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目的:观察醒脑静注射液联合双水平正压(Bi PAP)无创通气治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并肺性脑病患者的临床疗效及对降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)和生活质量的影响。方法:选择2013年1月~2016年1月在延安大学附属医院呼吸内科就诊治疗的AECOPD合并肺性脑病患者150例,按照完全随机原则分为观察组和对照组,每组各75例。对照组给予氧疗、抗炎、平喘、Bi PAP无创通气等常规治疗;观察组在常规治疗的基础上给予醒脑静注射液治疗。连续治疗5天。结果:治疗后观察组总有效率显著高于对照组(P<0.05)。治疗后两组患者肺功能(FEV1、PEF)、血气分析(pH、PaCO_2、PaO_2)及CAT评分均较治疗前改善,观察组改善显著优于对照组(P<0.05)。治疗后两组患者血清hs-CRP、PCT水平均较治疗前显著降低(P<0.05),且观察组hs-CRP、PCT水平显著低于对照组(P<0.05)。结论:醒脑静注射液联合Bi PAP无创通气治疗AECOPD合并肺性脑病疗效较好,可有效缓解临床症状,改善呼吸衰竭,提高生活质量和运动耐力,降低血清炎症因子水平,对肺康复具有较好作用。
Objective: To observe the clinical effect of Xingnaojing injection and Bi PAP noninvasive ventilation in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pulmonary encephalopathy, Sensitive C-reactive protein (hs-CRP) and quality of life. Methods: From January 2013 to January 2016, 150 patients with AECOPD complicated with pulmonary encephalopathy were treated in Department of Respiratory Medicine, Yan’an University Affiliated Hospital. The patients were randomly divided into observation group and control group, with 75 cases in each group. The control group was given oxygen therapy, anti-inflammatory, antiasthmatic, Bi PAP non-invasive ventilation and other conventional treatment; the observation group was given Xingnaojing injection on the basis of routine treatment. Continuous treatment for 5 days. Results: The total effective rate of the observation group after treatment was significantly higher than that of the control group (P <0.05). The pulmonary function (FEV1, PEF), blood gas analysis (pH, PaCO_2, PaO_2) and CAT scores of two groups after treatment were better than those before treatment, and the improvements in the observation group were significantly better than those in the control group (P <0.05). The serum hs-CRP and PCT levels in both groups were significantly lower than those before treatment (P <0.05), and the levels of hs-CRP and PCT in the observation group were significantly lower than those in the control group (P <0.05). Conclusion: Xingnaojing injection combined with Bi PAP noninvasive ventilation is effective in treating AECOPD with pulmonary encephalopathy, which can effectively relieve clinical symptoms, improve respiratory failure, improve quality of life and exercise tolerance, reduce serum levels of inflammatory cytokines, Good effect.