汉防己甲素联合改良缩唇呼吸对矽肺合并稳定期慢性阻塞性肺疾病患者的效果观察  

Effects of tetrandrine combined with modified pursed lip breathing on silicosis patients complicated with stable chronic obstructive pulmonary disease

作　　者：何钦 刘永泉 王智[2] 李艳文 容开萍 HE Qin;LIU Yongquan;WANG Zhi;LI Yanwen;RONG Kaiping(Jiangxi Province Institute of Occupational Disease Prevention and Control,Nanchang,Jiangxi 330006,China;Jiangxi Province Children's Hospital,Nanchang,Jiangxi 330006,China)

机构地区：[1]江西省职业病防治研究院,江西南昌330006 [2]江西省儿童医院,江西南昌330006

出　　处：《环境与职业医学》2021年第3期282-287,共6页Journal of Environmental and Occupational Medicine

基　　金：江西省卫生计生委科技计划(20196019)。

摘　　要：[背景]矽肺合并慢性阻塞性肺疾病(COPD)的治疗尚无特效药物。[目的]探究汉防己甲素联合改良缩唇呼吸对矽肺合并COPD稳定期患者血氧水平、呼吸功能及生活自理能力的影响。[方法]以2018年6月—2020年1月江西省职业病防治研究院门诊部收治的矽肺合并COPD稳定期患者81例为研究对象,采用随机数字表法将其分为药物治疗组(40例)和联合治疗组(41例),药物治疗组仅给予汉防己甲素治疗,联合治疗组给予汉防己甲素联合改良缩唇呼吸治疗。分别检测两组患者治疗前、后动脉血气指标动脉血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))、肺功能指标用力肺活量(FVC)、第1秒用力呼气容积占预测值的百分比(FEV1百分比)、肺最大通气量占预测值的百分比(MVV百分比)和FEV1/FVC、呼吸频率、6 min步行距离、改良版英国医学研究理事会(mMRC)评分、日常生活活动能力(ADL),并比较治疗前后指标变化。[结果]本研究纳入的81例矽肺合并COPD稳定期患者均为男性。药物治疗组和联合治疗组的年龄、体重指数、矽肺病程、COPD病程以及矽肺临床分期分布差异无统计学意义。治疗前,两组动脉血气指标和肺功能指标等观察指标差异也均无统计学意义。治疗后药物治疗组PaCO_(2)、mMRC、呼吸频率分别为(43.99±5.01)mmHg、(1.97±0.21)分、(23.09±2.02)次·min^(-1),联合治疗组分别为(38.09±3.04)mmHg、(1.52±0.19)分、(17.99±1.05)次·min^(-1),均较治疗前降低,且联合治疗组低于药物治疗组(P<0.05)。治疗后药物治疗组SaO_(2)、PaO_(2)、FVC、FEV1百分比、MVV百分比、FEV1/FVC分别为(86.69±8.57)%、(70.57±7.17)mmHg、(2.59±0.30)L、(77.69±7.47)%、(69.17±7.02)%、(56.24±5.69)%,联合治疗组分别为(98.49±9.15)%、(80.02±8.59)mmHg、(3.15±0.35)L、(86.29±8.05)%、(80.02±8.09)%、(63.01±6.52)%,较治疗前升高,且联合治疗组高于药物治疗组(P<0.05[Background]Currently,no specific medicine is available for silicosis complicated with chronic obstructive pulmonary disease(COPD).[Objective]This study investigates the effects of tetrandrine combined with a modified pursed lip breathing method on the blood oxygen level,respiratory function,and the ability of self care among silicosis patients complicated with COPD.[Methods]A total of 81 patients with silicosis and stable COPD admitted to the outpatient department of Jiangxi Province Institute of Occupational Disease Prevention and Control between June 2018 and January 2020 were selected as study subjects and divided into a drug therapy group(40 cases)and a combined treatment group(41 cases)by random number table method.The drug therapy group were treated with tetrandrine only,while the combined treatment group were treated with tetrandrine and a modified pursed lip breathing method.The arterial blood gas indicatorsarterial oxygen saturation(SaO_(2)),arterial partial pressure of oxygen(PaO_(2)),and arterial partial pressure of carbon dioxide(PaCO_(2)),lung function indicatorsforced vital capacity(FVC),the percentage of predicted forced expiratory volume in 1 second(FEV1%),the percentage of predicted maximum ventilatory volume(MVV%),and FEV1/FVC,respiratory rate,6-minute walking distance,modified Medical Research Council Dyspnea Scale(mMRC)scores,and activities of daily living(ADL)in both groups were detected and compared before and after the assigned treatment.[Results]The study included 81 male silicosis patients complicated with stable COPD.No differences were found between the drug therapy group and the combined treatment group in age,body mass index,silicosis duration,COPD duration,and silicosis stages.At baseline,there were also no differences in the observations such as arterial blood gas indicators and lung function indicators.After the designed treatment,the PaCO_(2)level,mMRC score,and respiratory rate of the drug therapy group were(43.99±5.01)mmHg,1.97±0.21,and(23.09±2.02)times·min^(-1),respectivel

关 键 词：矽肺 慢性阻塞性肺疾病 汉防己甲素 改良缩唇呼吸 

分 类 号：R13[医药卫生—劳动卫生]