温胆汤联合无创正压通气治疗重度阻塞性睡眠呼吸暂停低通气综合征患者的临床研究

中国临床药理学与治疗学 ›› 2014, Vol. 19 ›› Issue (6): 686-690.

温胆汤联合无创正压通气治疗重度阻塞性睡眠呼吸暂停低通气综合征患者的临床研究

张瑛¹, 周颖²

¹浙江省立同德医院中医内科,
²呼吸科, 杭州 310012, 浙江

收稿日期:2013-10-10 修回日期:2014-05-15 发布日期:2014-07-01
通讯作者: 周颖, 女, 硕士, 副主任医师, 研究方向:中西医结合呼吸内科学。Tel: 13858041758 E-mail: zhouyingxiehe2008@163.com
作者简介:张瑛, 女, 在读硕士, 主治医师, 研究方向:中医内科学。E-mail: it_zy@msn.com

Clinical study on wendantang combined non-invasive positive pressure ventilation in patients with severe obstructive sleep apnea hypopnea syndrome

ZHANG Ying¹, ZHOU Ying²

¹Chinese Medicine Department,
²the Respiratory Medicine in the Tongde Hospital of Zhejiang Provincial, Hangzhou 310012, Zhejiang, China

Received:2013-10-10 Revised:2014-05-15 Published:2014-07-01

摘要/Abstract

摘要： 目的: 观察温胆汤联合无创呼吸机对重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者临床症状、呼吸暂停次数、最长呼吸暂停时间, 低通气次数、平均指端血氧饱和度(MSpO₂)、最低指端血氧饱和度(LSpO₂)和血清瘦素(leptin)的影响。方法: 选择经多导睡眠图(PSG)确诊的重度OSAHS患者50例, 随机分为治疗组25例和对照组25例, 治疗组用温胆汤联合无创呼吸机治疗, 温胆汤每日一剂, 每服28剂为1疗程, 无创呼吸机每天治疗8~14 h, 共同治疗3个月, 而对照组则单用无创呼吸机治疗。两组均于治疗前及治疗后1月、2月、3月进行临床症状评分、睡眠监测及检测血清瘦素水平, 比较治疗前后各项指标的差异。结果: 治疗组经温胆汤联合无创呼吸机治疗3个月后, 呼吸暂停次数与低通气次数明显降低, MSpO₂和LSpO₂显著升高, 且血瘦素水平较治疗前显著降低。而且与对照组相比, 治疗组临床症状明显改善, 呼吸暂停次数、低通气次数及血瘦素水平都有明显的降低。相关性分析表明, OSAHS患者血瘦素与呼吸暂停次数、低通气次数呈正相关。结论: 温胆汤联合无创呼吸机治疗能够显著降低重度OSAHS患者血瘦素水平, 进而降低呼吸暂停次数和低通气次数, 从而改善OSAHS患者的预后。

关键词: 重度阻塞性睡眠呼吸暂停低通气综合征, 温胆汤, 瘦素

Abstract: AIM : To observe the impact of wendantang combined non-invasive ventilation on the number of clinical symptoms, apnea, the longest apnea time, the number of low hypopnea, average oxygen saturation finger, lowest oxygen saturation finger and leptin in the patients of severe OSAHS.METHODS: Total 50 severe cases of OSAHS as test group were chosen, and divided into treatment group and control group randomly, that was to say 25 cases each group. The treatment group peros wendantang day one of each serving 28 for a course, combined non-invasive positive pressure ventilation therapy 8-14 hours a day, while the control group used non-invasive ventilation only. Then the level of sleep monitoring indicators and leptin by polysomnography and radio-immunity assay was tested to compare the changes of these indexes before and after the treatment in one month, two months and three months.RESULTS:The level of the number of apnea, the number of low hypopnea, leptin obviously decreased while the level of average oxygen saturation finger, lowest oxygen saturation finger significantly increased by taking wendantang combined non-invasive ventilation in treatment group after three months. Moreover, the level of the clinical symptoms and the number of apnea, the number of low hypopnea, leptin obviously decreased as compared with the control group. The relative analysis indicated that the level of the number of apnea, the number of low hypopnea in the patients of severe OSAHS had positive correlation with leptin.CONCLUSION: Wendantang combined non-invasive ventilation can cut down the level of leptin in the patients of severe cases OSAHS obviously, thereby reducing the number of apnea and low hypopnea , and improve the prognosis in the patients of OSAHS accordingly.

Key words: severe obstructive sleep apnea hypopnea syndrome, wendantang, leptin

张瑛, 周颖. 温胆汤联合无创正压通气治疗重度阻塞性睡眠呼吸暂停低通气综合征患者的临床研究[J]. 中国临床药理学与治疗学, 2014, 19(6): 686-690.

ZHANG Ying, ZHOU Ying. Clinical study on wendantang combined non-invasive positive pressure ventilation in patients with severe obstructive sleep apnea hypopnea syndrome[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(6): 686-690.

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