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目的观察益气涤痰通腑汤辅助治疗脱机困难的慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者的临床疗效。方法将195例脱机困难的COPD合并呼吸衰竭患者随机分为治疗组100例和对照组95例,两组均采用机械通气、解痉化痰、导泻、抗感染、对症支持治疗,治疗组在此基础上鼻胃管灌服益气涤痰通腑汤,每日2次。治疗前和治疗第6、12天观察两组患者浅快呼吸指数(RSBI)、自主潮气量(sTv)及最大吸气负压(MIP)。治疗第6、12天记录两组患者脱机成功例数,计算脱机成功率,观察不良反应。结果治疗组治疗第6、12天脱机成功率分别为40.00%、78.00%,明显高于对照组的21.05%、43.16%。治疗组治疗第6、12天RSBI、sTv、MIP均较治疗前明显改善(P<0.05或P<0.01);对照组治疗第6、12天RSBI较治疗前明显降低,治疗第12天sTv、MIP均较治疗前明显升高(P<0.05或P<0.01)。治疗组治疗第6、12天RSBI、sTv、MIP均较对照组明显改善(P<0.05或P<0.01)。结论益气涤痰通腑汤辅助治疗脱机困难的COPD合并呼吸衰竭患者,能明显提高脱机成功率,改善通气功能。
Objective To observe the clinical efficacy of Yiqi Ditan Recipe Tongfu Decoction in the treatment of patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure. Methods A total of 195 patients with COPD complicated with respiratory failure who had difficulty in taking off-line were randomly divided into treatment group (n = 100) and control group (n = 95). The two groups were treated with mechanical ventilation, antispasmodic and phlegm, catharsis, On the basis of nasogastric tube to take Yiqi Ditan Tong Fu Tang, 2 times a day. Before treatment and on the 6th and 12th day of treatment, the shallow fast breathing index (RSBI), the independent tidal volume (sTv) and the maximum suction negative pressure (MIP) were observed. On the 6th and 12th days of treatment, the number of successful off-line patients in both groups was recorded, the off-line success rate was calculated, and the adverse reactions were observed. Results The successful rate of off-line on the 6th and 12th day in the treatment group was 40.00% and 78.00% respectively, which was significantly higher than that of the control group (21.05% and 43.16%). The RSBI, sTv and MIP of the treatment group on the 6th and 12th days were significantly improved (P <0.05 or P <0.01), while the RSBI of the control group on the 6th and 12th days was significantly lower than that before treatment, the sTv, MIP were significantly higher than before treatment (P <0.05 or P <0.01). The RSBI, sTv and MIP in the treatment group on the 6th and 12th days were significantly improved compared with the control group (P <0.05 or P <0.01). Conclusions Yiqi Ditan Recipe Tongfu Decoction can effectively improve off-line success rate and improve ventilation function in patients with COPD complicated with respiratory failure who have difficulty in off-line.