大承气汤灌肠联合有创机械通气治疗慢性阻塞性肺疾病呼吸衰竭疗效观察

目的观察大承气汤灌肠联合有创机械通气治疗重症慢性阻塞性肺疾病（COPD）呼吸衰竭患者的临床疗效。方法将78例重症COPD呼吸衰竭患者随机分为治疗组与对照组各39例，均采用有创机械通气及西医常规治疗，治疗组加用大承气汤灌肠，疗程7d。于治疗第2日观察两组患者的氧合指数（OI）、肺动态顺应性（Cdyn）；治疗第7日观察两组患者机械通气并发症发生率、脱机例数；治疗结束后观察最终脱机成功率、机械通气时间、住ICU时间及病死率。结果治疗组OI、Cdyn、机械通气并发症发生率、脱机例数、最终脱机成功率、机械通气时间、住ICU时间及病死率等方面优于对照组（P〈0．05）。结论大承气汤灌肠可改善COPD呼吸衰竭患者Cdyn、肺氧合功能，减少机械通气并发症，缩短机械通气时间，提高脱机成功率，并最终提高救治效果。

Observation of Dachengqi Decoction Enema combined with Invasive Mechanical Ventilation on Patients with COPD induced Respiratory Failure

Objective： To observe the therapeutic effects of Dachengqi Decoction enema combined with invasive mechanical ventilation（MV） on patients with COPD induced respiratory failure. Methods： 78 patients with COPD induced respiratory failure were selected and randomly divided into the treatment group and the control group with 39 cases in each group. The control group was treated with MV and routine western medicine. The treatment group was added with Dachengqi Decoction enema. Some indicators including oxygenation index （OI） and pulmonary dynamic compliance （Cdyn） were observed and compared between the two groups 2 days after. Complications of MV, number of ventilator withdrawal were observed 7 days after total. Success rate of ventilator withdrawal, MV time,days in ICU and mortality rate were observed after treatment. Results： In the treatment Group, OI, Cdyn, complications of MV, number of ventilator withdrawal, total success rate of ventilator withdrawal, MV time , days in ICU and mortality rate were better obviously than those of control group （P〈 0.05 or 0.01 ）. Conclusion： Dachengqi Decoction enema can markedly improve oxygenation function and Cdyn of lung in patients with COPD induced respiratory failure. Meanwhile,it can reduce the complications of MV, shorten MV time,improve success rate of ventilator withdrawal and eventually increase treatment effect.