The Clinical Study Of Wen Dan Tang On Chronic Obstructive Pulmonary Disease Mechanical Ventilation

ObjectiveThis experiment by randomized, prospective observation of chronic obstructive pulmonary diseases acute exacerbation period (AECOPD) patients with mechanical ventilation in the indicators before and after taking Wen Dan tang’s research, explore Wen Dan Tang the effect of mechanical ventilation in patients with AECOPD time and clinical curative effect, for clinical rational use of Wen Dan tang in the treatment of AECOPD patients with mechanical ventilation.MethodThe collection between the ages of 18 to 80 years old, diagnosed as AECOPD mechanical ventilation "phlegm heat obstructing lung type patients in 60 cases, which were randomly divided into treatment group and control group. Two groups were given the same basic treatment of Western Medicine (mechanical ventilation, propofol sedation, anti infection, Antispasmodic, asthma, phlegm cough, Glucocorticoid therapy), the treatment group was treated with" phlegm "method of Wen Dan Decoction on the basis of Western Medicine (mainly composed of pinellia, dried tangerine peel, bamboo shavings, bitter orange, Tuckahoe, liquorices, composition) through gastric tube,2 times a day, each about 200ML by Bispectral index (Bispectral Index, BIS) objective sedation level, the BIS value in the range of 60-80 for sedation, sedation and sedation before the observation after 20min and 1D,3D,7d in the morning 10:00 BIS, the two groups of patients were treated for 7 days. The two groups were observed during propofol doses, stop sedative recovery time and Extubation time, mechanical ventilation (MV) time, two groups of clinical symptoms and blood gas analysis and other changes.ResultsCompared with before the calm, the treatment group and control group patients calm after 20 min mean arterial pressure (MAP), heart rate (HR), respiratory frequency (RR) were decreased, oxygen saturation (SP02) increases, the difference was statistically significant. Two groups of patients after treatment of PaC02, Pa02 was improved, the all have significant difference; After treatment of PaC02 (mmHg) treatment group was significantly lower than the control group (58.5±10.6、69.1±7.7, P<0.05), after treatment of Pa02 (mmHg) in the treatment group is significantly higher than control group (86.8 ±4.7、86.3±4.8, P<0.05), the mechanical ventilation can obviously improve the patient’s arterial oxygen partial pressure, reduce co2 partial pressure retention, but the curative effect of treatment group was superior to that of the control group. After treatment the treatment group and control group total effective rate was 93.10% and 68.97%, comparing the two groups have significant difference, the total effective rate of treatment group is higher than the control group; Compare the two groups in calm after 20 min and 1 d, 3d,5d,7d in daily 10:00 a. m. BIS values, found that there is no significant difference between two groups of sedative effect, show two groups of similar level of sedation; Treatment during propofol maintained amount (mg/kg/h) in treatment group was significantly less than the control group (2.1±0.9、 3.1±0.5, P<0.01); Treatment group (d) mechanical ventilation time significantly less than the control group (7.9±2.4、12.5±4.6, P<0.01); Stop using sedative after waking time (min) in treatment group was significantly less than the control group (3.2±1.0、8.0±2.3, P<0.01); After stopping sedative decannulation time (d) is significantly less than control group (3.2±1. 0、8.0±2.3, P<0.01)。ConclusionThis study found that Wen Dan tang can obviously improve symptoms of cough, sputum, breathing in patients with AECOPD, improve pulmonary alveolar gas exchange, increase in arterial oxygen partial pressure, reduce co2 partial pressure, improve the clinical total effective rate. Under the BIS monitoring guide AECOPD mechanical ventilation patients adjust the dose of sedative drugs, and found that propofol combined Wen Dan tang mechanical ventilation in patients with AECOPD is superior to the simple use of propofol sedation effect, under the premise that achieve the same level of sedation, Wen Dan tang can reduce the dosage of propofol; Wen Dan tang combined propofol sedation effect is satisfied, easy to wake up, the time of mechanical ventilation and stop using sedative after extubation time.