益气活血法对重症肺炎机械通气患者的疗效观察  

Observation on Therapeutic Effect of Yiqi Huoxue Prescription on Patients with Severe Pneumonia Mechanical Ventilation

作　　者：高江宝 李辉[1] 杨英艺 吴少丽 宋斐 GAO Jiang-bao;LI Hui;YANG Ying-yi;WU Shao-li;SONG Fei(Panyu District Hospital of Traditional Chinese Medicine of Guangzhou City,Guangzhou 511400,China)

机构地区：[1]广州市番禺区中医院,广东广州511400

出　　处：《云南中医中药杂志》2021年第12期40-44,共5页Yunnan Journal of Traditional Chinese Medicine and Materia Medica

基　　金：广东省中医药局科研项目(20181219)。

摘　　要：目的探究采用益气活血法治疗对重症肺炎机械通气患者临床疗效的影响。方法选择重症肺炎患者61例作为研究对象,采用随机数表法将其随机分为对照组(n=30)和治疗组(n=31),其中对照组根据临床指南进行常规西医治疗,治疗组在常规西医治疗的基础上加用自拟益气活血方治疗。比较2组患者治疗1、5d外周血炎症指标(CRP、PCT、WBC)、免疫指标(LYM、CD4细胞)、肺顺应性、氧合指数、CIPS评分变化情况以及膈肌功能障碍发生率、有创机械通气时间、血管活性药物使用时间。结果治疗5d后,治疗组患者的外周血CRP、PCT、WBC、LYM、CD4细胞水平以及肺顺应性、氧合指数、CIPS评分均较对照组有显著的改善(P<0.05);治疗组膈肌功能障碍总发生率38.71%,明显低于对照组的73.33%(P<0.05);治疗组患者的有创机械通气时间、血管活性药物使用时间明显短于对照组(P<0.05)。结论益气活血法辅助治疗既能够减轻重症肺炎机械通气患者的炎症反应,改善其免疫功能和呼吸功能,又可减少膈肌功能障碍发生,缩短机械通气时间,对于改善患者预后具有积极的意义。Objective:To study the clinical effect of Yiqi Huoxue Prescription on the the patients with severe pneumonia mechanical ventilation.Methods:61 patients with severe pneumonia were selected as the research objects,and they were randomly divided into a control group(n=30) and a treatment group(n=31) by using a random number table.The control group was treated with conventional western medicine according to clinical guidelines and the treatment group was treated with self-made Yiqi Huoxue Prescription on the basis of conventional western medicine treatment.The changes of the peripheral blood inflammation indicators(CRP,PCT,WBC),immune indicators(LYM,CD4 cells),lung compliance,oxygenation index,CIPS score changes as well as the incidence of diaphragmatic dysfunction and invasive mechanical ventilation time and vasoactive drug use time of the two groups were compared on the 1 st and 5 th day of treatment.Results:After 5-day treatment,the peripheral blood CRP,PCT,WBC,LYM,CD4 cell levels,lung compliance,oxygenation index,and CIPS score changes of the treatment group were significantly improved when compared with those of the control group(P<0.05).The total incidence of diaphragmatic dysfunction was 38.71%,which was significantly lower than 73.33% of the control group(P<0.05).The invasive mechanical ventilation time and the vasoactive drug use time in the treatment group were significantly shorter than those in the control group(P<0.05).Conclusion:Yiqi Huoxue Prescription can not only reduce the inflammatory response of severe pneumonia patients with mechanical ventilation,improve their immune function and respiratory function,but also reduce the occurrence of diaphragmatic dysfunction and shorten the mechanical ventilation time,which has positive significance for improving the prognosis of patients.

关 键 词：重症肺炎 益气活血法 有创机械通气治疗 炎症因子 膈肌 

分 类 号：R563.1[医药卫生—呼吸系统]