中医辨证配合西医治疗慢性阻塞性肺疾病急性加重呼吸衰竭52例临床观察  

A Clinical Observation of TCM Treatment Combined with Western Medicine Therapy for 52 Cases of Acute Exacerbations and Respiratory Failure in Chronic Obstructive Pulmonary Disease

作　　者：王海峰[1] 李建生[2] 王丁超[3] 蒋艳丽[2] 杨晓静[2] 高娴[2] 张海龙[1] 赵栋梁[2] 李素云[1] 马利军[4] 

机构地区：[1]河南中医学院第一附属医院,河南省郑州市人民路19号450000 [2]河南中医学院老年医学研究所 [3]濮阳市中医院 [4]河南省人民医院

出　　处：《中医杂志》2013年第8期664-667,共4页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81102576);国家中医临床研究基地业务建设科研专项课题资助项目(JDZX2012028)

摘　　要：目的观察中医辨证配合西医治疗慢性阻塞性肺疾病急性加重(AECOPD)呼吸衰竭的临床疗效和安全性。方法将104例AECOPD呼吸衰竭患者随机分为治疗组和对照组各52例,对照组采用西医规范治疗,治疗组在对照组治疗基础上加用中医辨证治疗,两组疗程均为14天。两组患者分别于治疗前和治疗后第4、7、14天进行症状、体征评分和呼吸困难评分、急性生理学与慢性健康状况评分(APACHEⅡ)及血气分析,同时记录死亡率和不良反应。结果两组治疗后第14天与治疗前比较症状、体征积分和呼吸困难评分、APACHEⅡ评分均明显降低(P<0.05),且治疗组较对照组降低明显(P<0.05)。两组治疗后第14天与治疗前比较动脉血氧分压(PaO2)升高、二氧化碳分压(PaCO2)降低(P<0.05),且治疗组PaO2较对照组升高明显(P<0.05)。治疗组病死率为3.85%,对照组病死率为5.77%,两组比较差异无统计学意义(P>0.05)。两组各有2例轻度不良事件发生。结论中医辨证配合西医治疗AECOPD呼吸衰竭在改善临床症状、提高PaO2、减轻呼吸困难方面能明显提高疗效。Objective To observe the efficacy and safety of TCM treatment combined with western medicine therapy for acute exacerbations and respiratory failure in chronic obstructive pulmonary disease （COPD）. Methods A total of 104 patients with acute exacerbations and respiratory failure in COPD were randomized into the treatment group and control group, with 52 in each. The conventional western treatment was given to both groups and TCM treatment was added in the treatment group.The treatment lasted for 14 days. The symptom scores, sign scores, dyspnea scores, acute physiology and chronic health evaluation Ⅱ（APACHEⅡ） were assessed before treatment and on the 4th, 7th and 14th day of treatment. The blood gas analysis, mortality and adverse reactions were observed and recorded as well. Results The symptom scores, sign scores, dyspnea scores and APACHE Ⅱ scores were significantly decreased in both groups on the 14th day of treatment （P〈0.05）, especially in the treatment group （P〈0.05）. The partial pressure of oxygen in arterial blood （PaO2） was significantly increased but the partial pressure of carbon dioxide in arterial blood （PaCO2） was significantly decreased in both groups on the 14th day of treatment （P〈0.05）, especially PaO2 in the treatment group （P〈0.05）. The mortality of the treatment group and control group was 3.85 % and 5.77% respectively, with no significant difference between groups （P〉0.05）. Two mild adverse events occurred in each group. Conclusion TCM treatment combined with western medicine therapy is effective for acute exacerbations and respiratory failure in COPD, especially in relieving clinical symptoms, increasing PaOz and alleviating dyspnea.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 急性加重 辨证论治 

分 类 号：R563.9[医药卫生—呼吸系统]