the levels of lung function,arterial blood gas indicators,serum monocyte chemotactic protein-1(MCP-1),and soluble myeloid cell trigger receptor-1(sTREM-1)before and after treatment.Results:After treatment,the total effective rate of the treatment group was 96.92%,higher than the control group's 87.69%(P<0.05).After treatment,the forced vital capacity(FVC),forced expiratory volume(FEV1)in the first second,and the percentage of FEV1 to the expected value(FEV1%)in both groups were increased(P<0.05),and the treatment group was higher than the control group(P<0.05).After treatment,the arterial blood pH and partial pressure of oxygen(PaO2)in both groups were increased(P<0.05),while partial pressure of carbon dioxide(PaCO2)were decreased(P<0.05).Moreover,the PaO2 in the treatment group was higher than that in the control group(P<0.05),and the PaCO2 was lower than that in the control group(P<0.05).After treatment,the levels of MCP-1 and sTREM-1 in both groups were decreased(P<0.05),and the treatment group was lower than the control group(P<0.05).Conclusion:The use of Modified Qingqi Huatan Decoction combined with non-invasive positive pressure ventilation has a significant therapeutic effect on patients with acute exacerbation of COPD and respiratory failure.It can improve lung function,arterial blood gas indicators,and alleviate inflammatory reactions.