补肾纳气散联合无创辅助通气治疗稳定期COPD合并慢性呼吸衰竭的疗效观察
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摘要
目的观察补肾纳气散联合无创辅助通气治疗稳定期COPD合并慢性呼吸衰竭的疗效。方法将2014年6月～2017年6月在金华市中心医院中医科住院的稳定期COPD合并慢性呼吸衰竭患者60例,随机分为观察组与对照组,各30例,对照组给予雾化吸入异丙托溴铵溶液、布地奈德混悬液,口服顺尔宁、复方甲氧那明胶囊及无创辅助通气治疗,观察组在对照组治疗基础上加用自拟中药"补肾纳气散",早晚2次服用。疗程均为21 d,比较两组动脉血气分析、肺通气功能、肺换气功能改善情况及无创辅助通气参数的差异。结果治疗后两组患者PO_2、PCO_2、RV/TLC、DLco/VA均有改善(P均<0.05),且观察组改善较明显(P均<0.05);观察组IPAP、EPAP较对照组明显降低(P均<0.05)。结论补肾纳气散联合无创辅助通气可改善慢性阻塞性肺疾病合并慢性呼吸衰竭患者的肺功能。
Objective To observe the curative effect of Bushen Naqi powder combined with noninvasive assisted ventilation in the treatment of COPD with chronic respiratory failure. Methods A total of 60 patients of stable COPD combined with chronic respiratory failure who were hospitalized in the Department of Traditional Chinese Medicine of Jinhua Central Hospital from June 2014 to June 2017 were randomly divided into observation group and control group,with 30 cases in each group. The control group was given aerosol inhalation of protopine bromide solution, budesonide suspension and oral sulzerine, compound methoxyphenamine capsules and non-invasive assisted ventilation treatment.The observation group was additionally given self-made Chinese herbal medicine"Bushen Naqi powder" on the basis of treatment in the control group, twice a day. The treatment duration was 21 days. The arterial blood gas analysis, pulmonary ventilation function, lung ventilation function improvement, and non-invasive assisted ventilation parameters were compared between the two groups. Results After treatment, PO_2, PCO_2, RV/TLC, DLco/VA were improved in two groups(P<0.05), and the observation group improved significantly(P<0.05); The IPAP and EPAP in the observation group were significantly lower than those of the control group(P<0.05). Conclusion Bushen Naqi powder combined with noninvasive assisted ventilation can improve the lung function of chronic obstructive pulmonary disease patients with chronic respiratory failure.
Objective To observe the curative effect of Bushen Naqi powder combined with noninvasive assisted ventilation in the treatment of COPD with chronic respiratory failure. Methods A total of 60 patients of stable COPD combined with chronic respiratory failure who were hospitalized in the Department of Traditional Chinese Medicine of Jinhua Central Hospital from June 2014 to June 2017 were randomly divided into observation group and control group,with 30 cases in each group. The control group was given aerosol inhalation of protopine bromide solution, budesonide suspension and oral sulzerine, compound methoxyphenamine capsules and non-invasive assisted ventilation treatment.The observation group was additionally given self-made Chinese herbal medicine"Bushen Naqi powder" on the basis of treatment in the control group, twice a day. The treatment duration was 21 days. The arterial blood gas analysis, pulmonary ventilation function, lung ventilation function improvement, and non-invasive assisted ventilation parameters were compared between the two groups. Results After treatment, PO_2, PCO_2, RV/TLC, DLco/VA were improved in two groups(P<0.05), and the observation group improved significantly(P<0.05); The IPAP and EPAP in the observation group were significantly lower than those of the control group(P<0.05). Conclusion Bushen Naqi powder combined with noninvasive assisted ventilation can improve the lung function of chronic obstructive pulmonary disease patients with chronic respiratory failure.
引文
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[12]吴少芳.中医辨证综合疗法联合无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭临床研究[J].中医学报,2013,28(9):1284-1286.
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[14]罗建江,杨卫江,李风森.344例重度、极重度慢性阻塞性肺疾病患者中医证型特点研究[J].辽宁中医杂志,2012,39(10):1916-1918.
[15]梅蒙.抗缺氧中药的研究现状[J].云南中医中药杂志,2012,33(9):74-76.
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[17]李厚忠,齐敏,张羽飞.中药川贝对哮喘大鼠NO、TNF-α、MDA浓度和SOD活力及支气管平滑肌炎症反应的影响[J].中医药学报,2013,41(4):64-67.
[18]刘鹏年,李忆兰,张路,等.三七皂甙Rb1对肺系疾病的影响及作用机制概述[J].环球中医药,2015,8(7):794-797.
[19]孙晓芳,杨会慈,段斐,等.三七总皂苷对肺纤维化小鼠肺组织蛋白酶K表达的影响[J].时珍国医国药,2014,25(1):53-55.
[20]郑梦晓,宋张娟,马迎春,等.p38MAPK在低氧高二氧化碳肺动脉平滑肌中的表达及三七皂苷单体Rb1的干预[J].中国细胞生物学学报,2014,36(12):1630-1635.
[21]岳美颖,潘媛,敖慧.白术化学、药理与临床研究进展[J].亚太传统医药,2016,12(5):66-68.
[2]刘兴华,李少霞,詹秋璇.BiPAP无创通气在改善中重度慢阻肺稳定期患者运动耐力及肺功能中的效果[J].中国医学创新,2015,12(19):60-62.
[3]韦筱珊.老年患者使用无创呼吸机的安全隐患及护理对策[J].国际护理学杂志,2017,36(12):1725-1728.
[4]葛婷婷,黄贵芬,蔡文婷.循证护理对呼吸衰竭患者无创呼吸机并发吸入性肺炎的影响[J].国际护理学杂志,2014,33(9):2287-2289.
[5]韩兰萍,尹育红,江萍,等.COPD病人应用无创呼吸机治疗过程中出现并发症的原因分析及护理对策[J].全科护理,2017,15(16):1958-1960.
[6]赵晶晶,董强,山晓茵,等.无创辅助通气联合益气活血化痰法治疗慢性阻塞性肺疾病急性加重期呼吸衰竭疗效观察[J].现代中西医结合杂志,2015,24(31):3468-3470.
[7]韩云,张燕,谢东平,等.中医调肠法配合无创通气治疗AECOPD呼吸衰竭的临床研究[J].中国中西医结合杂志,2010,30(8):814-818.
[8]李德科,唐荣伟,赵淑芹.中医辨证治疗慢性阻塞性肺疾病合并呼吸衰竭[J].中国实验方剂学杂志,2014,20(10):213-215.
[9]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修定版)[J].中国医学前沿杂志,2014,6(2):67-79.
[10]齐玉晶,何志义.慢性阻塞性肺疾病药物治疗新进展[J].中国临床医生杂志,2017,45(9):12-14.
[11]狐启贵,刘良丽.益气活血化痰法联合无创辅助通气治疗慢阻肺急性加重期呼吸衰竭[J].中国实验方剂学杂志,2013,19(20):303-306.
[12]吴少芳.中医辨证综合疗法联合无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭临床研究[J].中医学报,2013,28(9):1284-1286.
[13]闵师强,万健.清热宣肺化痰法联合无创辅助通气治疗慢性阻塞性肺疾病急性加重期呼吸衰竭效果观察[J].现代中西医结合杂志,2017,26(34):3804-3806.
[14]罗建江,杨卫江,李风森.344例重度、极重度慢性阻塞性肺疾病患者中医证型特点研究[J].辽宁中医杂志,2012,39(10):1916-1918.
[15]梅蒙.抗缺氧中药的研究现状[J].云南中医中药杂志,2012,33(9):74-76.
[16]李厚忠,任公平,张羽飞.中药川贝对哮喘模型小鼠肺水肿和支气管炎症的影响[J].中医药信息,2014,31(6):19-22.
[17]李厚忠,齐敏,张羽飞.中药川贝对哮喘大鼠NO、TNF-α、MDA浓度和SOD活力及支气管平滑肌炎症反应的影响[J].中医药学报,2013,41(4):64-67.
[18]刘鹏年,李忆兰,张路,等.三七皂甙Rb1对肺系疾病的影响及作用机制概述[J].环球中医药,2015,8(7):794-797.
[19]孙晓芳,杨会慈,段斐,等.三七总皂苷对肺纤维化小鼠肺组织蛋白酶K表达的影响[J].时珍国医国药,2014,25(1):53-55.
[20]郑梦晓,宋张娟,马迎春,等.p38MAPK在低氧高二氧化碳肺动脉平滑肌中的表达及三七皂苷单体Rb1的干预[J].中国细胞生物学学报,2014,36(12):1630-1635.
[21]岳美颖,潘媛,敖慧.白术化学、药理与临床研究进展[J].亚太传统医药,2016,12(5):66-68.