振荡排痰辅助治疗老年AECOPD患者的疗效及对肺功能的影响  

Effect of oscillating expectoration in the adjuvant treatment of elderly patients with AECOPD and the impact on pulmonary function

作　　者：孙维 杨家兴 SUN Wei;YANG Jiaxing(Qianxinan Autonomous Prefecture Traditional Chinese Medicine Hospital,Guizhou Province,Xingyi 562400,China)

机构地区：[1]黔西南州中医院,贵州省兴义市562400

出　　处：《临床合理用药杂志》2024年第3期12-15,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察振荡排痰辅助治疗老年慢性阻塞性肺疾病急性加重期(AECOPD)患者的疗效及对肺功能的影响。方法选取2020年1月—2023年6月黔西南州中医院收治的50例老年AECOPD患者作为研究对象,根据单双数法分为药物治疗组和联合排痰组,各25例。患者入院后均给予对症治疗,在此基础上,药物治疗组患者采用痰热清注射液联合乙酰半胱氨酸雾化治疗,联合排痰组患者在药物治疗组基础上行振荡排痰治疗,2组均治疗7 d。比较2组临床疗效,治疗前后血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、pH值]、炎性指标[白细胞计数(WBC)、降钙素原(PCT)、C反应蛋白(CRP)]、肺功能指标[第1秒用力呼气容积(FEV 1)、用力肺活量(FVC)、FEV 1/FVC],临床症状消失时间。结果与药物治疗组比较,联合排痰组治疗总有效率较高(100.00%vs.76.00%,χ^(2)=4.735,P=0.030)。治疗后,2组PaO_(2)、pH值高于治疗前,PaCO_(2)、WBC及血清PCT、CRP水平低于治疗前,且联合排痰组升高/降低幅度大于药物治疗组(P<0.05或P<0.01);2组FEV 1、FVC、FEV 1/FVC高于治疗前,且联合排痰组高于药物治疗组(P<0.05或P<0.01)。与药物治疗组比较,联合排痰组喘息、胸闷、咳嗽消失时间更短(P<0.05或P<0.01)。结论老年AECOPD患者在痰热清注射液联合乙酰半胱氨酸雾化吸入治疗基础上加用振荡排痰治疗可有效纠正酸碱失衡,缓解炎性反应,提高肺功能,加快临床症状消失,提高临床疗效。Objective To observe the effect of oscillating expectoration in the adjuvant treatment of elderly patients with AECOPD and the impact on pulmonary function.Methods A total of 50 elderly patients with AECOPD were selected as the study subjects,all of whom were treated in Qianxinan Autonomous Prefecture Traditional Chinese Medicine Hospital from January 2022 to June 2023,and they were divided into the group A and the group B by odd-even number method,25 cases in each group.Patients in the group A were treated with Tanreqing injection combined with acetylcysteine atomization based on symptomatic treatment,and patients of the group B were treated with ascending oscillation expectoration based on the group A,both group were treated for 7 days.Clinical effect,arterial blood gas analysis indexes(PaO_(2),PaCO_(2),pH value),inflammatory indexes(WBC,PCT,CRP),pulmonary function indexes(FEV 1,FVC,FEV 1/FVC)before and after treatment,disappearance time of clinical symptom of the two groups were compared.Results Compared with that of the group A,group B had higher total effective rate(100.00%vs.76.00%,χ^(2)=4.735,P=0.030).After treatment,PaO_(2),pH value of the two groups were higher than those before treatment,PaCO_(2),WBC and serum levels of PCT,CRP were lower than those before treatment,and the group B were better than those of the group A(P<0.05 or P<0.01);FEV 1,FVC,FEV 1/FVC of the two groups were higher than those before treatment,and the group B were higher than those of the group A(P<0.05 or P<0.01).Compared with those of the group A,disappearance time of wheezing,chest tightness and cough in the group B were shorter(P<0.05 or P<0.01).Conclusion Oscillating expectoration can effectively correct acid-base imbalance in the adjuvant treatment of elderly patients with AECOPD based on Tanreqing injection combined with acetyl cysteine atomization,it can alleviate inflammatory response,improve pulmonary function,and accelerate the elimination of clinical symptoms,and then enhance clinical efficacy.

关 键 词：慢性阻塞性肺疾病 急性加重期 老年人 振荡排痰 痰热清注射液 乙酰半胱氨酸 

分 类 号：R563.9[医药卫生—呼吸系统]