益气活血化瘀汤辅助BiPAP治疗AECOPD合并呼吸衰竭临床疗效观察  

Yiqihuoxuehuayu Decoction Combined with BIPAP in the Treatment of AECOPD with Respiratory Failure

作　　者：严可风 何月利 潘利平[1] 

机构地区：[1]浙江省绍兴市中医院重症医学科,绍兴312000

出　　处：《浙江中西医结合杂志》2017年第11期931-935,共5页Zhejiang Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨益气活血化瘀汤辅助双水平式呼吸道正压通气(BiPAP)治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭的临床疗效。方法将72例AECOPD并呼吸衰竭患者分为观察组和对照组。全部患者给予常规对症治疗,对照组采用BiPAP治疗,观察组在对照组基础上,再加益气活血化瘀汤口服。对比两组治疗前后血气水平、肺功能、炎症因子的水平变化。结果观察组临床控制19例,显效10例,好转5例,无效2例;对照组临床控制11例,显效12例,好转7例,无效6例。观察组疗效较对照组更佳(P<0.05);与治疗前比较,两组治疗后血氧分压(PaO_2)[(93.17±8.20)、(82.64±7.05)mmHg]、氧合指数(P/F)[(320.18±47.52)、(276.05±40.65)]明显升高,二氧化碳分压(PaCO_2)[(41.98±8.15)、(52.36±9.07)mmHg]明显降低(P<0.05);治疗后,观察组的PaO_2、P/F明显高于对照组,PaCO_2明显低于对照组,差异有统计学意义(P<0.05);两组治疗后超敏C反应蛋白(hs-CRP)、白介素8(IL-8)、白介素1β(IL-1β)较治疗前均明显降低(P<0.05);治疗后,观察组hs-CRP、IL-8、IL-1β显著优于对照组hs-CRP[(29.56±7.04)比(38.42±9.36)mg/L,P<0.05];IL-8[(119.43±38.26)比(153.04±40.26)pg/mL,P<0.05];IL-1β[(0.18±0.04)比(0.29±0.05)mg/L,P<0.05];两组治疗后一秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)、呼气峰值流速(PEF)明显升高(P<0.05);治疗后,观察组的FEV1、FEV1/FVC、PEF明显高于对照组(P<0.05)。FEV1[(63.49±7.16)比(54.27±7.20)%,P<0.05];FEV1/FVC[(67.18±5.78)比(60.19±4.26)%,P<0.05];PEF[(5.69±0.58)比(4.72±0.51)mL/min,P<0.05]结论益气活血化瘀汤辅助BiPAP治疗AECOPD并呼吸衰竭,能有效提高治疗效果。Objective To investigate the clinical effect of Yiqihuoxuehuayu decoction combined with BIPAP in the treatment of acute exacerbation of chronic obstructive pulmonary disease( AECOPD) with respiratory failure.Methods Seventy two patients with AECOPD accompanied by respiratory failure were divided into observation group and control group. All patients were given conventional symptomatic treatment. Control group was treated with BiPAP, observation group was given Yiqihuoxuehuayu Decoction in addition to the basic treatment in control group. The changes of blood gas, lung function and inflammatory factors were compared between the two groups before and after treatment. Results In observation group, 19 cases were clinically controlled, 10 cases were markedly effective, 5 cases were improved, and 2 cases were invalid. In control group, 11 cases were clinically controlled, 12 cases were markedly effective, 7 cases were improved, and 6 cases were invalid. The treatment effect of observation group was better than that of control group( P<0.05). Compared with those before treatment, the PaO_2 and OI after treatment of the two groups were significantly increased PaO_2:[( 93.17±8.20) mmHg vs( 82.64±7.05)mmHg; OI:( 320.18 ±47.52 vs 276.05 ±40.65; P <0.05) and PaCO_2 was significantly lower [( 41.98 ±8.15) mmHg vs( 52.36±9.07) mmHg, P<0.05]. After treatment, the PaO_2 and OI in observation group were significantly higher than those in control group, PaCO_2 was significantly lower than that in control group( P<0.05); the hs-CRP, IL-8 and IL-1β after treatment of the two groups were significantly lower( P<0.05), and there were significant difference between observation group and control group [hs-CRP:( 29.56±7.04) mg/L vs( 38.42±9.36) mg/L; IL-8:( 119.43±38.26)pg/mL vs( 153.04±40.26) pg/mL; IL-1β:( 0.18±0.04) mg/L vs( 0.29±0.05) mg/L; all P<0.05]. FEV1, FEV1/FVC and PEF were significantly increased after treatment in the two groups( P <0.05). After treatment, the FEV1( 63.49 ±7.16) %, FEV1/FVC( 67.18±5.78) % and

关 键 词：益气活血化瘀汤 BI PAP AECOPD 呼吸衰竭 

分 类 号：R563[医药卫生—呼吸系统]