Wang W, Niu R J
Tongji Hospital, Tongji Medical University, Wuhan.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 1993 Feb;13(2):91-3, 69.
Diaphragmatic muscle fatigue (DMF) has long been recognized as causing and developing respiratory failure in patients with chronic obstructive pulmonary disease (COPD). Paradoxical motion of thoraco-abdomen is one of asynchronous breathing pattern, which is clinical sign of DMF. Thoracoabdominal motion curves were recorded with impedance respirograph (IRG). Indexes, alpha and M on IRG correlated well to the degrees of asynchronous breathing movement. 30 patients with COPD, their IRG showed paradoxical motion of thoraco-abdomen were divided randomly into two groups of 15 cases. Group A was treated intravenously with Sheng Mai injection at first and with glucose later. Among patients of group B, preceding Sheng Mai injection was glucose. IRG were recorded before and after treatment. Results showed that the IRG of 26 patients treated with Sheng Mai injection changed from paradoxical pattern to sychronous one. The difference of the indexes alpha and M before and after treatment of Sheng Mai injection was statistically significant (P < 0.001). Only one patient treated with glucose changed from paradoxical to sychronous pattern. The difference of the indexes between treated and non-treated with glucose was not statistically significant (P < 0.05). This study suggest that Sheng Mai injection has a positive inotropic effect on fatigued diaphragmatic muscle.
膈肌疲劳（DMF）长期以来一直被认为是慢性阻塞性肺疾病（COPD）患者呼吸衰竭的病因及发展因素。胸腹矛盾运动是一种呼吸不同步模式，是DMF的临床体征。用阻抗呼吸描记器（IRG）记录胸腹运动曲线。IRG上的α和M指标与呼吸不同步运动程度密切相关。30例COPD患者，其IRG显示有胸腹矛盾运动，随机分为两组，每组15例。A组先静脉注射生脉注射液，后注射葡萄糖。B组患者先注射葡萄糖，后注射生脉注射液。治疗前后记录IRG。结果显示，26例接受生脉注射液治疗的患者IRG从矛盾模式转变为同步模式。生脉注射液治疗前后α和M指标差异有统计学意义（P<0.001）。仅1例接受葡萄糖治疗的患者从矛盾模式转变为同步模式。葡萄糖治疗组与未治疗组指标差异无统计学意义（P<0.05）。本研究表明，生脉注射液对疲劳膈肌有正性肌力作用。
