【作者】 方堃； 石占利； 李志会；

【Author】 Fangkun Shizhanli Lizhihui.Zhejiang Hospital of integrated traditional Chinese and Western Medicine ICU,Zhejiang Hangzhou 310003

【机构】 浙江省中西医结合医院ICU；

【摘要】 目的:观察通腑平喘汤联合机械通气治疗慢性阻塞性肺疾病(COPD)并发呼吸衰竭的临床疗效.方法:将符合诊断标准的 COPD 呼吸衰竭患者随机分为治疗组20例和对照组20 例,两组均采用西医常规治疗(包括机械通气)。治疗组加用通腑平喘汤治疗。比较两组治疗前、治疗后(第3天、第5天)及脱机后的的动脉血气指标、痰液中性粒细胞占白细胞百分比(N%)、氧合指数(PaO2/FiO2)、动态顺应性(C_D)、死亡率、发生呼吸机相关性肺炎(VAP) 的例数及总机械通气时间。结果:治疗组第5天时血气分析、N%、PaO2/FiO2、C_D 较对照组显著改善(P<0.05),而其余观察点两组的上述指标没有显著性差异(P>0.05)。治疗组总机械通气时间较对照组显著缩短(P<0.05),VAP 发生率亦较对照组显著减少(P<0.05),两组死亡率无显著性差异。结论:在机械通气等治疗基础上加用通腑平喘汤有助于尽快控制 COPD 并发呼吸衰竭患者肺部炎症反应、改善呼吸功能,减少机械通气时间及 VAP 的发生。更多还原

【Abstract】 Objective:To evaluate Clinical effects of tongfu pingchuan Decoction with mechanical ventilation Combination in Patients with Respiratory Failure Induced by chronic obstructive pulmonary disease(COPD).Methods:Patients were divided into two groups randomly,therapy group(n=20)and control group(n=20),The therapeutic methods of Western Medicine(including mechanical ventilation)were used in two groups and therapy group was added the Decoction further.To compare two groups in arterial blood gas analysis,the ratio of neutrophil and leukocyte in sputum(N%),Oxygenate index(PaO2/Fi02),dynamic compliance(C_D),the mortality in hospital,the incidence of ventilation associated pneumonia(VAP)and the time of mechanical ventilation on such time as before therapy,the third and 5th day after therapy and weaning of mechanical ventilation.Result:compared with control group ,the index of therapy group were distinctly improved On the 5th day (P<0.05),including arterial blood gas analysis,N%,PaO2/FiO2 and CD,but which did not improved on the other times.The time of mechanical ventilation in therapy group was shorter than that of contol group(P<0.05).The incidence of VAP in therapy group was also reduced markedly than that of the other.The mortality showed no significant diffrernce in the two groups(P>0.05).Conclusion:With the therapy of mechanical ventilation in Patients with Respiratory Failure Induced by COPD,tongfu pingchuan Decoction could help to control inflammatory reaction and improve repiratory function as soon as possible,shorten the time of mechanical ventilation and reduce the incidence of VAP.更多还原