自拟化痰祛瘀方联合无创呼吸机治疗OSAHS合并COPD急性加重伴肺性脑病疗效观察

目的 观察使用自拟化痰祛瘀方联合无创呼吸机治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并慢性阻塞性肺疾病(COPD)急性加重伴肺性脑病的临床疗效。方法 选择2018年6月～2019年2月本院收治的60例西医诊断明确的OSAHS合并COPD急性加重伴肺性脑病患者,中医辨证为痰瘀互结,使用随机数字表法将患者随机分为两组,对照组和试验组各30例。对照组使用西医常规治疗联合无创呼吸机治疗,试验组使用西医常规治疗联合无创呼吸机,同时服用化痰祛瘀方治疗,疗程为15 d。观察并比较两组患者睡眠监测指标、血气分析指标和治疗效果情况。结果 经治疗后两组患者的呼吸暂停低通气指数(AHI)、夜间睡眠时最低血氧饱和度(LSaO2)以及血氧饱和度低于90%时间所占总睡眠时间百分比,治疗后血气分析中的二氧化碳分压(PaCO2)、氧分压(PaO2)、血氧饱和度(SaO2)、肺性脑病均有明显改善,且试验组改善优于对照组,差异有统计学意义(P0.05)。结论 中药化痰祛瘀联合无创呼吸机治疗可显著改善OSAHS合并COPD急性加重的临床症状,改善呼吸衰竭,有效治疗肺性脑病。

Therapeutic effect of self-made huatanquyu decoction combined with non-invasive ventilator on OSAHS combined with acute exacerbation of COPD and pulmonary encephalopathy

Objective To observe the clinical effect of the use of huatanquyu decoction combined with non-invasive ventilator in the treatment of obstructive sleep apnea-hypopnea syndrome(OSAHS) with acute exacerbation of chronic obstructive pulmonary disease (COPD) combined with pulmonary encephalopathy.Methods 60 patients diagnosed with OSAHS and COPD with acute exacerbation and pulmonary encephalopathy were enrolled in the hospital from June 2018 to February 2019.Their TCM syndrome was tanyu hujie.The patients were randomly divided into two groups according to the random number table,with 30 cases in the control group and the test group.The control group was treated with Western medicine routine treatment combined with non-invasive ventilator.The test group was treated with Western medicine routine treatment combined with non-invasive ventilator and treated with huatanquyu decoction.The course of treatment was 15 days.The sleep monitoring indicators,blood gas index and clinical effect between the two groups were compared.Results After treatment,the apnea hypopnea index (AHI),the lowest oxygen saturation when sleeping at night (LSaO2) and the percentage of oxygen saturation <90% in the total sleep time,partial pressure of carbon dioxide(PaCO2),partial pressure of oxygen(PaO2),oxygen saturation(SaO2),and pulmonary encephalopathy in blood gas analysis after treatment were significantly improved,and the improvement of the experimental group was better than that of the control group,with statistically significant difference(P<0.05).Conclusion Chinese huatanquyu combined with non-invasive ventilator can significantly improve the clinical symptoms of OSAHS combined with acute exacerbation of COPD,improve respiratory failure,and effectively treat pulmonary encephalopathy.