摘要
目的观察瓜蒌大黄汤联合无创通气(NIV)治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭(RF)的疗效及对血气指标、肺功能的影响。方法选取于本院治疗的114例AECOPD合并RF患者,采用随机数字表法分为NIV组与大黄汤组各57例。NIV组采用常规治疗加NIV治疗,大黄汤组在NIV组基础上加用瓜蒌大黄汤治疗。比较两组临床疗效、相关评分指标、肺功能[用力肺活量(FVC)、最大呼气流量(PEF)、第1秒用力呼气容积(FEV_(1))]、血清炎症因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)]、血气指标[动脉血氧分压(PaO_(2))、pH、动脉血二氧化碳分压(PaCO_(2))]。结果大黄汤组总有效率为92.98%,显著高于NIV组的77.19%(P<0.05);两组中医证候积分、圣乔治呼吸问卷(SGRQ)评分、CRP、TNF-α、PCT、PaCO_(2)水平均下降,且大黄汤组显著低于NIV组(P<0.05);两组FVC、PEF、FEV_(1)、PaO_(2)水平均升高,且大黄汤组显著高于NIV组(P<0.05)。结论瓜蒌大黄汤联合NIV治疗AECOPD合并RF患者具有较好的疗效,能够缓解相关中医证候,改善体征,减少气流受限,改善血气情况及呼吸功能,抑制炎性因子释放,控制疾病发展,促进肺功能恢复,提高生活质量。
Objective:To observe the clinical efficacy of Gualou Dahuang Decoction combined with non-inva-sive ventilation(NIV)in treating patients with acute exacerbation of chronic obstructive pulmonary disease(AECO-PD)complicated with respiratory failure(RF),and to evaluate its effects on blood gas parameters and pulmonary function.Methods:A total of 114 patients with AECOPD complicated by RF treated in our hospital were random-ly divided into an NIV group and a Gualou Dahuang Decoction group(57 cases each).The NIV group received conventional treatment and NIV,while the Gualou Dahuang Decoction group received additional treatment with Gualou Dahuang Decoction.Outcomes including therapeutic effect,symptom scores,pulmonary function[forced vital capacity(FVC),peak expiratory flow(PEF),forced expiratory volume in one second(FEV_(1))],serum inflammato-ry factors[C-reactive protein(CRP),tumor necrosis factor(TNF)-α,procalcitonin(PCT)],and blood gas indica-tors[arterial oxygen pressure(PaO_(2)),pH,arterial carbon dioxide pressure(PaCO_(2))]were compared between groups.Results:The total effective rate in the Gualou Dahuang Decoction group was 92.98%,which was signifi-cantly higher than 77.19%in the NIV group(P<0.05).Both groups showed reductions in TCM syndrome scores,St.George's Respiratory Questionnaire(SGRQ)scores,CRP,TNF-α,PCT,and PaCO_(2),levels after treatment,with greater improvements observed in the Gualou Dahuang Decoction group(P<0.05).Increases in FVC,PEF,FEV_(1),and PaO_(2)were also observed in both groups,with more significant improvements in the Gualou Dahuang Decoction group(P<0.05).Conclusion:The combination of Gualou Dahuang Decoction and NIV demonstrates favorable therapeutic effects in treating AECOPD with RF.It can effectively alleviate TCM syndromes,relieve symptoms,re-duce airflow obstruction,improve blood gas status and respiratory function,inhibit inflammatory responses,control disease progression,promote pulmonary function recovery,and enhance quality of life.
作者
杨莹
冯瑞琪
王彤冉
苏奎国
Yang Ying;Feng Ruiqi;Wang Tongran;Su Kuiguo(Hebei University of Chinese Medicine,Hebei,Shijiazhuang 050091,China)
出处
《中国中医急症》
2025年第8期1375-1378,共4页
Journal of Emergency in Traditional Chinese Medicine
基金
河北省中医药管理局科研计划项目(2019014)。
关键词
慢性阻塞性肺疾病
呼吸衰竭
瓜蒌大黄汤
无创通气
肺功能
Chronic obstructive pulmonary disease
Non-invasive ventilation
Gualou Dahuang Decoction
Respi-ratory failure
Pulmonary function
作者简介
通信作者:苏奎国。
