中药保留灌肠联合无创通气治疗COPD临床研究  

Clinical study of noninvasive mechanical ventilation combined with traditional chinese medicine retention enema therapy for acute exacerbation chronic obstructive pulmonary disease

作　　者：吴文娟[1] 顾亮[1] 钦光跃[1] 陆晓玲[1] 

机构地区：[1]浙江医院呼吸内科,杭州市310012

出　　处：《中华全科医学》2015年第2期287-288,291,共3页Chinese Journal of General Practice

基　　金：浙江省中医药科学研究基金计划项目(2013ZB016)

摘　　要：目的探讨加味大承气汤保留灌肠联合无创通气治疗COPD急性加重(AECOPD)呼吸衰竭的临床疗效及安全性。方法将68例AECOPD呼吸衰竭患者随机分为试验组33例和对照组35例。对照组给予无创正压通气、控制感染等常规治疗,试验组在对照组的基础上予以中药加味大承气汤保留灌肠。结果 2组患者肺部感染控制后,心率、呼吸频率及血气分析指标较治疗前明显好转(P均<0.05),但组间比较差别无统计学意义(P>0.05);试验组机械通气时间和感染控制出现时间明显小于对照组(P均<0.05);治疗期间试验组腹胀、机械通气相关肺炎发生率明显低于对照组(P均<0.05),撤机成功率明显高于对照组(P<0.05)。结论加味大承气汤保留灌肠联合无创通气治疗AECOPD呼吸衰竭可显著提高临床疗效,缩短机械通气时间,降低不良反应发生率。Objective To explore the clinical efficacy and safety of noninvasive mechanical ventilation combined with Jiaweidachengqi soup retention enema in the treatment of respiratory failure in acute exacerbation chronic obstructive pulmonary disease（ AECOPD）. Methods 68 patients with respiratory failure in AECOPD were randomly divided into experimental group（ n = 33） and control group（ n = 35）. The patients in the control group were given noninvasive positive pressure ventilation and infection control,while the patients in the treatment group were given Jiaweidachengqi soup retention enema on the basis of the treatment on the control group. Results When the pulmonary infection of patients was controlled,the heart rate,breathing rate and blood gas analysis index in both groups were significantly improved as compared to the levels before the treatment（ P〈0. 05）,but there was no significant difference between the two groups（ P〉0. 05）;the time for the mechanical ventilation and infection control were less in the experimental group as compared to the control group（ P〈0. 05）; the incidence of abdominal distension and mechanical ventilation associated pneumonia was lower in the experimental group than that in the control group（ P〈0. 05）; the success rate of ventilator withdraw was significantly higher in the experimental group than that in the control group（ P〈0. 05）. Conclusion Jiaweidachengqi soup retention enema combined with noninvasive ventilation can effectively improve the therapeutic efficacy of respiratory failure in AECOPD,shorten the time of mechanical ventilation and reduce the incidence of adverse reactions.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 无创机械通气 中药灌肠 

分 类 号：R563[医药卫生—呼吸系统] R28[医药卫生—内科学]