目的 探討參麥注射液聯(lián)合沙美特羅替卡松粉吸入劑治療慢性阻塞性肺疾病(COPD)合并呼吸衰竭的臨床療效。方法 選取2013年6月-2015年6月重慶三博長安醫(yī)院呼吸內(nèi)科收治的COPD合并呼吸衰竭患者78例,按治療方案的差別分為對照組和治療組,每組各39例。對照組患者在常規(guī)治療基礎(chǔ)上霧化吸入沙美特羅替卡松粉吸入劑,1吸/次,2次/d。治療組在對照組的基礎(chǔ)上靜脈輸注參麥注射液,100 mL/次,1次/d。兩組患者均治療14 d。觀察兩組臨床療效,并比較兩組患者的動(dòng)脈血?dú)庵笜?biāo)、肺功能指標(biāo),白細(xì)胞(WBC)、C反應(yīng)蛋白(CRP)和降鈣素原(PCT)的變化。結(jié)果 治療后,對照組與治療組患者的總有效率分別為79.49%、94.87%,兩組總有效率比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者的pH值和pO₂均較治療前顯著升高,而pCO₂卻較治療前顯著降低,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者FEV₁、FVC以及FEV₁/FVC均較治療前顯著升高,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者的WBC、CRP和PCT均較治療前顯著下降,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度明顯好于對照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 參麥注射液聯(lián)合沙美特羅替卡松粉吸入劑治療COPD合并呼吸衰竭具有較好的臨床療效,能降低呼吸道中的炎癥反應(yīng),明顯改善肺功能,具有一定的臨床推廣應(yīng)用價(jià)值

Objective To investigate the clinical effect of Shenmai Injection combined with Salmeterol Xinafoateand Fluticasone Propionate Powder for inhalation in treatment of chronic obstructive pulmonary disease (COPD) complicating with respiratory failure.Methods Patients (78 cases) with COPD complicating with respiratory failure in Department of Respiratory, Chongqing Sanbo Changan Hospital from June 2013 to June 2015 were enrolled in this study. According to the different treatment plan, patients were divided into control and treatment groups, and each group had 39 cases. The patients in the control group were aerosol inhalation administered with Salmeterol Xinafoateand Fluticasone Propionate Powder for inhalation on the basis of conventional treatment, 1 suck/time, twice daily. The patients in the treatment group were iv administered with Shenmai Injection on the basis of control group, 100 mL/time, once daily. The patients in two groups were treated for 14 d. After treatment, the efficacy was evaluated, and arterial blood gas indexes, pulmonary function indexes, WBC, CRP, and PCT in two groups were compared.Results After treatment, the clinical efficacies in the control and treatment groups were 79.49% and 94.87%, respectively, and there was difference between two groups (P<0.05). After treatment, pO₂ and PH in two groups were significantly increased, but the pCO₂ in two groups was significantly decreased, and the differences were statistically significant in the same group (P<0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant differences between two groups (P<0.05) After treatment, FEV₁, FVC, and FEV₁/FVC in two groups were significantly increased, and the differences were statistically significant in the same group (P<0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant differences between two groups (P<0.05). After treatment, WBC, CRP, and PCT in two groups were significantly decreased, and the differences were statistically significant in the same group (P<0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant differences between two groups (P<0.05).Conclusion Shenmai Injection combined with Salmeterol Xinafoateand Fluticasone Propionate Powder for inhalation has clinical curative effect in treatment of COPD complicating with respiratory failure, and can reduce inflammatory reaction in respiratory tract, significantly improve pulmonary function, which has a certain clinical application value.