Clinical Observation Of Shenlingbaizhu Powder On Energy Metabolism In Mechanically Ventilated Patients With AECOPD

ObjectiveA randomized controlled study was conducted to observe the the effect of Shenlingbaizhu powder on respiratory muscle fatigue,energy metabolism disorder and the influence in nutritional support of mechanically ventilated patients with Acute exacerbation of COPD and evaluate it,in order to provide the evidence of evidence-based medicine for the clinical application of Shenlingbaizhu powder in the treatment of the mechanically ventilated patients with AECOPD.MethodA prospective randomized controlled clinical trial was conducted to select 60 mechanically ventilated patients with AECOPD,who were newly treated in the Intensive Care Unit of Zhongshan traditional Chinese Medicine Hospital affiliated to Guangzhou University of Chinese Medicine from April 2019 to January 2020.These patients were randomly divided into observation group(n=30)and control group(n=30).Both groups were given conventional treatment and enteral nutrition support therapy guided by REE.Based on that,the observation group were Shenlingbaizhu powder decoction and the control group were received nasal feeding with warm water of the same method and frequency as the observation group.The changes of REE in the two groups were observed and recorded at three observation points on the first,third and fifth day of treatment.Respiratory mechanical indexes and nutritional laboratory indicators were observed and recorded before and after treatment.The duration of mechanical ventilation and EN intolerance event in the two groups were recorded.At the same time,adverse reactions were recorded.SPSS 22.0 was used for statistical analysis of the data.Results1.A total of 60 patients were finally enrolled in and completed the clinical trial,including 30 patients in the observation group and 30 patients in the control group.There was no significant difference between the two groups in general information such as age,sex,APACHE Ⅱ score and basic nutritional status(P>0.05),and the two groups were comparable.2.Before treatment,there were no significant differences in blood gas analysis index(OI,PCO2),respiratory mechanics index(MIP,RSBI),resting energy expenditure,laboratory indicators(ALB,PA)between the two groups(P>0.05).After treatment,OI,MIP,ALB and PA increased in different degrees(P<0.05),while REE,PCO2 and RSBI decreased in different degrees(P(0.05)in both two groups,;among them,REE gradually decreased with the treatment time,the difference was statistically significant(P<0.05).3.Compared with the control group,the increase of OI,MIP and PA in the observation group were more significantly(P<0.05);Compared with the control group,the increase of Alb in the observation group were not significant(P>0.05);the decrease of PCO2 and RSBI in the observation group were more significantly.The difference was statistically significant(P<0.05);the REE in the observation group decreased significantly over the treatment time compared with the control group;The difference was statistically significant(P<0.05).4.The incidence of EN intolerance event in the observation group was significantly lower than that in the control group(P<0.05);The duration of mechanical ventilation in the observation group was shorter than that in the control group(P<0.05).Conclusions1.The Shenlingbaizhu powder,to a certain extent,can improve the respiratory muscle fatigue of mechanically ventilated patients with AECOPD so as to improve the energy metabolism disorders of such patients.2.Shenlingbaizhu powder has a certain strengthening effect on the short-term nutritional support of mechanically ventilated patients with AECOPD and can reduce the incidence of intolerance event during EN.3.Shenlingbaizhu powder has good safety,no obvious toxicity and serious adverse reactions were found in the course of clinical observation.