| 1.Objective To explore the effects of Jianpiyangfei Decoction(an experienced prescription of Zhou Dayong,director of Anhui Traditional Chinese Medicine Hospital)on breathing indicators,arterial blood gas analysis,mechanical ventilation time,and offline success rate of patients with AECOPD respiratory failure mechanical ventilation,and evaluate its clinical efficacy To provide a theoretical basis for clinical Chinese medicine to intervene in patients with AECOPD mechanical ventilation and to open a new treatment idea for clinical offline problems.2.Methods This study followed the principle of randomized control,designed and implemented a prospective research protocol,and observed 56 patients with chronic acute obstructive pulmonary disease and mechanical ventilation with respiratory failure in the comprehensive ICU of Anhui Province Traditional Chinese Medicine Hospital from December 2018 to December 2019.It belongs to the type of deficiency of lung and spleen,and was randomly divided into control group and treatment group,each with 28 cases.The control group received basic western medicine treatment(mechanical ventilation,anti-infection,phlegm elimination,antispasmodic and asthma,nutritional support,maintaining internal environment stability,etc.),and the treatment group received Jianpiyangfei decoction based on western medicine,composition: Codonopsis,Coix Seed,Yam,White Lentils,Eustoma,and Licorice 12 g each,9g each of Atractylodes macrocephala,Poria cocos,Cotinus coggygria,Chenpi,Pinellia ternata,Lianzixin,Forsythia,Jujube,Amomum villosum(after the lower part)6g.The decoction was prepared by the decoction room of our hospital,200 m L per bag,400 m L/d,injected through the nasogastric tube,and taken in the morning and evening.The changes of breathing indicators(oxygenation index,tidal volume,shallow rapid respiration index),arterial blood gas analysis,nutritional index(albumin,hemoglobin),infection index(white blood cell count,percentage of neutrophils,c-reactive protein),mechanical ventilation time,offline success rate,APACHE II score,TCM syndrome integral,TCM curative effect determination were observed in the two groups before treatment.3.Results(1)There was no significant difference in baseline data(sex,age,course of disease,comorbidity,infection index,nutritional index,breathing indicators,etc.)between the two groups before treatment.(2)Comparison of continuous mechanical ventilation time and offline success rate during the total treatment period of the two groups(14d).The treatment group was superior to the control group in shortening mechanical ventilation time and increasing offline success rate,which was statistically significant(P<0.05);(3)After 7 days and 14 days of treatment in both groups,the APACHE II score and TCM syndrome scores were improved compared with before treatment(P<0.05);compared with the control group,the APACHE II score of the treatment group was on the 7th and 14 th days.It was significantly lower than the control group(P<0.05);there was no significant difference in TCM syndrome scores between the two groups on the 7th day(P>0.05),and there was a significant statistical significance on the 14 th day(P<0.05).(4)After 7 days and 14 days of treatment in the two groups,PH,Pa O2 and oxygenation index increased(P<0.05),and Pa CO2 decreased(P<0.05).On the 7th day,the p H and Pa O2 of the two groups were compared.There was no significant statistical difference(P>0.05).The treatment group was better than the control group on the 14 th day,with significant statistical significance(P<0.05).The Pa CO2 level and oxygenation index increased on the 7th and 14 th days The level was better than the control group,which was statistically significant(P<0.05);(5)After 7 days and 14 days of treatment in both groups,the tidal volume and superficial fast breathing index were significantly improved compared with before treatment(P<0.05);On the 7th and 14 th days,the treatment group had a higher level of tidal volume and a lower level of shallow fast breathing index than the control group,with statistical significance(P<0.05).(6)After 7 days and 14 days of treatment in the two groups,WBC,N%,and CRP were all lower than before treatment(P<0.05);the levels of WBC and CRP reduction in the treatment group were better than those in the control group on the 7th and 14 th days,It was statistically significant(P<0.05);the N% of the two groups was not statistically significant at day 7(P>0.05),and it was statistically significant at day 14(P<0.05);(7)After 7 days and 14 days of treatment in the two groups,the ALB level was significantly increased compared with that before treatment(P<0.05),and the HGB level in the two groups was not statistically significant compared with that before treatment(P>0.05)at 7 days.It was statistically significant at 14 days(P<0.05);the ALB rise level of the treatment group on the 7th and 14 th days was better than that of the control group,which was statistically significant(P<0.05);Compared with the HGB on the 7th day,there was no Significantly statistically significant(P>0.05),with significant statistical significance on day 14(P<0.05).(8)Within the total course of treatment(14d)of the two groups,the total effective rate of TCM efficacy in the treatment group(92.86%>78.57%)was significantly better than that in the control group,with statistical significance(P<0.05).4.Conclusion Jian Pi Yang Fei Decoction combined with Western medicine-related treatments can help improve the clinical symptoms of patients with mechanical ventilation of AECOPD respiratory failure,improve the effectiveness of traditional Chinese medicine,effectively reduce the patient's infection indicators,improve nutritional status,enhance body functions,improve breathing indicators,and improve oxygen Finally,the goals of shortening the mechanical ventilation time,offline time window in advance,and improving the success rate of offline are also important to the prognosis of offline patients. |
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