清肺宽胸理气汤联合布地奈德对慢阻肺合并呼吸衰竭患者的应用效果

摘要/Abstract

摘要： 目的探讨清肺宽胸理气汤联合布地奈德对慢阻肺合并呼吸衰竭患者的应用效果及对肺功能的影响。方法选择2020年5月—2022年7月敦煌市医院收治的96例慢阻肺合并呼吸衰竭患者作为研究对象,按照随机数表法分为试验组和对照组,每组48例。对照组在常规治疗基础上加布地奈德雾化吸入治疗,试验组在对照组基础上加清肺宽胸理气汤治疗,两组均观察14 d。记录两组治疗前后的血气分析指标、肺功能改善情况及临床疗效。结果治疗后,两组患者的肺功能指标均明显升高,且试验组肺功能指标水平高于对照组,差异有统计学意义（P<0.05）。治疗后,两组患者的氧分压（PaO₂）、血氧饱和度（SpO₂）、pH、氧合指数（PaO₂/FiO₂）均明显升高,二氧化碳分压（PaCO₂）均降低,差异有统计学意义（P<0.05）,且试验组PaO₂、SpO₂、pH、PaO₂/FiO₂明显高于对照组,PaCO₂低于对照组,差异有统计学意义（P<0.05）。两组患者治疗后临床疗效比较,差异无统计学意义（P>0.05）。试验组急性加重次数明显少于对照组,差异有统计学意义（P<0.05）。结论与单用布地奈德治疗相比,联用清肺宽胸理气汤有助于促进肺功能和血气分析的改善,并降低急性发作风险。

关键词: 慢阻肺, 呼吸衰竭, 清肺宽胸理气汤, 布地奈德, 肺功能

Abstract: Objective To investigate the effect of Qingfei Kuanxiong Liqi Decoction combined with budesonide on chronic obstructive pulmonary disease (COPD) patients with respiratory failure and its influence on pulmonary function. Methods A total of 96 patients with COPD failure admitted to Dunhuang City Hospital from May 2020 to July 2022 were divided into two groups. The control group was treated with budesonide nebulization inhalation in addition to conventional treatment,the experimental group was treated with Qingfei Kuanxiong Liqi Decoction in addition to the control group,and the two groups were observed for 14 d. Record the blood gas analysis indicators, improvement of lung function, and clinical efficacy before and after treatment in both groups. Results After treatment, FEV₁, FEV₁ / FVC and PEF of the two groups were significantly higher, and the difference was statistically significant (P<0.05),while the improvement in the experimental group was significantly higher than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the levels of PaO₂, SpO₂, pH, PaO₂ / FiO₂ were significantly increased, and the PaCO₂ level was reduced, and the difference was statistically significant (P<0.05), while in the experimental group, PaO₂, SpO₂, pH, PaO₂/FiO₂ levels were significantly higher than the control group, and the PaCO₂ level was lower than the control group, the difference was statistically significant (P<0.05). There was no statistically significant difference in the total effective rate between the two groups of patients (P>0.05). The number of acute exacerbations in the experimental group was significantly less than that in the control group (P<0.05). Conclusion Compared with budesonide alone, Qingfei Kuanxiong Liqi Decoction is helpful to improve lung function and blood gas analysis, and reduce the risk of acute attack.

Key words: chronic obstructive pulmonary disease, respiratory failure, Qingfei Kuanxiong Liqi Decoction, budesonide, pulmonary function

中图分类号:

R563.1

李树纲, 胡俊波, 刘园园, 于涛, 田晓东. 清肺宽胸理气汤联合布地奈德对慢阻肺合并呼吸衰竭患者的应用效果[J]. 中华养生保健, 2023, 41(14): 71-75.

LI Shu-gang, HU Jun-bo, LIU Yuan-yuan, YU Tao, TIAN Xiao-dong. The Application Effect of Qingfei Kuanxiong Liqi Decoction Combined with Budesonide in Patients with Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(14): 71-75.

参考文献

[1] 国家卫生健康委员会急诊医学质控中心,中华医学会急诊医学分会,中国医师协会急诊医师分会,等.中国慢性阻塞性肺疾病急性加重中西医诊治专家共识(2021)[J].中华危重病急救医学,2021,33(11):1281-1289.
[2] WANG C, XU J Y, YANG L, et al.Prevalence and risk factors of chronic obstruc tive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study[J]. Lancet,2018,391(10131):1706-1717.
[3] 陈军,彭亚,毛锦娟,等.慢性阻塞性肺疾病患者继发呼吸衰竭的危险因素的系统评价[J].华西医学,2021,36(11):1563-1569.
[4] 李正欢,张晓云,陈扬,等.2020年慢性阻塞性肺疾病全球倡议《COPD诊断,治疗与预防全球策略》指南解读(一) ——稳定期药物管理[J].中国全科医学,2021, 24(8):923-929.
[5] 王晓娟,方向阳.慢性阻塞性肺疾病全球倡议2019:慢性阻塞性肺疾病诊断、治疗与预防全球策略解读[J].中国全科医学,2019,22(18):2141-2149.
[6] 钟南山,陆再英.内科学[M].北京:人民卫生出版社,2008:141-150.
[7] 世界中医药学会联合会.国际中医临床实践指南慢性阻塞性肺疾病[J].世界中医药,2020,15(7):1084-1092.
[8] STOCKLEY R A, HALPIND M G, CELLI B R, et al.Chronic obstructive pulmonary disease biomarkers and theirinterpretation[J]. Am J Respir Crit Care Med,2019,199(10):1195-1204.
[9] 李建生,余学庆.慢性阻塞性肺疾病中医分期分级防治策略[J].中医杂志, 2019,60(22):1895-1899.
[10] 方晗语,冯沁祺,张洪春.基于肺肾相关理论治疗慢性阻塞性肺疾病稳定期研究进展[J].北京中医药,2021,40(6):681-684.
[11] 温敏勇,杨柳柳,夏欣田,等.健脾益肾化痰方合穴位注射对慢性阻塞性肺疾病合并慢性呼吸衰竭疗效观察[J].陕西中医,2017,38(12):1655-1657.
[12] 禚昌红,张沁园,张道伟.《伤寒论》中白术运用撷英[J].西部中医药, 2017,30(6):44-46.
[13] 张丽艳,梁茂新.论陈皮潜在功用的发掘与利用[J].中华中医药杂志,2017,32(1):107-110.
[14] 苑萌,卢晶,韩宝华,等.麻黄水提物对肺炎克雷伯菌所致重症肺炎幼龄大鼠细胞因子,间质纤维化以及NF-κB活化的影响[J].医学分子生物学杂志, 2021,18(1):32-39.
[15] 杨婷,徐旭,窦德强.茯苓对上焦水饮内停大鼠的利水作用研究[J].辽宁中医杂志,2017,44(5):1096-1099.
[16] 刘锐,侯体保,何嘉,等.清气化痰通络方治疗慢性阻塞性肺疾病急性加重期临床观察[J].中华中医药杂志,2019,34(10):4753-4757.
[17] 邹纯才,徐启祥,鄢海燕,等.瓜蒌不同溶剂提取物的抗氧化活性及保护大鼠心肌缺血再灌注损伤的作用[J].中国药学杂志,2017,52(2):124-129.
[18] 黄芳,李晶晶,尹强,等.瓜蒌-薤白药对治疗心血管及肺部疾病作用机制的研究进展[J].山东医药,2017,57(41):106-109.
[19] 栾哲宇,李小娟,李杨,等.基于“伏邪”理论探讨慢阻肺稳定期的病机与治疗[J].中医药学报,2022,50(5):55-58.
[20] 李杨,李小娟.以“金郁泄之”理论探讨慢阻肺急性加重期的中医治疗方法[J].中国中医急症,2021,30(5):833-842.