| 引用本文:刘婉嫣，马维辉，潘金龙.麻黄汤联合机械通气治疗急性心肌梗死并急性肺水肿患者的临床效果[J].世界中医药,2019,(09):. |
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| 麻黄汤联合机械通气治疗急性心肌梗死并急性肺水肿患者的临床效果 |
| Clinical Study on Mahuang Decoction Combined with Mechanical Ventilation in the Treatment of Acute Myocardial Infarction Complicated with Acute Pulmonary Edema |
| 投稿时间：2018-12-31 |
| DOI：10.3969/j.issn.1673-7202.2019.09.026 |
| 中文关键词: 麻黄汤 机械通气 急性心肌梗死 急性肺水肿 临床症状 动脉血气 脑钠肽 血流速度 |
| English Keywords:Mahuang Decoction Mechanical ventilation Acute myocardial infarction Acute pulmonary edema Clinical symptoms Arterial blood gas Brain natriuretic peptide Blood flow velocity |
| 基金项目:吉林市科技发展计划项目（201737077） |
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| 中文摘要: |
| 目的：探究麻黄汤联合机械通气对急性心肌梗死并急性肺水肿患者的疗效。方法：选取2017年9月至2018年11月吉林中西医结合医院收治的急性心肌梗死并急性肺水肿患者60例作为研究对象，按照就诊顺序编号随机分为对照组和观察组，每组30例。2组均纠正心力衰竭并机械通气，观察组加用麻黄汤鼻饲，每日1剂，分3次给药，连续治疗7 d。观察并比较2组治疗前、治疗后呼吸（RR）、心率（HR）、收缩压（SBP）、舒张压（DBP）、动脉血氧分压（PaO2）、动脉二氧化碳分压（PaCO2）、血清脑钠肽（BNP）、C反应蛋白（CRP）、APACHEⅡ评分、血氧饱和度（SaO2）、各瓣膜口血流速度、临床症状变化及临床疗效差异。结果：治疗后2组RR、HR、SBP、DBP、PaCO2、BNP、CRP、APACHEⅡ评分较治疗前均显著下降，PaO2、SaO2较治疗前均显著升高，差异有统计学意义（P<0.05），治疗后观察组PaO2、SaO2均显著高于对照组，余指标均显著低于对照组，差异有统计学意义（P<0.05）。治疗后2组胸闷、心悸、咯粉红色泡沫样痰、罗音、舌紫暗或瘀斑积分较治疗前显著下降，差异有统计学意义（P<0.05），治疗后观察组以上指标积分均显著低于对照组，差异有统计学意义（P<0.05）。治疗后2组二尖瓣、三尖瓣、主动脉瓣、肺动脉瓣、LVEF较治疗前均显著升高，差异有统计学意义（P<0.05），治疗后观察组与对照组以上各指标比较，差异无统计学意义（P>0.05）。观察组显效率、治疗有效率均显著高于对照组，差异有统计学意义（P<0.05）。结论：麻黄汤联合机械通气能改善急性心肌梗死并急性肺水肿临床症状，改善动脉血气，稳定生命体征，促进血流速度，提高疗效。 |
| English Summary: |
| To explore the curative effect of Mahuang Decoction combined with mechanical ventilation on acute myocardial infarction complicated with acute pulmonary edema.Methods:A total of 60 patients with acute myocardial infarction and acute pulmonary edema were enrolled as research objects in the Jilin Traditional Chinese and Western Medicine Hospital from September 2017 to November 2018.They were randomly divided into control group(30 cases)and observation group(30 cases)according to the order of admition.Heart failure was corrected and mechanical ventilation was performed in both groups.The observation group was also given Mahuang Decoction by nasal feeding，administered 3 times a day，for 7 d.Changes of respiration(RR)，heart rate(HR)，systolic blood pressure(SBP)，diastolic blood pressure(DBP)，arterial partial oxygen pressure(PaO2)，arterial partial pressure of carbon dioxide(PaCO2)，serum brain natriuretic peptide(BNP)，C-reactive protein(CRP)，APACHE II score，blood oxygen saturation(SaO2)，blood flow velocity of each valve orifice，clinical symptoms and clinical efficacy before and after the treatment were observed and compared between the 2 groups.Results:1)After the treatment，the RR，HR，SBP，DBP，PaCO2，BNP，CRP and APACHE II scores in the 2 groups were significantly decreased，while the PaO2 and SaO2 were significantly increased(P<0.05).The PaO2 and SaO2 in the observation group were significantly higher than those in the control group，and the remaining indicators were significantly lower than those in the control group(P<0.05). 2)After the treatment，the scores of chest tightness，palpitation，pink frothy sputum，lung rales and the tongue with purple and dark color or ecchymosis in the 2 groups were significantly lower than those before the treatment(P<0.05).After the treatment，the scores of the above indexes in the observation group were significantly lower than those in the control group(P<0.05). 3)The blood flow velocities at mitral valve，tricuspid valve，aortic valve and pulmonary valve and the LVEF were significantly higher in the 2 groups after the treatment than those before the treatment(P<0.05).There was no significant difference in the above indexes between the observation group and the control group after the treatment(P>0.05). 4)The marked and total effective rates in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:Mahuang Decoction combined with mechanical ventilation can improve the clinical symptoms of acute myocardial infarction complicated with acute pulmonary edema，improve arterial blood gas，stabilize vital signs，promote blood flow velocity，and improve the curative effect. |
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