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[目的]观察香砂六君子合大黄汤联合西药治疗慢性阻塞性肺疾病无创通气后胃肠功能障碍疗效。[方法]使用随机平行对照方法,将104例住院患者按掷骰子法简单随机分为两组。采取VELA型呼吸机进行无创正压通气,设定为NPPV+PC模式。对照组48例氨溴索30mg/次,3次/d,静推;甲强龙0.5g+250m L 9%生理盐水,2次/d,静滴;氨茶碱0.25g+250m L 5%葡萄糖,2次/d,静滴。治疗组56例香砂六君子合大黄汤(党参、白术各15g,茯苓12g,甘草4g,陈皮5g,半夏、砂仁各6g,木香4g,生大黄~(后下)10g),1剂/d,水煎400m L,早晚口服,200m L/次。西药治疗同对照组。连续治疗7d为1疗程。观测临床症状、腹内压、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组痊愈20例,显效20例,有效13例,无效3例,总有效率94.64%。对照组痊愈8例,显效8例,有效20例,无效12例,总有效率75.00%。治疗组疗效优于对照组(P<0.01)。腹内压两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]香砂六君子合大黄汤联合西药治疗慢性阻塞性肺疾病无创通气后胃肠功能障碍疗效满意,无严重不良反应,值得推广。
[Objective] To observe the efficacy of Xiangsha Liujunzi Dahuang Decoction combined with western medicine in treating gastrointestinal dysfunction after noninvasive ventilation of chronic obstructive pulmonary disease. [Methods] Using randomized parallel control method, 104 inpatients were randomly divided into two groups according to the method of dice rolling. Take VELA ventilator non-invasive positive pressure ventilation, set to NPPV + PC mode. The control group 48 ambroxol 30mg / times, 3 times / d, intravenous injection; methylprednisolone 0.5g +250 m L 9% saline 2 times / d, intravenous infusion; aminophylline 0.25g + 250m L 5% Glucose, 2 times / d, intravenous infusion. In the treatment group, 56 cases of Xiangsha Liujunzihu Dahuang Decoction (15g of Codonopsis, Atractylodes, 12g of Poria cocos, 4g of licorice, 5g of dried tangerine peel, 5g of dried tangerine peel, 6g of pinellia tuber, 4g of woody yellow, 10g of rhubarb ~ Agent / d, decoction 400m L, morning and evening oral, 200m L / time. Western medicine treatment with the control group. Continuous treatment 7d for a course of treatment. Observation of clinical symptoms, intra-abdominal pressure, adverse reactions. Continuous treatment of 2 courses to determine the efficacy. [Result] In the treatment group, 20 cases were cured, 20 cases were markedly effective, 13 cases were effective and 3 cases were ineffective. The total effective rate was 94.64%. The control group recovered in 8 cases, markedly effective in 8 cases, effective in 20 cases, ineffective in 12 cases, the total effective rate was 75.00%. The treatment group than the control group (P <0.01). Intra-abdominal pressure was improved in both groups (P <0.01), and the treatment group improved better than the control group (P <0.01). [Conclusion] Xiangsha Liujunzi Dahuang Decoction combined with western medicine has satisfactory curative effect on gastrointestinal dysfunction after noninvasive ventilation in patients with chronic obstructive pulmonary disease. It has no serious side effects and is worth popularizing.