胃肠起搏治疗在慢性阻塞性肺疾病合并胃肠功能紊乱患者中的应用  

Application of gastrointestinal pacing therapy in patients with chronic obstructive pulmonary disease complicated with gastrointestinal dysfunction

作　　者：张海林 葛海珏 仇爱民 张建生 ZHANG Hailin;GE Haijue;QIU Aimin;ZHANG Jiansheng(Department of Respiratory,Yancheng Third People's Hospital,Affiliated Hospital of Jiangsu Vocational College of Medicine,Yancheng,Jiangsu,224001,China;Department of Gastroenterology,Yancheng Third People's Hospital,Affiliated Hospital of Jiangsu Vocational College of Medicine)

机构地区：[1]江苏医药职业学院附属盐城市第三人民医院呼吸内科,江苏盐城224001 [2]江苏医药职业学院附属盐城市第三人民医院消化内科

出　　处：《中国中西医结合消化杂志》2022年第6期424-430,共7页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：2020年度江苏医药职业学院临床教学基地科研发展专项课题立项项目(No:20219119)。

摘　　要：目的:探讨胃肠起搏治疗在慢性阻塞性肺疾病(COPD)合并胃肠功能紊乱患者中的应用疗效。方法:选取2020年9月—2021年9月盐城市第三人民医院收治的COPD合并胃肠功能紊乱患者80例作为研究对象,按照随机数表法分为胃肠起搏组、中药汤剂组、穴位按摩组和对照组,每组各20例,并予以对应治疗,疗程均为14 d。分别检测4组患者治疗前后肺功能、动脉血气分析、免疫功能及促胃液素水平,记录患者治疗前后COPD评估测试量表(CAT)评分、呼吸困难指数(mMRC)评分、6分钟步行试验(6MWT)距离、生活质量(QOL)评分及消化道症状积分,并统计4组患者临床疗效。结果:胃肠起搏组患者治疗后第1秒末用力呼气量(FEV1)、第1秒末用力呼气量与用力肺活量比值(FEV1/FVC)均稍高于其他3组(P>0.05);4组患者治疗后酸碱度(pH)、血氧饱和度(SPO;)、氧分压(PO;)、二氧化碳分压(PCO;)均差异无统计学意义(P>0.05);胃肠起搏组患者治疗后CD3^(+)、CD4^(+)均明显高于其他3组(P<0.05),CD8^(+)明显低于其他3组(P<0.05);胃肠起搏组患者治疗14 d后促胃液素水平均明显低于其他3组(P<0.05);胃肠起搏组患者治疗后CAT及mMRC评分均明显低于其他3组(P<0.05);胃肠起搏组患者治疗后6MWT距离明显长于其他3组(P<0.05),QOL评分明显低于其他3组(P<0.05);胃肠起搏组患者治疗4、7、14 d后消化道积分均明显低于其他3组(P<0.05);4组患者间临床疗效比较,胃肠起搏组稍高于其他3组(P>0.05)。结论:胃肠起搏治疗能有效缓解COPD合并胃肠功能紊乱患者胃肠道症状,提高患者运动耐力及免疫力,且可在一定程度上改善患者肺功能。Objective:To explore the efficacy of gastrointestinal pacing treatment in patients with chronic obstructive pulmonary disease(COPD)combined with gastrointestinal dysfunction.Methods:A total of 80 patients with COPD and gastrointestinal dysfunction admitted from September 2020 to September 2021 were selected as the study subjects.They were divided into gastrointestinal pacing group,TCM decoction group,acupuncture massage group and control group,with 20 cases in each group.The corresponding treatment was given,and the course was 14 days.Lung function,arterial blood gas analysis,immune function and gastrin levels were examined before and after treatment in the four groups.The COPD assessment test scale(CAT)score,respiratory difficulty index(mMRC)score,6-minute walk trial(6 MWT)distance,quality of life(QOL)score,and digestive tract symptoms score were recorded before and after treatment in the four groups.The clinical effects of the four groups of patients were also counted.Results:After treatment,forced expiratory volume at the end of the first second(FEV1),ratio of forced expiratory volume to forced vital capacity at the end of first second(FEV1/FVC)in the gastrointestinal pacing group were slightly higher than the other three groups(P>0.05);There were no significant differences in acid(pH),blood oxygen saturation(SPO;),oxygen pressure(PO;)and carbon dioxide pressure(PCO;)in the four groups,respectively(P>0.05);Patients in the gastrointestinal pacing group had significantly higher CD3^(+)and CD4^(+)compared with the other three groups(P<0.05)and CD8^(+)was significantly lower than the other three groups(P<0.05);Patients in the gastrointestinal pacing group had significantly lower gastrin levels after 14 d than in the other three groups(P<0.05);Both the CAT and mMRC scores were significantly lower than those in the other three groups(P<0.05);The 6 MWT distance in the gastrointestinal pacing group was significantly longer than the other three groups(P<0.05);The QOL score was significantly lower than that in the other

关 键 词：胃肠起搏 慢性阻塞性肺疾病 胃肠功能紊乱 应用 

分 类 号：R563[医药卫生—呼吸系统] R57[医药卫生—内科学]