Clinical Study Of Modified Xiezhuo Naqi Decoction In The Treatment Of COPD Complicated With Pulmonary Encephalopathy

Objective:The purpose of this study was to observe the clinical effect of Xiezhuo Naqi decoction on COPD patients with lung and kidney qi deficiency and phlegm stagnation syndrome,TCM syndrome score,Glasgow coma score（GCS）,serum prealbumin（PA）,interleukin-6（IL-6）,blood gas analysis,tracheal intubation rate of the two groups and per capita mechanical ventilation time.To explore the clinical efficacy and safety of modified Xiezhuo Naqi decoction in the treatment of COPD complicated with pulmonary encephalopathy,and to provide theoretical basis for the prevention and treatment of COPD complicated with pulmonary encephalopathy by combination of traditional Chinese and western medicine in the future.Method:In this study,60 inpatients in the Department of Respiratory and critical Medicine,Ruikang Hospital affiliated to Guangxi University of traditional Chinese Medicine from February 2021 to February 2022 were randomly divided into control group（n=30）and treatment group（n=30）.The patients were divided into control group（n=30）and treatment group（n=30）according to the syndrome of lung and kidney qi deficiency and phlegm stagnation of pulmonary encephalopathy.Control group received conventional western medicine treatment（anti-infection,expectorant,bronchial dilation,non-invasive mechanical ventilation,etc.）The treatment group was treated with Xiezhuo Naqi decoction for 5 days on the basis of the control group.Five days later,the differences in clinical efficacy,TCM syndrome score,Glasgow coma score,serum prealbumin,interleukin-6,blood gas analysis,endotracheal intubation rate and per capita mechanical ventilation time were compared between the two groups.Results:（1）In the control group,there were 30 cases,4 cases of detachment and 26 cases of completion.In the treatment group,there were 30cases,2 cases fell off,28 cases completed,a total of 54 cases completed.（2）comparison of clinical efficacy:the total effective rate of the control group was 65.38%,and that of the treatment group was 85.71%.The treatment group was superior to the control group（P<0.05）.（3）Comparison of TCM syndrome scores:before treatment,the main symptoms（wheezing,abnormal consciousness,expectoration）and secondary symptoms（cough,constipation,abdominal distension,sore waist and knees）were comparable between the two groups（P>0.05）.It decreased significantly after treatment（P<0.05）,and after treatment,the treatment group was better than the control group（P<0.05）.（4）comparison of IL-6,PA,GCS score,blood gas analysis（PH,Pa O₂,Pa CO₂）:IL-6,PA,GCS score,blood gas analysis（PH,Pa O₂,Pa CO₂）of the control group and the treatment group were improved after treatment,and the difference was statistically significant.（5）comparison of endotracheal intubation rate:the endotracheal intubation rate in the treatment group was lower than that in the control group（P<0.05）.（6）comparison of per capita mechanical ventilation time:the ventilation time in the treatment group was shorter than that in the control group,and the difference was statistically significant（P<0.05）.Conclusion:（1）modified Xiezhuo Naqi decoction can improve the clinical effect of COPD complicated with pulmonary encephalopathy with lung and kidney qi deficiency and phlegm stagnation syndrome,and improve TCM syndrome.（2）Xiezhuo Naqi decoction can relieve airway inflammation and restore the nutritional status of patients to a certain extent.（3）Modified Xiezhuo Naqi decoction can shorten the time of mechanical ventilation,reduce the dependence of non-invasive ventilator,quickly correct hypoxemia and hypercapnia,promote the recovery of patients,reduce the rate of endotracheal intubation,delay the progress of the disease and improve the prognosis.（4）Xiezhuo Naqi decoction is safe and has no obvious side effects.