补中益气汤加减联合营养支持对重症肺结核合并呼吸衰竭疗效临床研究  

A study on clinical effects of the Buzhong Yiqi decoction plus nutritional support on severe pulmonary tuberculosis with respiratory failure

作　　者：黄远智 HUANG Yuanzhi

机构地区：[1]广东省中山市第二人民医院,广东中山528400

出　　处：《中医临床研究》2022年第2期47-50,共4页Clinical Journal Of Chinese Medicine

基　　金：中山市医学科研项目(2020A020159)。

摘　　要：目的:探讨补中益气汤加减联合营养支持对重症肺结核合并呼吸衰竭的疗效。方法:选取2018年2月-2020年2月在广东省中山市第二人民医院呼吸内科住院治疗的重症肺结核合并呼吸衰竭的患者70例,根据随机数字表法分为对照组和观察组,各35例。两组均采用抗痨治疗,对照组使用医学营养支持疗法,以静脉输注营养液为主,观察组在对照组的基础上给予补中益气汤,两组患者均连续治疗14天。观察两组患者临床症状缓解情况、肺功能、血气分析情况。结果:观察组总有效率高于对照组(P<0.05);观察组患者的胸闷、紫绀、憋气等症状缓解时间均短于对照组患者(P<0.05);观察组患者治疗后血清白细胞介素-6(Interleukin-6,IL-6)、血清降钙素原(Procalcitonin,PCT)指标均低于对照组(P<0.05);观察组患者治疗后血清前白蛋白(Pre-albumin,PA)指标高于对照组(P<0.05);观察组患者治疗后血气分析中pH动脉血氧分压(Partial Pressure of Oxygen,PaO_(2))均高于对照组(P<0.05);观察组患者动脉血二氧化碳分压(Partial Pressure of Carbon Dioxide,PaCO_(2))均低于对照组(P<0.05)。结论:补中益气汤加减与营养支持联合治疗重症肺结核合并呼吸衰竭能有效缓解临床症状,有效降低全身炎性反应情况,对血气分析指标改善明显,值得临床借鉴。Objective:To explore clinical effects of the Buzhong Yiqi decoction(补中益气汤)plus nutritional support on severe pulmonary tuberculosis with respiratory failure.Methods:70 hospitalized cases from February 2018 to February 2020 were selected and divided into the control group and the observation group according to the random number table method,with 35 cases in each group.Both groups were treated by anti-tuberculosis treatment.The control group received medical nutrition support therapy mainly by intravenous infusion of nutrient solution,and the observation group was given medical nutrition support therapy plus the Buzhong Yiqi decoction.The treatment in both groups was continuously for 14 days.Results:The total efficiency in the observation group was higher than that in the control group(P<0.05).The relief time of symptoms such as chest tightness,cyanosis,and suffocation in the observation group was shorter than the control group(P<0.05).The levels of serum IL-6 and PCT indicators after treatment in the observation group were lower than those in the control group(P<0.05).The serum PA level in the observation group after treatment was higher than the control group(P<0.05).The levels of pH,PaO_(2) and PaCO_(2) indicators in the blood gas analysis in the observation group after treatment were higher than the control group after treatment(P<0.05).Conclusion:The Buzhong Yiqi decoction plus nutritional support on severe pulmonary tuberculosis with respiratory failure can effectively relieve the clinical symptoms,effectively reduce the systemic inflammatory reaction,and significantly ameliorate the blood gas analysis indicators,which is worthy of clinical reference.

关 键 词：补中益气汤 营养支持 重症肺结核 呼吸衰竭 临床研究 

分 类 号：R521[医药卫生—内科学]