参芪桂夏桃红汤联合高流量呼吸湿化氧疗对慢性血栓栓塞性肺动脉高压伴低氧血症型呼吸衰竭患者的临床疗效观察OA
Clinical Efficacy of Shenqi Guixia Taohong Decoction Combined with High-Flow Respiratory Humidification Oxygen Therapy in Patients with Chronic Thromboembolic Pulmonary Hypertension Complicated with Hypoxemic Respiratory Failure
目的:考察参芪桂夏桃红汤联合高流量呼吸湿化氧疗对慢性血栓栓塞性肺动脉高压(CTEPH)伴低氧血症型呼吸衰竭(HRF)的临床疗效.方法:前瞻性选取 2022 年1月～2024年 8月本院收治的120 例 CTEPH 伴 HRF 患者,按照随机数字表法分为对照组(剔除1例,最终纳入 59 例)和观察组(剔除1例、中止1例,最终纳入 58例).对照组给予高流量呼吸湿化氧疗,观察组在对照组基础上给予参芪桂夏桃红汤治疗.比较两组血气指标[动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、最低血氧饱和度(LSaO2)、氧合指数(OI)]、痰液黏稠度、血清生物学标志物[趋化因子受体4(CXCR4)、N 末端 B 型利钠肽原(NT-proBNP)、内皮素-1(ET-1)、一氧化氮(NO)]、病情严重程度评分[改良英国医学研究理事会呼吸困难量表(mMRC)评分、急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分]以及不良反应发生情况.结果:治疗后,两组 PaO2、LSaO2、OI、NO 均升高,且观察组高于对照组(P＜0.05);两组 PaCO2、CXCR4、NT-proBNP、ET-1、mMRC 评分、APACHE Ⅱ评分均降低,且观察组低于对照组(P＜0.05);两组痰液黏稠度均得到改善,且观察组改善程度优于对照组(P＜0.05).治疗期间,两组不良反应总发生率比较无统计学差异(P＞0.05).结论:参芪桂夏桃红汤联合高流量呼吸湿化氧疗治疗 CTEPH 伴 HRF,可调节血管内皮功能,改善血气指标与痰液黏稠度,且未显著增加不良反应发生风险.
Objective:To investigate the clinical efficacy of Shenqi Guixia Taohong Decoction combined with high-flow respiratory humidification oxygen therapy in patients with chronic thromboembolic pulmonary hypertension(CTEPH)complicated with hypoxemic respiratory failure(HRF).Methods:A total of 120 patients with CTEPH complicated with HRF admitted to our hospital from January 2022 to August 2024 were prospectively enrolled and randomly divided into the control group and the observation group by random number table method.One case was excluded from the control group(finally n=59);1 case was excluded and 1 case discontinued in the observation group(finally n=58).The control group received high-flow respiratory humidification oxygen therapy,while the observation group received additional Shenqi Guixia Taohong Decoction on the basis of the control group.Blood gas indicators[partial pressure of arterial oxygen(PaO2),partial pressure of arterial carbon dioxide(PaCO2),lowest oxygen saturation(LSaO2),oxygenation index(OI)],sputum viscosity,serum biomarkers[chemokine receptor 4(CXCR4),N-terminal pro-B-type natriuretic peptide(NT-proBNP),endothelin-1(ET-1),nitric oxide(NO)],disease severity scores[modified Medical Research Council dyspnea scale(mMRC)score,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score],and adverse reactions were compared between the two groups.Results:After treatment,PaO2,LSaO2,OI and NO in both groups were increased,and the observation group was higher than the control group(P<0.05).PaCO2,CXCR4,NT-proBNP,ET-1,mMRC score and APACHE Ⅱ score in both groups were decreased,and the observation group was lower than the control group(P<0.05).Sputum viscosity was improved in both groups,with better improvement in the observation group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion:Shenqi Guixia Taohong Decoction combined with high-flow respiratory humidification oxygen therapy can regulate vascular endothelial function,improve blood gas indicators and sputum viscosity in patients with CTEPH complicated with HRF,without significantly increasing the risk of adverse reactions.
李华;李珂;朱沙沙
安阳市中医院重症医学科,安阳 455000安阳市中医院重症医学科,安阳 455000安阳市中医院重症医学科,安阳 455000
医药卫生
参芪桂夏桃红汤高流量呼吸湿化氧疗慢性血栓栓塞性肺动脉高压低氧血症型呼吸衰竭血气指标
Shenqi Guixia Taohong Decoctionhigh-flow respiratory humidification oxygen therapychronic thromboembolic pulmonary hypertensionhypoxemic respiratory failureblood gas indicators
《中国合理用药探索》 2026 (3)
141-147,7
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