Clinical Study On The Effects Of Intestinal Transfer Therapy Combined With Noninvasive Mechanical Ventilation In Patients With Respiratory Failure Due To Acute Exacerbations Of Chronic Obstructive Pulmonary Disease

BackgroudChronic obstructive pulmonary disease(COPD) is a high incidence of chronic respiratory diseases,often combined malnutrition,reduced immune function, leading to recurrent disease,persistent not healing.Noninvasive ventilation (NIV) is the first-line treatment of chronic obstructive pulmonary disease with acute exacerbation(AECOPD) in patients with respiratory failure means, but because of the existence of defects,such as abdominal distension,is limited to the application.ObjectiveObservation the effects of Intestinal Transfer Therapy combined with NIV for AECOPD in patients with respiratory failure immune function and ventilation function;such as the role of reduce the side effects of NIV,Shorten the time of mechanical ventilation,Reduced hospitalization costs.The purpose of this study is the randomized controlled trials looking to explore the Chinese medicine in patients with respiratory failure AECOPD immunomodulatory functions and to find a better treatment of mechanical ventilation.MethodsThis study is randomized controlled trials looking,Since March 2008-2009 year in March,from our hospital ICU,Department of Respiratory Medicine, Sixty patients with respiratory failure due to acute exacerbations of COPD were randomly divided into treatment group and control group,of which 30 cases of treatment group(Intestinal transfer therapy+NIV+Conventional drug therapy),30 cases of the control group(NIV+Conventional drug therapy). Observed before and after treatment about "cough,sputum,wheezing,stuffy,Palpitation,swelling,cyanosis",Pulmonary tale,Heart rate,Respiratory rate, Blood gas analysis,APACHEâ…¡score,liver and kidney functions,B-free and T-lymphocyte subsets were recorded in both groups.Compared between the two groups of noninvasive ventilation in patients with the incidence of complications such as abdominal bulging,belch,aspiration,the Mechanical ventilation time,Length of hospital stay and costs and so on.ResultsIn this study,there were 2 cases of loss,the two cases do not statistical analysis.The two groups in the basis of the situation before treatment no significant difference.Comparison of the total effect of the two groups, There are 28 cases of treatment group,seven cases of markedly effective, nineteen cases of effective,two cases of invalid,The total effective rate was 92.86%;There are 30 cases of control group,four cases of markedly effective,twenty-one cases of effective,five cases of invalid,the total effective rate was 83.3%.The two groups after treatment of respiratory rate,PH,PaO₂,PaCO₂,APACHEâ…¡score and other indicators are more significant improvement(P＜0.05,P＜0.01),the control group after treatment no significant change in heart rate(P＞0.05),and various indicators of group difference was not significant(P＞0.05).The control group ALB,TP,HGB decreased after treatment(P＜0.05,P＜0.01), The treatment group TP,HGB decreased after treatment(P＜0.05,P＜0.01), and ALB increased than before treatment,but the difference was not significant.Compared with control group,total protein was higher in the treatment group(P＜0.05),the treatment group after treatment,although the level of albumin than the control group no significant difference,but the albumin level reduce was lower than the control group(P＜0.01).The two groups before and after treatment there is no significant difference in the level of HGB.About immunological indicators,the two groups after treatment IgG,IgA,CD3,CD4,CD4/CD8 higher than before(P＜0.05,P＜0.01);Compared with control group,after treatment,IgG,IgA,CD3,CD4,CD4/CD8 were higher in the treatment group(P＜0.05,P＜0.01).The control group after treatment than before the marked increase in abdominal distension,and the treatment group after noninvasive ventilation abdominal bulging,belch and the incidence of aspiration was significantly lower than the control group(P＜0.05,P＜0.01);the treatment group may be an effective process to reduce noninvasive ventilation the highest PS and PEEP, reducing the noninvasive mechanical ventilation time,reducing the hospitalization costs in the ICU,but the total cost of hospitalization, length of hospital stay than the control group no significant difference, may be related to the smaller sample size.ConclusionChinese medicine help to improve the transfer of intestinal law AECOPD respiratory failure in patients with noninvasive ventilation in the nutritional status,and enhance immune function,can improve the efficiency of noninvasive ventilation,mechanical ventilation to reduce the time,a significant reduction in noninvasive ventilation abdominal distension,belch,aspiration and other complications from occurring.Prompt transfer of Chinese medicine combined with intestinal noninvasive ventilation to treat respiratory failure in patients with AECOPD a more comprehensive program of Immunore gulation and mechanical ventilation.