"Step Sequential Rule Is" Worse Off Clinical Research In Patients With Chronic Obstructive Pulmonary Disease And Acute

Objective:To observe the effects of the "three-step sequential treatment" to offline of Acute Exacerbation Chronic Obstructive Pulmonary Disease (AECOPD) patients. Besides, we study the treatment’s feasibility and safety. So we can come up with new ideas in clinical treatment of this disease.Method:The60individuals who met the inclusion criteria are randomly divided into two groups, test group and control group, every group have30people, test group is used a "three-step sequential treatment" and routine western medicine, control group only is used western medicine, treatment for14days. Records of patients general information, medical history, admission consciousness and so on. We observe the change of numerical indicators of the two groups, such as duration of mechanical ventilation, offline success rate, comparing two groups of patients after arterial blood gas (pH, PaO2, PaCO2), oxygenation index,24h sputum volume, infection indicators (WBC, N%, CRP), nutrition indicators (ALB, HGB). Then, we analyze data using statistical methods and provide evaluation of treatment effect.Results:1. Compared with the sex, age, duration of admission consciousness, concomitant diseases, arterial blood gases, oxygenation index,24h sputum volume, infection indicators, nutrition indicators of the two groups patients before treatment, the difference is not statistically significant (P>0.05), its comparable.2. Compare the two groups, continuous mechanical ventilation after treatment14days have a significant difference (P<0.05); the test group surpass the control group. Test group of29patients, the disposable of offline success rate is55.17%, the total of offline success rate is89.66%. control group of28patients, the disposable of offline success rate is28.57%, the total of offline success rate is67.86%, compared the disposable of offline success rate, the total of offline success rate of the two groups have significant statistical difference (P<0.05), the test group surpass the control group.3.7and14days after treatment, both groups were decreased PaCO2, PH and PaO2were higher than before, there are very significant difference when comparing the group with the inclusion (P<0.01), but arterial blood gas of the two groups have no statistically significant difference (P>0.05); oxygenation index was higher than before, there are very significant difference when comparing the group with the inclusion(P<0.01), comparing7days with14days after treatment have statistically significant differences (P<0.05), the test group surpass the control group.4.24h expectoration7and14days after treatment, both groups were decreased, and there is a significant statistical difference (P<0.01) when comparing the groups with the inclusion;24h sputum volume between the two treatment groups has statistically significant difference (P<0.05)7days after treatment, the test group surpass the control group; there are no statistically significant difference between groups after treatment14days (P>0.05).5.7and14days after treatment, WBC, N%, CRP declined, there are significant difference when comparing the group with the inclusion(P<0.05); Comparing two groups of patients, WBC, CRP have a statistically significant difference between the groups after7 days of infection index (P<0.05), the test group surpass the control group; N%after treatment7days have no statistically significant (P>0.05); Comparing two groups of patients, WBC have very statistically significant difference between the groups after14days of infection index (P<0.01), the test group surpass the control group; N%have no statistically significant difference (P>0.05); CRP have a significant difference (P<0.05), test group surpass the control group.6.7and14days after treatment, ALB, HGB level before treatment was significantly higher, there are a significant difference when comparing the group with the inclusion (P<0.01); two groups of patients7and14days of nutrition comparison between the index of the group, there are no statistically significant difference (P>0.05).7. During the study, two groups of patients are not found significant adverse reactions and side effects.Conclusion:1. Plus "three-step sequential treatment" on the basis of conventional treatment can effectively reduce the duration of mechanical ventilation in patients and improve the disposable and the total offline success rate. Significantly increased oxygenation index.2. Plus "three-step sequential treatment" on the basis of conventional treatment can significantly reduce the amount of sputum24h, lower WBC, CRP level, which may reduce the risk of infection.3. The "three-step sequential treatment" combined conventional treatment period found no adverse reactions, and good safety.In summary, plus "three-step sequential treatment" on the basis of conventional treatment can effectively reduce the duration of mechanical ventilation in patients and improve the disposable and the total offline success rate. Significantly increased oxygenation index; plus "three-step sequential treatment" on the basis of conventional treatment can significantly reduce the amount of sputum24h, lower WBC, CRP level, which may reduce the risk of infection, further research is needed to verify; The "three-step sequential treatment" combined conventional treatment is safety.