清肺化痰中药配合呼吸机无创正压通气救治慢性阻塞性肺病伴呼吸衰竭的疗效观察_医学论文.docVIP

清肺化痰中药配合呼吸机无创正压通气救治慢性阻塞性肺病伴呼吸衰竭的疗效观察_医学论文 清肺化痰中药配合呼吸机无创正压通气救治慢性阻塞性肺病伴呼吸衰竭的疗效观察_医学论文 作者：张瑜，李剑莹，邓屹琪，张忠德，江俊珊，张文青，徐慧聪 【摘要】 【目的】观察清肺化痰为主中药配合呼吸机无创正压通气救治慢性阻塞性肺疾病(COPD)急性发作合并Ⅱ型呼吸衰竭的疗效。【方法】将41例患者随机分为观察组(21例)和对照组(20例)，两组患者均予以常规西药及BiPAP呼吸机进行无创性间歇正压通气治疗，观察组同时予以中药汤剂(药物组成：苇茎、薏苡仁、冬瓜仁、瓜蒌皮、黄芩、北杏、枳实、桃仁、丹参、党参、茯苓、胆星、法半夏)口服。比较两组患者治疗后的血气变化情况和成功脱机患者的无创通气治疗时间。【结果】治疗后两组的pH值和动脉血氧分压(PaＯ２）均有所升高(Ｐ＜００５或Ｐ＜００1)，动脉血二氧化碳分压(PaＣＯ２)有所下降(Ｐ＜００1)；两组比较，观察组在改善PaＣＯ２和PaＯ２方面优于对照组(Ｐ＜００５或Ｐ＜００1)。观察组无创通气时间较对照组缩短(Ｐ＜００５)。【结论】清肺化痰为主中药配合呼吸机无创正压通气救治COPD急性发作合并Ⅱ型呼吸衰竭可改善患者通气换气功能，缩短呼吸机无创通气时间。 【关键词】 肺疾病，慢性阻塞性/中西医结合疗法；呼吸功能不全/中西医结合疗法；通气机，机械/治疗应用；苇茎汤/治疗应用；清气化痰丸/治疗应用 　　【Objective】To observe the therapeutic effect of herbal medicine mainly with the actions of clearing lung and removing phlegm on type Ⅱ respiratory failure patients with acute exacerbation of chronic obstructive pulmonary diseases receiving positivepressure noninvasive ventilation. 　　 　　【Methods】Forty one patients were randomized into groups A (n=21) and B (n=20).The two groups received routine western medicine and bissure noninvasive ventilation.Group A received decoction of herbal medicines (mainly composed of Culmus Phragmitis,Semen Coicis,Semen Benincasea,Pericarpium Trichosanthis,Radix Scutellariae,Semen Armeniacae,Fructus Aurantii Immaturus,etc.) additionally.The changes of blood gas parameters and noninvasive ventilation time in patients with respiratory machine removed were compared after treatment. 　　 　　【Results】Oxygen partial pressure (PaO2) and pH value increased,and carbon dioxide partial pressure (PaCO2) decreased in the two groups (P＜005 or P＜0＜0Ｐ＜００1 compared with group B).The noninvasive ventilation time was shortened in group A as compared with group B (P＜05). 　　 　　【Conclusion】Herbal medicine mainly with the actions of clearing lung and removing phlegm combined with noninvasive ventilation by respiratory machine can improve the ventilation of type Ⅱ respiratory failure patients with acute exacerbation of chronic obstructive pulmonary di