Zhong Lian-Jiang, Zhang Lian-Sheng, Gu Chun-Feng, Long Jun, Shen Juan-Hui, Zhu Chen-Yang, Cheng Ling-Zhi, Zhang Ying-Zhang
Department of Internal Medicine, the Second People＇s Hospital of Tongxiang City, Tongxiang 314511, China.
Zhongguo Zhong Yao Za Zhi. 2018 Jul;43(14):3026-3030. doi: 10.19540/j.cnki.cjcmm.20180327.002.
To observe the effect of Xiaoqinglong decoction combined with noninvasive ventilation on procalcitonin (PCT), blood gas analysis and respiratory functions in acute exacerbation of chronic obstructive pulmonary disease in the elderly (AECOPD), and investigate its correlation and clinical significance. Eighty-four elderly AECOPD patients with respiratory failure in our hospital from January 2015 to October 2017, were randomly divided into control group and observation group, 42 cases in each group. The control group received western medicine combined with noninvasive ventilator therapy, and the patients in observation group additionally received Xiaoqinglong decoction on the basis of the treatment in control group. Both groups were treated for 2 weeks. The clinical effects of two groups were observed and their PCT, blood gas analysis outcomes [arterial oxygen partial pressure (PaO₂), arterial partial pressure of carbon dioxide (PaCO₂), respiratory function, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC], TCM syndrome score and other indexes and adverse reactions were compared before and after treatment. The total efficiency was 95.24% (40/42) in observation group, higher than 76.19% (32/42) in control group, with statistically significant difference (<0.05). There were no statistically significant differences in PCT, PaO₂, PaCO₂, FVC, FEV1/FVC, FEV1, and TCM syndrome scores between two groups before treatment. But after treatment, PCT and PaCO₂ levels in the observation group were lower and PaO₂, FVC, FEV1/FVC, FEV1 levels was higher than those in the control group (<0.05); TCM syndrome scores were lower than those in the control group (<0.05); both groups had no obvious adverse reactions. The results showed that Xiaoqinglong decoction combined with noninvasive ventilator could significantly reduce the procalcitonin level, effectively improve the respiratory function and blood gas analysis indexes, and significantly reduce the clinical symptoms in AECOPD patients, so it is worthy of promotion.
观察小青龙汤联合无创通气对老年慢性阻塞性肺疾病急性加重期（AECOPD）患者降钙素原（PCT）、血气分析及呼吸功能的影响，并探讨其相关性及临床意义。选取2015年1月至2017年10月我院收治的84例老年AECOPD呼吸衰竭患者，随机分为对照组和观察组，每组42例。对照组采用西药联合无创通气治疗，观察组在对照组治疗基础上加用小青龙汤。两组均治疗2周。观察两组临床疗效，比较治疗前后两组患者的PCT、血气分析指标[动脉血氧分压（PaO₂）、动脉血二氧化碳分压（PaCO₂）、呼吸功能、用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、FEV1/FVC]、中医证候积分等指标及不良反应。观察组总有效率为95.24%（40/42），高于对照组的76.19%（32/42），差异有统计学意义（<0.05）。治疗前两组患者PCT、PaO₂、PaCO₂、FVC、FEV1/FVC、FEV1及中医证候积分比较，差异无统计学意义。但治疗后，观察组PCT及PaCO₂水平低于对照组，PaO₂、FVC、FEV1/FVC、FEV1水平高于对照组（<0.05）；中医证候积分低于对照组（<0.05）；两组均无明显不良反应。结果表明，小青龙汤联合无创通气可显著降低AECOPD患者降钙素原水平，有效改善呼吸功能及血气分析指标，明显减轻临床症状，值得推广。
