苓桂术甘汤加减联合纳洛酮对肺癌术后呼吸衰竭患者血气指标和肺功能的影响  

Effects of modified Linggui Zhugan Decoction combined with naloxone on blood gas indicators and lung function in postoperative respiratory failure patients with lung cancer

作　　者：和建武 赵丽丽 申丁丁 He Jianwu;Zhao Lili;Shen Dingding(Department of Respiratory and Critical Care Medicine,Tongchuan People′s Hospital,Tongchuan,Shaanxi 727000,China)

机构地区：[1]铜川市人民医院呼吸与危重症医学科,陕西铜川727000

出　　处：《中国药物与临床》2024年第6期353-358,共6页Chinese Remedies & Clinics

摘　　要：目的探讨苓桂术甘汤加减联合纳洛酮对肺癌术后呼吸衰竭血气指标和肺功能的影响。方法选取2020年1月1日至2023年1月1日陕西省铜川市人民医院收治的140例肺癌术后呼吸衰竭患者,按治疗方法分为观察组和对照组。对照组接受常规治疗以及纳洛酮治疗,观察组在对照组基础上进行苓桂术甘汤联合治疗,并进行相应加减。对比2组患者的治疗效果,观察患者的临床疗效和不良反应发生情况。在治疗前后,进行血气指标、心率、呼吸频率、肺功能指标的检测,评估患者的焦虑和抑郁自评量表的评分变化。结果观察组患者的辅助通气时间[(5.4±2.7)d与(9.6±3.2)d]、重症监护病房(ICU)留观时间[(9±4)d与(12±4)d]和病死率(7%与15%)均低于对照组,一次拔管成功率(79%与52%)高于对照组(t/χ^(2)=12.4131、7.3428、15.6974、3.1791,P<0.05)。治疗后,观察组的动脉血氧分压(PaO2)较治疗前和同期对照组升高[(97.7±2.4)与(90.5±3.6)],而动脉血二氧化碳分压(PaCO_(2))[(43±6)与(54±6)]、心率[(82±8)次/min与(91±9)次/min]和呼吸频率[(17±4)次/min与(22±4)次/min]较治疗前和同期对照组降低(t=15.450、11.300、8.249、8.751,P<0.05)。此外,观察组的肺功能指标和焦虑[(30±7)与(46±9)]、抑郁自评量表评分[(38±8)与(59±8)]均改善(t=9.226、7.209、7.829、8.869、13.298、18.420,P<0.05)。观察组不良反应总发生率高于对照组,相比差异无统计学意义(P>0.05)。结论对症支持治疗基础上,联合使用纳洛酮和苓桂术甘汤加减,可改善肺癌术后呼吸衰竭患者肺功能,疏导不良情绪,降纸辅助通气并发症、减少使用辅助通气的次数和ICU留观时间,降低病死率。Objective To explore the effect of modified Linggui Zhugan Decoction combined with naloxone on blood gas indicators and lung function in postoperative respiratory failure patients with lung cancer.Methods A total of 140 patients with respiratory failure after lung cancer surgery admitted to Tongchuan People′s Hospital from January 1,2020 to January 1,2023 were divided into a observation group and a control group depending on treatment method.The control group was treated with naloxone on the basis of routine treatment,while the observation group was treated with Linggui Zhugan Decoction on the basis of the control group.The therapeutic effects of the two groups were compared,and the clinical efficacy indexes and the occurrence of adverse reactions were observed.Before and after treatment,blood gas index,heart rate,respiratory rate and lung function index were detected,and the score changes of anxiety and depression self-rating scale were evaluated.Results The duration of assisted ventilation[(5.4±2.7)d vs(9.6±3.2)d],average ICU observation time[(9±4)d vs(12±4)d],and mortality rate(7%vs 15%)in the observation group were significantly lower than those in the control group,while the success rate of one-time extubation(79%vs 52%)was higher than that in the control group(t/χ^(2)=12.4131,7.3428,15.6974,3.1791,P<0.05).After treatment,the PaO_(2)in the observation group was significantly higher than that before treatment and the control group during the same period[(97.7±2.4)vs(90.5±3.6)],while the Pa-CO_(2)[(43±6)vs(54±6)],heart rate[(82±8)times/min vs(91±9)times/min],and respiratory rate[(17±4)times/min vs(22±4)times/min]were significantly lower than those before treatment and the control group during the same period(t=15.450,11.300,8.249,8.751,P<0.05).Additionally,the lung function indicators,anxiety score[(30±7)vs(46±9)],and self-rating depression scale score[(38±8)与(59±8)]in the observation group were significantly improved(t=9.226,7.209,7.829,8.869,13.298,18.420,P<0.05).The total incidence of a

关 键 词：纳洛酮 苓桂术甘汤 肺肿瘤 呼吸功能不全 

分 类 号：R734.2[医药卫生—肿瘤]