摘要
目的应用"健脾益肺汤",观察健脾益肺法改善肺脾气虚型慢性阻塞性肺疾病(COPD)无创机械通气患者呼吸肌疲劳的疗效。方法选取COPD急性加重期无创机械通气、中医辨证具有肺脾气虚证的临床特点的患者,采用随机、对照研究方法,随机分为对照组(标准治疗组)和治疗组(标准治疗+健脾益肺汤剂口服组)。从患者开始到结束无创机械通气期间,观察患者的中医症状、呼吸肌疲劳、血气分析等指标。结果治疗组患者中医症状改善有效率89.7%,对照组58.6%,治疗组显著优于对照组(P<0.01);两组均可升高动脉血氧分压、降低二氧化碳分压(P<0.05),疗后两组各项指标之间比较差异无统计学意义(P>0.05);两组治疗后较治疗前肺功能各项指标均有明显改善(P<0.05);治疗组最大吸气压、最大呼气压显著升高且优于对照组,同时可以改善患者用力呼气1秒容量和呼吸频率,与对照组比较差异均有统计学意义(P<0.05)。结论在常规无创通气治疗基础上,应用健脾益肺法,采用经验方"健脾益肺汤",能够进一步改善临床症状、缓解患者呼吸肌疲劳,改善呼吸衰竭。
Objective To observe the efficacy of adopting strengthening spleen and tonifying lung method by using JPYF decoction, to improve the muscle strength of COPD patients＇who need non-invasive mechanical ventilation to release their respiratory muscle fatigue. Methods Subjects for this study were acute exacerbation of COPD patients who need noninvasive mechanical ventilation therapy to release symptoms of respiratory failure, and all the patients have the traditional Chinese medicine clinical features of Qi deficiency of lung and spleen. A randomized, controlled study was performed. All the patients were ran- domly divided into control group （ standard treatment group） and treatment group （ standard treatment group ＋ JPYF decoction orally taken group）. Observation was started when patient began to receive nonin- vasive mechanical ventilation therapy, the patient＇s clinical symptoms during the observation, indicators of respiratory muscle fatigue, blood gas analysis and other indicators were collected. Results The clinical symptoms in treatment group were improved by 89. 7% , and 58.6% of the control group, the treatment group was significantly better than the control group （ P 〈 0. 01 ） ; two groups show increased PaO2 , lower PaCO2 （P 〈 0. 05 ） after treatment. After treatment, the indicators of the two groups had no significant difference （ P 〉 0. 05 ） ; lung function were significantly improved after treatment （ P 〈 0. 05 ） ; MIP, MEP of treatment group were significantly increased than the control group, and compare to control group,FEVL % and RR can also be improved （P 〈 0. 05 ）. Conclusion On the basis of the conventional non-invasive ventilation, applying the method of strengthening spleen and tonifying lung, and using the experience prescription JPYF decoction can improve the clinical symptoms, relieve patients＇ respiratory muscle fatigue and improve respiratory failure.
出处
《环球中医药》
CAS
2013年第10期725-728,共4页
Global Traditional Chinese Medicine
基金
北京市中医药科技项目(QN2009-01)
关键词
健脾益肺汤
肺脾气虚型
慢性阻塞性肺疾病
无创机械通气
呼吸肌疲劳
Jianpi Yifei （JPYF） Decoction
Qi deficiency of lung and spleen
Chronic obstructive pulmonary disease
Non-invasive mechanical ventilation
Respiratory muscle fatigue
