针灸联合四君子汤治疗慢性阻塞性肺疾病急性加重期无创通气并发腹胀的疗效观察

肖鹏云 辛大永 秦鸿

摘要 目的：探討针灸和四君子汤对慢性阻塞性肺疾病急性加重期（AECOPD）无创通气并发腹胀患者的效果。方法：选取2016年1月至2018年1月北京中医医院顺义医院收治的AECOPD无创通气并发腹胀患者86例作为研究对象，按照治疗方式的不同分为对照组和观察组，每组43例，对照组应用针灸治疗，观察组应用针灸和四君子汤治疗。比较QOL评分、肺功能指标、中医症候积分、不良反应、肠胃功能、效果。结果：观察组躯体功能、社会功能、认知功能和角色功能显著高于对照组（P<0.05）;观察组FEV1、FEV1%、FEV1%/FVC以及6MWT等指标明显升高，与对照组比较差异有统计学意义（P<0.05）;观察组咳嗽、咯痰、喉痒等症状积分明显低于对照组（P<0.05）;观察组呼吸困难、咳嗽、发热和食欲不振等不良反应发生率明显低于对照组（P<0.05）;观察组患者肠胃功能明显优于对照组（P<0.05）;治观察组的治疗效果明显好于对照组（P<0.05）。结论：AECOPD无创通气并发腹胀患者的治疗过程当中，采用针灸结合四君子汤可以提高治疗的效果，改善相关的指标，临床上应进一步的推广和应用。

关键词 针灸;四君子汤;慢性阻塞性肺疾病;无创通气;腹胀;不良反应发生率;生命质量;肺功能指标;中医症候积分

Abstract Objective：To explore the Effect of acupuncture combined with Sijunzi Decoction on abdominal distension induced by non-invasive ventilation of AECOPD patients.Methods：A total of 86 abdominal distension induced by non-invasive ventilation of AECOPD patients admitted to Shunyi hospital， Beijing Hospital of Traditional Chinese Medicine from January 2016 to January 2018 were selected and randomly divided into a control group and a study group（43 cases in each group）.The control group was treated with acupuncture and the study group was treated with Sijunzi Decoction on the basis of the control group.QOL scores， lung function indexes， TCM syndrome score， incidence of adverse reactions， gastrointestinal function and treatment effect were compared between the two groups.Results：The physical function， social function， cognitive function and role function of the study group were significantly higher than those of the control group（P<0.05）; the FEV1， FEV1%， FEV1%/FVC and 6MWT of the study group were significantly increased， compared with the control group， there was Statistical significance（P<0.05）; the cough， sputum， itching and other symptoms scores of the study group were significantly lower than the control group（P<0.05）; the incidence of adverse reactions such as dyspnea， cough， fever and loss of appetite in the study group was significantly lower compared with the control group（P<0.05）; the gastrointestinal function of the study group was significantly better than that of the control group（P<0.05）; the treatment effect of the study group was significantly better than that of the control group（P<0.05）.Conclusion：In the treatment of abdominal distension induced by non-invasive ventilation of AECOPD patients， acupuncture combined with Sijunzi Decoction can improve the effect of treatment and improve related indicators.It should be further promoted and applied clinically.

Keywords Acupuncture; Sijunzi Decoction; Chronic obstructive pulmonary disease; Noninvasive ventilation; Abdominal distention; Incidence rate of adverse reactions; Quality of life; Lung function indexes; TCM syndrome score

中图分类号：R256.1文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.13.028

慢性阻塞性肺疾病（Chronic Obstructive Pulmonary Disease，COPD）在临床上又称为慢阻肺，异常气体到达炎性反应的慢性气道炎性反应和气流连续性的受到限制都会导致疾病的发生[1]。如果COPD患者病情在短时间内发生病情持续恶化，就会导致患者COPD的急性加重（AECOPD）。对AECOPD患者主要采用无创通气的治疗方法，该方法使得患者的缺氧现象得到了有效的缓解，同时降低了动脉血二氧化碳的压力，缓解了患者的病症[2]。但是采用无创通气的治疗方法存在一定的弊端，它不仅能够引起并发症的发生，同时还会导致患者出现腹胀现象。对于腹胀这种并发症，主要采用针灸结合四君子汤的治疗方法，不仅患者的治疗效果显著，同时降低了患者并发症的发生，患者满意度高，相关报道如下。

1 资料与方法……