| 叶溪茜.健脾消食贴对慢性阻塞性肺病急性加重期患者呼吸机相关性肺炎的作用研究[J].浙江中西医结合杂志,2022,32(9): |
| 健脾消食贴对慢性阻塞性肺病急性加重期患者呼吸机相关性肺炎的作用研究 |
| Effect of Jianpi Xiaoshi Paste on ventilator-associated pneumonia in patients with acute exacerbation of chronic obstructive pulmonary disease |
| 投稿时间：2021-11-22 修订日期：2022-01-20 |
| DOI： |
| 中文关键词: 健脾消食贴；ICU；慢性阻塞性肺病急性加重期 呼吸机相关性肺炎； |
| 英文关键词:Jianpi Xiaoshi patch ICU Acute exacerbation of chronic obstructive pulmonary disease Ventilator associated pneumonia |
| 基金项目:杭州市医药卫生科技项目(0020190133) |
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| 中文摘要: |
| 目的 观察健脾消食贴剂外敷神阙穴对ICU内脾胃阳虚型慢性阻塞性肺病急性加重期(acute exacerbation of chronic obstructive pulmonary disease，AECOPD)患者呼吸机相关性肺炎的作用。方法 选择2019年4月-2020年12月在我院ICU住院的脾胃阳虚型AECOPD患者60例为研究对象，采用随机数字表法分为对照组和试验组各30例。对照组采用集束化管理方案，试验组在此基础上给予健脾消食贴外贴神阙穴，每日1次，共治疗7天。对比两组治疗后中医消化功能证候积分、胃潴留、声门下滞留液pH值以及呼吸机相关性肺炎（ventilator associated pneumonia，VAP）发生率、28天撤机成功率、机械通气时间和ICU入住时间等情况，并进行中医疗效评定。结果 两组组中医消化功能证候积分在治疗前差异无统计学意义（P＞0.05），治疗后试验组中医消化功能证候积分、中医证候疗效情况均明显优于对照组，差异均具有显著的统计学意义(P＜0.01）；试验组胃潴留、声门下滞留液pH情况均优于对照组，差异有统计学意义(P＜0.05）；试验组治疗后的VAP发生率7%，28天撤机成功率22%，对照组分别为16%和13%，组间差异有统计学意义(P＜0.05）；试验组机械通气时间和ICU入住时间分别为22.73±8.40天和24.87±8.21天，对照组分别为29.13±10.93天和31.43±10.82天，试验组上述指标时长均短于对照组，组间差异有统计学意义(P＜0.05）。结论 健脾消食贴可显著减轻行机械通气的AECOPD患者胃脘胀满、胃脘疼痛、嗳气等中医消化功能症状，改善胃潴留，降低胃内容物返流引起的误吸风险，从而降低VAP的发生率，提高28天撤机成功率，缩短机械通气时间和ICU入住时间，具有一定的临床价值。 |
| 英文摘要: |
| Objective To observe the effect of jianpiXiaoshi patch on ventilator associated pneumonia in ICU patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods a total of 60 AECOPD patients with spleen and stomach Yang deficiency in ICU of our hospital from April 2019 to December 2020 were selected as the study subjects, and were divided into control group and experimental group by random number table method (30 cases in each group). The control group was treated with Cluster management scheme, and the experimental group was treated with shenque point, once a day, for 7 days. The scores of TCM digestive syndrome, gastric retention, pH value of subglottic retained fluid, incidence of VENTILator associated pneumonia (VAP), success rate of ventilator withdrawal at 28 days, length of mechanical ventilation and length of ICU stay were compared between the two groups after treatment, and TCM efficacy was evaluated. Results There was no statistically significant difference in TCM digestive syndrome score between the two groups before treatment (P>0.05), but after treatment, the TCM digestive syndrome score and TCM syndrome efficacy of the experimental group were better than those of the control group, and the difference was statistically significant (P<0.05). Gastric retention and subglottic fluid pH in experimental group were better than those in control group, and the differences were statistically significant (P<0.05). The incidence of VAP after treatment was 7% in the experimental group, and the success rate of withdrawal after 28 days was 22% in the control group, and 16% and 13% in the control group, respectively, with statistical significance (P < 0.05). The duration of mechanical ventilation and ICU stay in experimental group were 22.73±8.40 and 24.87±8.21 days respectively, and 29.13±10.93 and 31.43±10.82 days respectively in control group. The duration of above indexes in experimental group was significantly shorter than that in control group, and the difference between groups was statistically significant (P < 0.05). Conclusion Jianpixiaoshi Patch can significantly reduce the digestive symptoms of TRADITIONAL Chinese medicine such as epigastric distention, epigastric pain and belching in AECOPD patients receiving mechanical ventilation, improve gastric retention, reduce the risk of aspiration caused by reflux of gastric contents, reduce the incidence of VAP, improve the success rate of withdrawal at 28 days, shorten mechanical ventilation time and ICU stay time. It has certain clinical value. |
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