目的 探讨参麦注射液联合沙美特罗替卡松粉吸入剂治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭的临床疗效。方法 选取2013年6月-2015年6月重庆三博长安医院呼吸内科收治的COPD合并呼吸衰竭患者78例,按治疗方案的差别分为对照组和治疗组,每组各39例。对照组患者在常规治疗基础上雾化吸入沙美特罗替卡松粉吸入剂,1吸/次,2次/d。治疗组在对照组的基础上静脉输注参麦注射液,100 mL/次,1次/d。两组患者均治疗14 d。观察两组临床疗效,并比较两组患者的动脉血气指标、肺功能指标,白细胞(WBC)、C反应蛋白(CRP)和降钙素原(PCT)的变化。结果 治疗后,对照组与治疗组患者的总有效率分别为79.49%、94.87%,两组总有效率比较差异有统计学意义(P<0.05)。治疗后,两组患者的pH值和pO₂均较治疗前显著升高,而pCO₂却较治疗前显著降低,同组治疗前后差异具有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者FEV₁、FVC以及FEV₁/FVC均较治疗前显著升高,同组治疗前后差异具有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者的WBC、CRP和PCT均较治疗前显著下降,同组治疗前后差异具有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显好于对照组,两组比较差异具有统计学意义(P<0.05)。结论 参麦注射液联合沙美特罗替卡松粉吸入剂治疗COPD合并呼吸衰竭具有较好的临床疗效,能降低呼吸道中的炎症反应,明显改善肺功能,具有一定的临床推广应用价值

Objective To investigate the clinical effect of Shenmai Injection combined with Salmeterol Xinafoateand Fluticasone Propionate Powder for inhalation in treatment of chronic obstructive pulmonary disease (COPD) complicating with respiratory failure.Methods Patients (78 cases) with COPD complicating with respiratory failure in Department of Respiratory, Chongqing Sanbo Changan Hospital from June 2013 to June 2015 were enrolled in this study. According to the different treatment plan, patients were divided into control and treatment groups, and each group had 39 cases. The patients in the control group were aerosol inhalation administered with Salmeterol Xinafoateand Fluticasone Propionate Powder for inhalation on the basis of conventional treatment, 1 suck/time, twice daily. The patients in the treatment group were iv administered with Shenmai Injection on the basis of control group, 100 mL/time, once daily. The patients in two groups were treated for 14 d. After treatment, the efficacy was evaluated, and arterial blood gas indexes, pulmonary function indexes, WBC, CRP, and PCT in two groups were compared.Results After treatment, the clinical efficacies in the control and treatment groups were 79.49% and 94.87%, respectively, and there was difference between two groups (P<0.05). After treatment, pO₂ and PH in two groups were significantly increased, but the pCO₂ in two groups was significantly decreased, and the differences were statistically significant in the same group (P<0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant differences between two groups (P<0.05) After treatment, FEV₁, FVC, and FEV₁/FVC in two groups were significantly increased, and the differences were statistically significant in the same group (P<0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant differences between two groups (P<0.05). After treatment, WBC, CRP, and PCT in two groups were significantly decreased, and the differences were statistically significant in the same group (P<0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant differences between two groups (P<0.05).Conclusion Shenmai Injection combined with Salmeterol Xinafoateand Fluticasone Propionate Powder for inhalation has clinical curative effect in treatment of COPD complicating with respiratory failure, and can reduce inflammatory reaction in respiratory tract, significantly improve pulmonary function, which has a certain clinical application value.