加减涤痰汤治疗慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭(肺胀病-痰蒙神窍证)的临床研究  

Clinical Study of Modified Ditan Decoction in the Treatment of Chronic Obstructive Pulmonary Disease Complicated with TypeⅡRespiratory Failure(Lung Distension Syndrome-Phlegm Obstructing the Mind Syndrome)

作　　者：杨兴嫕 王士汉 王琦 张阳阳 王芳 Yang Xingyi;Wang Shihan;Wang Qi;Zhang Yangyang;Wang Fang(Lu′an Hospital of Tradition-al Chinese Medicine,Anhui,Lu′an 237000,China)

机构地区：[1]安徽省六安市中医院,安徽六安237000

出　　处：《中国中医急症》2023年第11期1937-1940,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：安徽省长三角名中医工作室(王琦教授工作室)建设项目(皖中医药发展秘[2021]15号);安徽省高等学校科学研究项目(自然科学类)一般项目(2021LAYB009)。

摘　　要：目的 探讨加减涤痰汤对慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭(肺胀病-痰蒙神窍证)的疗效。方法选择慢性阻塞性肺疾病并发Ⅱ型呼吸衰竭(肺胀病-痰蒙神窍证)患者60例,按照随机数字表法分为治疗组与对照组各30例。两组基础治疗均采取无创机械通气及常规药物治疗。治疗组在常规治疗的基础上口服加减涤痰汤治疗,疗程为7 d。比较两组临床疗效、血气、中医证候积分、QLICD-COPD评分。结果 两组治疗前血气指标、中医证候积分、QLICD-COPD评分比较,差异无统计学意义(P> 0.05)。两组治疗后血气PCO_(2)、中医证候积分低于治疗前,pH、PO_(2)、QLICD-COPD评分高于治疗前(P<0.05)。与对照组比较,治疗组血气pH、PO_(2)水平升高,PCO_(2)降低,中医证候积分降低、QLICD-COPD评分改善与治疗组比较差异均有统计学意义(P<0.05),且治疗组的总有效率高于对照组(P<0.05)。结论 在常规治疗基础上联合加减涤痰汤能改善肺胀病-痰蒙神窍证患者的血气指标、中医证候积分及生命质量,提高临床疗效。Objective:To explore the therapeutic effect of modified Ditan Decoction on chronic obstructive pul⁃monary disease complicated with typeⅡrespiratory failure(lung distension syndrome-phlegm obstructing the mind syndrome).Methods:60 patients with chronic obstructive pulmonary disease complicated with typeⅡrespi⁃ratory failure(lung distension syndrome-phlegm obstructing the mind syndrome)were selected and randomly di⁃vided into a treatment group and a control group,30 cases each.Both groups of basic treatment were treated with non-invasive mechanical ventilation and conventional medication.The treatment group was orally treated with mod⁃ified Ditan Decoction on the basis of routine treatment,with a course of 7 days.The clinical efficacy,blood gas,tra⁃ditional Chinese medicine syndrome scores,and QLICD-COPD scores were compared between the two groups.Re⁃sults:There was no statistically significant difference in blood gas indicators,traditional Chinese medicine syn⁃drome scores,and QLICD-COPD scores between the two groups before treatment(P>0.05).After treatment,the blood gas PCO_(2) and traditional Chinese medicine syndrome scores of the two groups were lower than before treat⁃ment,while the pH,PO2,and QLICD-COPD scores were higher than before treatment(P<0.05).Compared with the control group,the treatment group showed an increase in blood gas pH and PO2 levels,a decrease in PCO_(2),a decrease in traditional Chinese medicine syndrome scores,and an improvement in QLICD-COPD scores,with sta⁃tistical differences(P<0.05).The total effective rate of the treatment group was higher than that of the control group(P<0.05).Conclusion:On the basis of conventional treatment,the combination of modified Ditan Decoc⁃tion can improve the blood gas indicators,traditional Chinese medicine syndrome scores,and quality of life of pa⁃tients with lung distension disease and phlegm deficiency syndrome,and improve clinical efficacy.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 肺胀病 痰蒙神窍证 QLICD-COPD评分 

分 类 号：R563.8[医药卫生—呼吸系统]