中国中西医结合急救杂志2025，Vol.32Issue(4)：428-432,5.DOI:10.3969/j.issn.1008-9691.2025.04.008
呼吸功能康复训练结合中医针灸治疗对危重症呼吸衰竭机械通气患者临床疗效的影响
The impact of respiratory function rehabilitation training combined with traditional Chinese acupuncture therapy on the clinical efficacy of critically ill patients with respiratory failure requiring mechanical ventilation
摘要
Abstract
Objective To explore the clinical application value of respiratory function rehabilitation training combined with traditional Chinese medicine acupuncture therapy in the weaning and extubation of critically ill patients with respiratory failure.Methods A total of 82 patients with critical respiratory failure who had been treated with endotracheal intubation and ventilator therapy in the department of critical care of the Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine from August 2021 to August 2024 were enrolled.The patients were divided into control group(40 cases)and observation group(42 cases)according to different treatment methods.The control group was treated with the original underlying disease according to the condition,and was given symptomatic support and other active rescue treatment when there was an acute progressive exacerbation of respiratory failure and heart failure.On the basis of the treatment of the control group,the observation group was trained by a professional respiratory function rehabilitation therapist to conduct respiratory rehabilitation training on the patients.Acupuncture treatment was performed by acupuncturists specializing in traditional Chinese medicine who have undergone special training.The differences of general data[including gender,age,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)],laboratory tests indicators[including white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),oxygenation index(PaO2/FiO2)],prognosis(including the success rate of weaning and extubation,28-day respiratory failure recurrence rate,90-day mortality,incidence of lung infection,and incidence of right heart failure)between the two groups were compared.Results There were no significant differences in gender,age,APACHE Ⅱ score,WBC,CRP,PCT,and PaO2/FiO2 between the two groups(all P>0.05).After treatment,WBC,CRP,and PCT in both groups were significantly lower than before treatment,while PaO2/FiO2 was significantly higher than before treatment,compared with the control group,the observation group showed significantly decreased WBC,CRP and PCT,and significantly increased PaO2/FiO2 after treatment[WBC(×109/L):8.09±4.28 vs.14.63±5.07,CRP(mg/L):79.11±51.22 vs.117.49±49.24,PCT(μg/L):5.46±4.29 vs.10.56±8.64,PaO2/FiO2(mmHg,1 mmHg≈0.133 kPa):193.12±2.88 vs.190.83±3.90,all P<0.05],the success rate of weaning extubation in the observation group was significantly increased[57.1％(24/42)vs.35.0％(14/40)],and the 28-day respiratory failure recurrence rate,90-day mortality,the incidence of lung infection,and the incidence of right heart failure were significantly reduced[28-day respiratory failure recurrence rate:23.8％(10/42)vs.45.0％(18/40),and the 90-day mortality:28.6％(12/42)vs.50.0％(20/40),incidence of pulmonary infection:23.8％(10/42)vs.45.0％(18/40),incidence of right heart failure:14.3％(6/42)vs.35.0％(14/40),all P<0.05].Conclusion Through respiratory rehabilitation training combined with acupuncture treatment,it is possible to improve the blood oxygen supply to the vital organs of patients with critical respiratory failure who are on mechanical ventilation,reduce inflammatory responses,and thereby improve the prognosis of the patients.关键词
呼吸衰竭/呼吸机/呼吸康复训练/针灸治疗/脱机Key words
Respiratory failure/Ventilator/Respiratory rehabilitation training/Acupuncture and moxibustion therapy/Weaning ventilator引用本文复制引用
Li Zhigang,Zheng Taizu,Zhang Yinjun,Li Zhenchen..呼吸功能康复训练结合中医针灸治疗对危重症呼吸衰竭机械通气患者临床疗效的影响[J].中国中西医结合急救杂志,2025,32(4):428-432,5.基金项目
甘肃省中医药研究中心开放课题计划(zyzx-2020-zx14) The Open Project Plan of Gansu Provincial Center for Traditional Chinese Medicine Research(zyzxx-2020-zx14) （zyzx-2020-zx14）
