目的:探讨泻浊纳气醒神汤加味联合无创机械通气对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstruc-tive pulmonary disease,AECOPD)患者动脉血气指标和肺功能的影响.方法:选取2019 年 8 月至 2022 年 8 月北京中医药大学东直门医院洛阳医院收治的AECOPD患者120 例,采用简单随机分组法分为机械通气组和联合组,每组60 例.两组患者均给予常规治疗,机械通气组在常规治疗基础上给予无创机械通气治疗,联合组在机械通气组治疗的基础上加用泻浊纳气醒神汤加味治疗.观察两组患者治疗前后中医证候积分、肺功能[第 1 秒用力呼气容积(forced expiratory volume in one second,FEV1)、用力肺活量(forced vital capacity,FVC)]、血气指标[动脉血氧分压(arterial partial pressure of oxygen,PaO2)、动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO2)]及临床疗效、不良反应发生情况.结果:联合组有效率为 91.67%,机械通气组有效率为78.33%,联合组有效率高于机械通气组,差异有统计学意义(P<0.05).联合组治疗后咳嗽、喘息气急、胸闷等中医证候积分低于机械通气组,差异具有统计学意义(P<0.05).联合组治疗后FEV1、FVC水平高于机械通气组,差异有统计学意义(P<0.05).联合组治疗后PaO2 水平高于机械通气组,PaCO2 水平低于机械通气组,差异有统计学意义(P<0.05).两组患者不良发生情况比较,差异无统计学意义(P>0.05).结论:泻浊纳气醒神汤加味联合无创机械通气治疗AECOPD,能够提高患者的临床疗效,减轻患者临床症状,提高肺功能,改善血气状况.
The Influence of Decoction for Purging Turbidity and Improving Qi Reception and Arousing from Unconsciousness Combined with Noninvasive Mechanical Ventilation on Arterial Blood-Qi Indexes and Pulmonary Function in Patients with Acute Exacerbation of Chroni
Objective:To study the influence of Decoction for Purging Turbidity and Improving Qi Reception and Arousing from Uncon-sciousness combined with noninvasive mechanical ventilation on arterial blood-qi indexes and pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 120 patients with AECOPD admitted to our hos-pital from August 2019 to August 2022 were selected and divided into the mechanical ventilation group and the combined group by using a simple random grouping method,with 60 cases in each group.The patients in the two groups were all given conventional treatment.Then the mechanical ventilation group was further given noninvasive mechanical ventilation on the basis of conventional treatment,and the combined group was further given Decoction for Purging Turbidity and Improving Qi Reception and Arousing from Unconsciousness on the basis of the treatment of the mechanical ventilation group.The TCM syndrome scores,pulmonary function[including forced ex-piratory volume in one second(FEV1),forced vital capacity(FVC)],blood-qi indexes[including arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2)]and clinical efficacy and adverse reactions of the two groups were ob-served before and after treatment.Results:The effective rate of the combined group was91.67%,while that of the mechanical ventila-tion group was 78.33%.The effective rate of the combined group was higher than that of the mechanical ventilation group,and the difference was statistically significant(P<0.05).After treatment,the TCM syndrome scores of cough,wheezing,shortness of breath,chest tightness in the combined group were lower than those in the mechanical ventilation group,and the differences were statistically significant(P<0.05);the levels of FEV1 and FVC in the combined group were higher than those in the mechanical ventilation group,and the differences were statistically significant(P<0.05);the level of PaO2 in the combined group was higher than that in the me-chanical ventilation group,while the level of PaCO2 was lower than that in the mechanical ventilation group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the occurrence of adverse events between the two groups(P>0.05).Conclusion:Decoction for Purging Turbidity and Improving Qi Reception and Arousing from Unconsciousness com-bined with noninvasive mechanical ventilation can improve the treatment efficiency of patients with AECOPD,reduce the symptoms of TCM,improve the pulmonary function,and enhance blood-qi status.
chronic obstructive pulmonary disease(AECOPD)Decoction for Purging Turbidity and Improving Qi Reception and Arou-sing from Unconsciousnessnoninvasive mechanical ventilationarterial blood-qi indexpulmonary function
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