目的 探讨丹参川芎嗪注射液联合尼可刹米注射液治疗慢性呼吸衰竭急性加重的临床疗效。方法 选取临泉县人民医院在2022年1月—2023年12月收治的70例慢性呼吸衰竭患者，按计算机随机排列法将所有患者分为对照组和治疗组，每组各35例。对照组静脉注射尼可刹米注射液，1支/次，必要时在1～2 h内重复给药1次。治疗组在对照组基础上静脉滴注丹参川芎嗪注射液，将10 mL丹参川芎嗪注射液加入250 mL生理盐水后充分稀释，10 mL/次，1次/d。两组持续治疗10 d。比较两组患者的临床疗效、病情严重程度、健康状况、肺功能指标、血气分析指标、血清指标。结果 治疗组和对照组的总有效率分别为94.29%、77.14%，组间比较差异显著（P＜0.05）。治疗后，两组的急性生理学与慢性健康状况评分系统Ⅱ（APACHE Ⅱ）评分、慢性阻塞性肺疾病评估测试（CAT）评分均显著降低（P＜0.05），且治疗组APACHE Ⅱ评分、CAT评分低于对照组（P＜0.05）。治疗后，两组的第一秒用力呼气容积（FEV1）/用力肺活量（FVC）、第1秒用力呼气容积占预计值百分比（PEF% pre）高于治疗前，残气量/肺总量比值（RV/TLC）低于治疗前（P＜0.05）；治疗组的FEV1/FVC、PEF% pre高于对照组，RV/TLC低于对照组（P＜0.05）。治疗后，两组的氧合指数、血氧饱和度、氧分压均显著升高（P＜0.05），且治疗组的氧合指数、血氧饱和度、氧分压显著高于对照组（P＜0.05）。治疗后，两组的C-反应蛋白/白蛋白（HCAR）、中性粒细胞计数/淋巴细胞计数（NLR）、血小板计数/淋巴细胞计数（PLR）均显著降低（P＜0.05），且治疗组HCAR、NLR、PLR均低于对照组（P＜0.05）。结论 丹参川芎嗪注射液联合尼可刹米注射液可提高慢性呼吸衰竭的疗效，进一步减轻病情严重程度，改善健康状况，提高肺功能，降低炎症反应。

Objective To investigate the clinical effect of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with Nikethamide Injection in treatment of acute exacerbation of chronic respiratory failure. Methods Selecting 70 patients with chronic respiratory failure admitted to Linquan County People’s Hospital from January 2022 to December 2023, all patients were divided into a control group and a treatment group using computer randomization method, with 35 patients in each group. Patients of the control group was intravenously injected with Nikethamide Injection, 1 tube/time, and if necessary, repeated administration within 1—2 h. Patients of the treatment group received intravenous infusion of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection on the basis of the control group, 10 mL was added to 250 mL of physiological saline and fully diluted, 10 mL/time, once daily. Patients of two groups received continuous treatment for 10 d. The clinical efficacy, the severity of the condition, health status, lung function indicators, blood gas analysis indicators, and serum indicators in two groups were compared. Results The total effective rates of the treatment group and the control group were 94.29% and 77.14%, with statistically significant differences between the groups (P < 0.05). After treatment, APACHE II scores and CAT scores of two groups significantly decreased (P < 0.05), and APACHE II scores and CAT scores of the treatment group were lower than those of the control group (P < 0.05). After treatment, FEV1/FVC and PEF% pre of two groups were higher than before treatment, while RV/TLC was lower than before treatment (P < 0.05). FEV1/FVC and PEF% pre in the treatment group were higher than those in the control group, while RV/TLC was lower than those in the control group (P < 0.05). After treatment, the oxygenation index, blood oxygen saturation, and oxygen partial pressure of two groups significantly increased (P < 0.05), and the oxygenation index, blood oxygen saturation, and oxygen partial pressure of the treatment group were significantly higher than those of the control group (P < 0.05). After treatment, HCAR, NLR, and PLR of two groups were significantly decreased (P < 0.05), and HCAR, NLR, and PLR of the treatment group were lower than those of the control group (P < 0.05). Conclusion The combination of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection and Nikethamide Injection can improve the therapeutic effect of chronic respiratory failure, further reduce the severity of the condition, improve health status, enhance lung function, and reduce inflammatory reactions.

R974

安徽省红十字基金会中医药传承创新发展研究项目（2022ZYYD25）