改良肺脑合剂联合常规治疗用于慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭的疗效观察
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摘要
目的:探讨改良肺脑合剂(注射用甲泼尼龙琥珀酸钠+尼可刹米注射液+多索茶碱注射液)联合常规治疗用于慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭的疗效。方法:选取2016年12月至2018年12月重庆市中医院收治的慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭患者130例,按照随机对照试验方法分为对照组和观察组,每组65例。两组患者均给予常规治疗,观察组患者加用改良肺脑合剂。比较两组患者的临床疗效、动脉血气分析指标[动脉血二氧化碳分压(PaCO_2)、动脉血氧分压(PaO_2)]水平、气管插管及呼吸机相关并发症发生情况。结果:观察组患者的总有效率为84.6%(55/65),明显高于对照组的60.0%(39/65),差异有统计学意义(P<0.05)。治疗后,两组患者PaCO_2、PaO_2水平较治疗前明显改善,且观察组患者明显优于对照组,差异均有统计学意义(P<0.05)。观察组患者的气管插管率为4.6%(3/65),明显低于对照组的15.4%(10/65),差异有统计学意义(P<0.05)。观察组、对照组患者呼吸机相关并发症发生率分别为18.5%(12/65)、16.9%(11/65),差异无统计学意义(P>0.05)。结论:改良肺脑合剂(注射用甲泼尼龙琥珀酸钠+尼可刹米注射液+多索茶碱注射液)联合常规治疗用于慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭的疗效显著,可改善患者症状。
OBJECTIVE: To investigate the clinical efficacy of modified lung-brain mixture(methylprednisolone sodium succinate injection + nikethamide injection + doxofylline injection) combined with routine treatment for chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure. METHODS: Totally 130 patients with chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure admitted into Chongqing Traditional Chinese Medicine Hospital from Dec. 2016 to Dec. 2018 were extracted to be divided into the control group and the observation group by the random controlled trial method, with 65 cases in each group. Both groups were given routine treatment, and patients in the observation group were treated with modified lung-brain mixture. The clinical efficacy and arterial blood gas analysis indexes [arterial partial pressure of carbon dioxide(PaCO_2), arterial partial pressure of oxygen(PaO_2)], tracheal intubation and ventilator-related complications were compared between two groups. RESULTS: The total effective rate of the observation group was 84.6%(55/65), significantly higher than that of the control group [60.0%(39/65)], and the difference was statistically significant(P<0.05). After treatment, the levels of PaCO_2 and PaO_2 in two groups were significantly improved compared with those before treatment, and the observation group was significantly better than the control group, the difference was statistically significant(P<0.05). The tracheal intubation rate of the observation group was 4.6%(3/65), significantly lower than that of the control group [15.4%(10/65)], the difference was statistically significant(P<0.05). The incidence of ventilator-related complications in the observation group and the control group was 18.5%(12/65) and 16.9%(11/65), and the difference was not statistically significant(P>0.05). CONCLUSIONS: The efficacy of modified lung-brain mixture combined with routine treatment for chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure is significant, which can improve patient's symptoms.
OBJECTIVE: To investigate the clinical efficacy of modified lung-brain mixture(methylprednisolone sodium succinate injection + nikethamide injection + doxofylline injection) combined with routine treatment for chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure. METHODS: Totally 130 patients with chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure admitted into Chongqing Traditional Chinese Medicine Hospital from Dec. 2016 to Dec. 2018 were extracted to be divided into the control group and the observation group by the random controlled trial method, with 65 cases in each group. Both groups were given routine treatment, and patients in the observation group were treated with modified lung-brain mixture. The clinical efficacy and arterial blood gas analysis indexes [arterial partial pressure of carbon dioxide(PaCO_2), arterial partial pressure of oxygen(PaO_2)], tracheal intubation and ventilator-related complications were compared between two groups. RESULTS: The total effective rate of the observation group was 84.6%(55/65), significantly higher than that of the control group [60.0%(39/65)], and the difference was statistically significant(P<0.05). After treatment, the levels of PaCO_2 and PaO_2 in two groups were significantly improved compared with those before treatment, and the observation group was significantly better than the control group, the difference was statistically significant(P<0.05). The tracheal intubation rate of the observation group was 4.6%(3/65), significantly lower than that of the control group [15.4%(10/65)], the difference was statistically significant(P<0.05). The incidence of ventilator-related complications in the observation group and the control group was 18.5%(12/65) and 16.9%(11/65), and the difference was not statistically significant(P>0.05). CONCLUSIONS: The efficacy of modified lung-brain mixture combined with routine treatment for chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure is significant, which can improve patient's symptoms.
引文
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[14] 苗润丰,方蕾,刘大禹.无创正压通气联合尼可刹米治疗AECOPD并Ⅱ型呼吸衰竭的临床疗效[J].贵州医科大学学报,2017,42(10):1191-1195.
[15] 李倩,刘运秋,兰璇,等.多索茶碱与茶碱治疗中度稳定期慢性阻塞性肺疾病的临床疗效研究[J].河北医科大学学报,2017,38(12):1376-1380.
[16] 程津津,郭红荣,黄波,等.特布他林联合甲强龙对慢性阻塞性肺病患者肺功能、血气分析及炎性因子的影响[J].海南医学院学报,2017,23(24):3362-3365.
[17] Leivo-Korpela S,Lehtim?ki L,Vuolteenaho K,et al.Adiponectin is associated with dynamic hyperinflation and a favourable response to inhaled glucocorticoids in patients with COPD[J].Respir Med,2014,108(1):122-128.
[2] Liting Zhou,Ying Liu,Xin Chen,et al.Over-expression of nuclear factor-κB family genes and inflammatory molecules is related to chr-onic obstructive pulmonary disease[J].Int J Chron Obstruct Pulmon Dis,2018,13:2131-2138.
[3] Bifan Zhu,Yanfang Wang,Jian Ming,et al.Disease burden of COPD in China:a systematic review[J].Int J Chron Obstruct Pulmon Dis,2018,13:1353-1364.
[4] Vestbo J,Hurd SS,Agustí AG,et al.Global strategy for the diag-nosis,management,and prevention of chronic obstructive pul-monary disease:GOLD executive summary[J].Am J Respir Crit Care Med,2013,187(4):347-365.
[5] 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年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264.
[6] 徐秀君,付会文,李英,等.慢性阻塞性肺疾病急性加重期患者无创通气效果的研究[J].临床肺科杂志,2016,21(1):111-113,118.
[7] 徐虹,卢慧宇,唐蓉.双水平气道正压无创通气对慢性阻塞性肺病患者疗效观察[J].中国慢性病预防与控制,2016,24(5):365-366.
[8] Amri Maleh V,Monadi M,Heidari B,et al.Efficiency and outcome of non-invasive versus invasive positive pressure ventilation therapy in respiratory failure due to chronic obstructive pulmonary disease[J].Caspian J Intern Med,2016,7(2):99-104.
[9] 余静.无创呼吸机治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的临床疗效[J].中华临床医师杂志:电子版,2016,10(4):216.
[10] 曹辉英.肺脑合剂治疗Ⅱ型呼吸衰竭的疗效探讨[J].中国实用医药,2015,10(5):179-180.
[11] 梁奇.肺脑合剂在肺性脑病中的应用[J].西部医学,2012,24(11):2199-2200.
[12] 李雪松,杨伶俐,杨家爱,等.多索茶碱、尼可刹米、甲泼尼龙琥珀酸钠注射剂配伍稳定性研究[J].中国药业,2008,17(15):20-21.
[13] 徐泾.尼可刹米治疗慢性阻塞性肺疾病急性加重期并呼吸衰竭的疗效观察[J].现代药物与临床,2017,32(12):2373-2376.
[14] 苗润丰,方蕾,刘大禹.无创正压通气联合尼可刹米治疗AECOPD并Ⅱ型呼吸衰竭的临床疗效[J].贵州医科大学学报,2017,42(10):1191-1195.
[15] 李倩,刘运秋,兰璇,等.多索茶碱与茶碱治疗中度稳定期慢性阻塞性肺疾病的临床疗效研究[J].河北医科大学学报,2017,38(12):1376-1380.
[16] 程津津,郭红荣,黄波,等.特布他林联合甲强龙对慢性阻塞性肺病患者肺功能、血气分析及炎性因子的影响[J].海南医学院学报,2017,23(24):3362-3365.
[17] Leivo-Korpela S,Lehtim?ki L,Vuolteenaho K,et al.Adiponectin is associated with dynamic hyperinflation and a favourable response to inhaled glucocorticoids in patients with COPD[J].Respir Med,2014,108(1):122-128.