止咳化痰汤联合盐酸氨溴索治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭临床研究  

Clinical Study on Zhike Huatan Decoction Combined with Ambroxol Hydrochloride for Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with TypeⅡRespiratory Failure

作　　者：马正兴 金英豪 邵烈培 MA Zhengxing;JIN Yinghao;SHAO Liepei(Dongyang Garden Tianshi Hospital,Dongyang Zhejiang 322121,China)

机构地区：[1]东阳花园田氏医院,浙江东阳322121

出　　处：《新中医》2023年第23期86-90,共5页New Chinese Medicine

摘　　要：目的:观察止咳化痰汤联合盐酸氨溴索治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭的疗效及对血清磷脂酶A2(PLA2)水平的影响。方法:选取114例AECOPD合并Ⅱ型呼吸衰竭患者,按随机数字表法分为对照组55例及治疗组59例。2组均采取常规对症治疗,对照组在此基础上给予盐酸氨溴酸注射液,治疗组在对照组基础上给予止咳化痰汤,2组均连续治疗2周。观察2组临床疗效及不良反应发生情况,比较2组治疗前后肺功能[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、呼气峰流速(PEF)]、血气分析[动脉血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))]、血清炎症因子[C-反应蛋白(CRP)、肿瘤坏死因子-α]、血清PLA2水平的变化。结果:治疗组临床疗效总有效率为96.61%,对照组为83.64%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组FEV_(1)、FVC、PEF指标值均较治疗前升高(P<0.05),治疗组FEV_(1)、FVC、PEF指标值均高于对照组(P<0.05)。治疗后,2组PaO_(2)指标值均较治疗前升高(P<0.05),PaCO_(2)指标值均较治疗前下降(P<0.05);治疗组PaO_(2)指标值高于对照组(P<0.05),PaCO_(2)指标值低于对照组(P<0.05)。治疗后,2组血清CRP、TNF-α、PLA2水平均较治疗前下降(P<0.05),治疗组血清CRP、TNF-α、PLA2水平均低于对照组(P<0.05)。结论:止咳化痰汤联合盐酸氨溴索治疗AECOPD合并Ⅱ型呼吸衰竭临床疗效显著,可降低炎症反应,有效改善患者肺功能及血气指标,治疗安全性高。Objective:To observe the curative effect of Zhike Huatan Decoction combined with ambroxol hydrochloride for acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with typeⅡrespiratory failure,and its effect on levels of ambroxol hydrochloride and phospholipase A2(PLA2)in serum.Methods:A total of 114 AECOPD patients with typeⅡrespiratory failure were selected and divided into the control group and the treatment group according to the random number table method,with 59 cases in each group.Both groups received routine symptomatic treatment;the control group additionally received Ambroxine Hydrochloride Injection,and the treatment group received Zhike Huatan Decoction based on the treatment of the control group.Both groups received continuous treatment for 2 weeks.The clinical effects and incidence of adverse reactions were observed between two groups.The changes in levels of pulmonary function[forced expiratory volume(FEV_(1)),forced vital capacity(FVC),and peak expiratory flow rate(PEF)],blood gas analysis[arterial oxygen partial pressure(PaO_(2)),and carbon dioxide partial pressure(PaCO_(2))],inflammatory factors[C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)]and PLA2 levels in serum were compared before and after treatment in the two groups.Results:The total effective rate was 96.61%in the treatment group,and 83.64%in the control group,the difference being significant(P<0.05).After treatment,the values of FEV_(1),FVC,and PEF in the two groups were increased when compared with those before treatment(P<0.05),and the values of FEV_(1),FVC,and PEF in the treatment group were higher than those in the control group(P<0.05).After treatment,the PaO_(2)values in the two groups were increased when compared with those before treatment(P<0.05),and the PaCO_(2)values were decreased when compared with those before treatment(P<0.05).The PaO_(2)value in the treatment group was higher than that in the control group(P<0.05),and the PaCO_(2)value was lower than that in the control group(P<

关 键 词：慢性阻塞性肺疾病 急性加重期 Ⅱ型呼吸衰竭 止咳化痰汤 盐酸氨溴索 血清磷脂酶A2 

分 类 号：R563[医药卫生—呼吸系统]