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目的:观察加味小承气汤灌肠联合无创正压通气治疗慢性阻塞性肺病急性加重期(AECOPD)患者呼吸衰竭的临床疗效。方法:将32例AECOPD呼吸衰竭的患者随机分为治疗组与对照组,各16例,2组均采用无创正压通气及西医常规治疗方法,治疗组加用加味小承气汤保留灌肠。比较2组临床症状、血气分析、无创通气并发症、气管插管发生率及平均通气时间变化。结果:2组治疗24 h后心率(HR)、呼吸频率(RR)、血气分析指标较治疗前均有改善(P<0.05),2组间治疗后比较,差异无统计学意义(P>0.05)。2组治疗后腹胀、呕吐、误吸等症状发生率、气管插管率及平均通气时间比较,治疗组明显低于对照组,差异有统计学意义(P<0.05)。结论:加味小承气汤灌肠可减少AECOPD呼吸衰竭患者无创通气并发症,降低气管插管率,缩短无创通气时间。
Objective: To observe the clinical effect of Modified Xiaochengqi Decoction combined with noninvasive positive pressure ventilation on respiratory failure in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: Thirty-two patients with AECOPD respiratory failure were randomly divided into treatment group and control group, with 16 cases in each group. Non-invasive positive pressure ventilation and routine western medicine were used in the two groups. The treatment group was treated with Jiawei Xiaochengqi Decoction. The clinical symptoms, blood gas analysis, complications of noninvasive ventilation, incidence of tracheal intubation and mean duration of ventilation were compared between the two groups. Results: The heart rate (HR), respiratory rate (RR) and blood gas analysis index of two groups were all improved 24 h after treatment (P <0.05), but there was no significant difference between the two groups after treatment (P> 0.05 ). The incidence of abdominal distension, vomiting, aspiration and other symptoms, tracheal intubation rate and mean duration of ventilation in the two groups after treatment were significantly lower in the treatment group than in the control group (P <0.05). Conclusion: Modified Xiao Cheng Cheng Decoction can reduce non-invasive ventilation complications in AECOPD patients with respiratory failure, reduce tracheal intubation rate and shorten the duration of noninvasive ventilation.