Intervention Study Of TCM Triple Therapy Combined With Comfortable Nursing On Patients With AECOPD Invasive Mechanical Ventilation

Objective:To explore the effect of traditional Chinese medicine(TCM)triple therapy combined with comfortable nursing on the prognosis of AECOPD patients with invasive mechanical ventilation,to provide theoretical guidance and evidence-based basis for patients' rehabilitation,and to develop a nursing plan with the overall concept of traditional Chinese medicine.by investigating the comfort degree,satisfaction rate,anxiety,complication rate,the average days with ventilator and days in ICU(Intensive Care Unit,ICU)of AECOPD patients' with invasive MV.Method:1.With single blind randomized controlled method,192 patients with AECOPD were randomly divided into control group and observation group,each group has 96 cases.2.Intervention methods:Routine nursing mode was implemented in control group,and TCM the triple method combined with Comfort Care mode was implemented in observation group on the basis of routine nursing mode.The intervention time was to start using the ventilator to remove the tracheal intubation.3.Statistical methods:The numerical value is represented by the mean±standard deviation(x ±S).ANOVA or t-test were used to comparison between groups,chi-square Test is used to the analysis of Counting data and comparison of rate,with a significant difference between the two groups(P<0.05).Results:1 General informationIn the observation group,2 cases were excluded(1 case died of aggravation.1 case was abandoned by family members),94 cases were included in the study,including 66 males and 28 females,aged 52 to 85 years old.Control group:one case was excluded(1 case was abandoned by family members),95 cases were included in the study,including 65 males and 30 females,aged 50 to 83 years old.The results showed that there were no significant differences between the two groups in gender,age,education,and severity of illness,scores of Hamilton Anxiety Scale(HAMA)(P>0.05),they are Comparable.2 Comfort degreeThe results of Kolcaba's comfort condition scale showed that there were significant differences in comfort degree and high comfort rate between the observation group and the control group(P<0.01),and the observation group was superior to the control group.3 Anxiety scoreThe results of Hamilton Anxiety Scale(HAMA)showed that the HAMA scores of both groups were between 14 and 20,belonged to mild anxiety,scored on the second morning of MV and 1 hours before stopping MV,but the difference was significant(P<0.01),and the scores of observation group was lower than the control group.4 Complication incidenceThere was a significant difference in the incidence of pipe-shift between the two groups(P<0.05).and a significant difference in oral ulcer and VAP incidence(P<0.01),the observation group incidence was lower than the control group.5 Mean mechanical ventilation time?ICU average hospital dayThere was a significant difference between the two groups in the mean duration with mechanical ventilation and ICU average hospital day(P<0.01),the observation group was lower than the control group.6 Cognition of nursing staff96.55%nurses think that TCM triple combined with Comfort Care can improve the disease observation and risk assessment coincidence ability of professional nurses;82.76%think it can enhance critical thinking ability:93.10%think it can increase the frequency of active request for sputum aspiration from patients;100%think it can promote technological innovation,increase the tacit degree of nurse-patient cooperation,improve problem-solving ability,work efficiency,psychological intervention ability,reduce the restraint band use frequency,improve the patients' comfort degree.7 Satisfaction rateAfter tracheal intubation extraction,there was significant difference between the two groups in nursing satisfaction rate(P<0.05),and the observation group was superior to the control group.Conclusion:Improving nurses' cognition and carrying out TCM the triple method combined with Comfort Care can improve the comfort degree and satisfaction rate of patients with AECOPD,relieve anxiety,reduce the complications incidence such as oral ulcer,pipe shift,VAP and so on.The combination of TCM the triple method and Comfort Care is an effective nursing scheme to intervene the adverse reaction and prognosis of AECOPD with invasive mechanical ventilation.