【摘要】 目的：观察粗针针刺膻中穴辅助改善慢性阻塞性肺疾病急性加重期（AECOPD）呼吸机脱机困难的临床效果。方法：选择100例AECOPD呼吸机脱机困难患者为研究对象，采用双色球随机法分为对照组与观察组各50例。对照组给予体外膈肌起搏辅助治疗，观察组在对照组基础上联合粗针针刺膻中穴治疗。比较2组呼吸机脱机时间、脱机成功率、28 d死亡率，并比较2组治疗前后膈肌功能与肺功能、血气指标、氧合指数。结果：观察组呼吸机脱机时间短于对照组（P<0.05），脱机成功率高于对照组（P<0.05）,28 d死亡率低于对照组（P<0.05）。基线时，2组膈肌移动度（DE）、第1秒用力呼气容积占预计值的百分比（FEV₁%）比较，差异无统计学意义（P>0.05）；终点时，2组DE、FEV₁%均升高（P<0.05），且观察组高于对照组（P<0.05）。基线时，2组动脉血氧分压（PaO₂）、动脉二氧化碳分压（PaCO₂）、氧合指数（OI）比较，差异无统计学意义（P>0.05）；终点时，2组PaO₂、OI均升高（P<0.05）,PaCO₂均降低（P<0.05），且观察组PaO₂、OI高于对照组（P<0.05）,PaCO₂低于对照组（P<0.05）。结论：粗针针刺膻中穴用于AECOPD可改善患者血气指标，提升膈肌功能、肺功能与OI，缩短呼吸机脱机时间，提高脱机成功率，降低28 d死亡率。更多还原

【Abstract】 Objective:To observe the clinical effect of acupuncture with thick needle at Danzhong point（CV 17） to assist in improving difficulty in weaning from ventilator during acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods: A total of 100 cases of AECOPD patients with difficulty in weaning from ventilator were selected as the study subjects and divided into the control group and the observation group according to the two-color ball random method,with 50 cases in each group.The control group was given the adjuvant treatment of external diaphragm pacemaker,and the observation group was additionally treated with acupuncture with thick needle at Danzhong point based on the treatment of the control group. The ventilator weaning time, weaning success rates, and 28-day mortality rates were compared between the two groups. Before and after treatment, the diaphragmatic function, lung function,blood gas indexes,and oxygenation indexes were compared between the two groups. Results:The ventilator weaning time in the observation group was shorter than that in the control group（P<0.05）,the weaning success rate was higher than that in the control group（P<0.05）,and the 28-day mortality rate was lower than that in the control group（P<0.05）. At baseline,there was no significant difference being found in the comparison of the diaphragm mobility（DE） and the percentage of predicted value of forced expiratory volume in one second（FEV₁%） between the two groups（P>0.05）. At the endpoint, DE and FEV₁% in two groups were increased（P<0.05）,and DE and FEV₁% in the observation group were higher than those in the control group（P<0.05）. At baseline,there was no significant difference being found in the comparison of partial pressure of oxygen（PaO₂）, partial pressure of carbon dioxide（PaCO₂）, and oxygenation index（OI） between the two groups（P>0.05）. At the endpoint,PaO₂,and OI in the two groups were increased（P<0.05）, and PaCO₂was decreased（P<0.05）; PaO₂and OI in the observation group were higher than those in the control group（P<0.05）,and PaCO₂was lower than that in the control group（P<0.05）. Conclusion:Acupuncture with thick needle at Danzhong point for AECOPD can improve blood gas indexes, enhance diaphragmatic function, lung function and OI, shorten ventilator weaning time,increase weaning success rates,and reduce 28-day mortality rate.更多还原