麻杏二三汤联合盐酸右美托咪定治疗慢性阻塞性肺疾病急性加重期胃肠功能障碍临床研究  

Clinical Study on Maxing Ersan Tang Combined with Dexmedetomidine Hydrochloride for Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Gastrointestinal Dysfunction

作　　者：李国法 杨宇舟 LI Guofa;YANG Yuzhou

机构地区：[1]诸暨市中医医院重症医学科,浙江诸暨311800 [2]诸暨市中医医院肾内科,浙江诸暨311800

出　　处：《新中医》2020年第6期24-27,共4页New Chinese Medicine

基　　金：浙江省医学会临床科研基金项目(2017ZYC-A98)。

摘　　要：目的:探讨麻杏二三汤联合盐酸右美托咪定对慢性阻塞性肺疾病急性加重期(AECOPD)机械通气患者镇静期间胃肠功能的影响。方法:选取AECOPD机械通气患者80例,按随机数字表法分为观察组和对照组各40例。2组均给予常规对症处理,对照组给予盐酸右美托咪定镇静治疗,观察组在对照组基础上给予麻杏二三汤治疗。比较2组临床疗效,评估主要症状积分变化,检测2组血清超氧化物歧化酶(SOD)、脂质过氧化物(LPO)、白细胞介素-8(IL-8)水平,分析不良反应发生情况。结果:观察组总有效率为95.00%,高于对照组80.00%(P<0.05)。治疗3 d、7 d后,2组肠鸣音、腹胀、排便、胃潴留评分均低于治疗前(P<0.05),且观察组各项评分均低于对照组(P<0.05)。治疗3 d、7 d后,2组SOD水平高于治疗前,LPO、IL-8水平低于治疗前;且观察组SOD水平高于对照组,LPO、IL-8水平低于对照组;差异均有统计学意义(P<0.05)。结论:麻杏二三汤联合盐酸右美托咪定治疗AECOPD机械通气患者,能改善其镇静期间的胃肠功能,上调SOD水平,下调LPO、IL-8水平,用药安全性高。Objective:To discuss the effect of the therapy of Maxing Ersan tang combined with dexmedetomidine hydrochloride on the gastrointestinal function of mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 80 mechanically ventilated patients with AECOPD were selected and divided into the observation group and the control group according to the random number table,40 cases in each group.Both groups were given routine symptomatic treatment.The control group was additionally treated with sedation of dexmedetomidine hydrochloride,and the observation group was additionally treated with Maxing Ersan tang based on the treatment of the control group.The clinical effect in the two groups was compared;the changes in major symptom scores were observed,and the levels of superoxide oxygenase(SOD),lipid peroxidase(LPO)and interleuk-8(IL-8)in serum in the two groups were detected;the occurrence of adverse reactions was analyzed.Results:The total effective rate was 95.00%in the observation group,higher than that of 80.00%in the control group(P<0.05).After three days and seven days of treatment,the scores of bowel sounds,abdominal distension,defecation and gastric retention in the two groups were all lower than those before treatment(P<0.05),and the above scores in the observation group were lower than those in the control group(P<0.05).After three days and seven days of treatment,SOD levels in both groups were higher than those before treatment,while LPO and IL-8 levels were lower than those before treatment;SOD level in the observation group was higher than that in the control group,while LPO and IL-8 levels were lower than those in the control group,differences being significant(P<0.05).Conclusion:The therapy of Maxing Ersan tang combined with dexmedetomidine hydrochloride can improve gastrointestinal function,increase SOD level,decrease LPO and IL-8 levels in mechanically ventilated patients with AECOPD.

关 键 词：慢性阻塞性肺疾病急性加重期(AECOPD) 盐酸右美托咪定 麻杏二三汤 机械通气 胃肠功能障碍 超氧化物歧化酶(SOD) 脂质过氧化物(LPO) 白细胞介素-8(IL-8) 

分 类 号：R563[医药卫生—呼吸系统]