目的 探討丹參川芎嗪注射液聯(lián)合尼可剎米注射液治療慢性呼吸衰竭急性加重的臨床療效。方法 選取臨泉縣人民醫(yī)院在2022年1月—2023年12月收治的70例慢性呼吸衰竭患者，按計(jì)算機(jī)隨機(jī)排列法將所有患者分為對照組和治療組，每組各35例。對照組靜脈注射尼可剎米注射液，1支/次，必要時(shí)在1～2 h內(nèi)重復(fù)給藥1次。治療組在對照組基礎(chǔ)上靜脈滴注丹參川芎嗪注射液，將10 mL丹參川芎嗪注射液加入250 mL生理鹽水后充分稀釋，10 mL/次，1次/d。兩組持續(xù)治療10 d。比較兩組患者的臨床療效、病情嚴(yán)重程度、健康狀況、肺功能指標(biāo)、血?dú)夥治鲋笜?biāo)、血清指標(biāo)。結(jié)果 治療組和對照組的總有效率分別為94.29%、77.14%，組間比較差異顯著（P＜0.05）。治療后，兩組的急性生理學(xué)與慢性健康狀況評分系統(tǒng)Ⅱ（APACHE Ⅱ）評分、慢性阻塞性肺疾病評估測試（CAT）評分均顯著降低（P＜0.05），且治療組APACHE Ⅱ評分、CAT評分低于對照組（P＜0.05）。治療后，兩組的第一秒用力呼氣容積（FEV1）/用力肺活量（FVC）、第1秒用力呼氣容積占預(yù)計(jì)值百分比（PEF% pre）高于治療前，殘氣量/肺總量比值（RV/TLC）低于治療前（P＜0.05）；治療組的FEV1/FVC、PEF% pre高于對照組，RV/TLC低于對照組（P＜0.05）。治療后，兩組的氧合指數(shù)、血氧飽和度、氧分壓均顯著升高（P＜0.05），且治療組的氧合指數(shù)、血氧飽和度、氧分壓顯著高于對照組（P＜0.05）。治療后，兩組的C-反應(yīng)蛋白/白蛋白（HCAR）、中性粒細(xì)胞計(jì)數(shù)/淋巴細(xì)胞計(jì)數(shù)（NLR）、血小板計(jì)數(shù)/淋巴細(xì)胞計(jì)數(shù)（PLR）均顯著降低（P＜0.05），且治療組HCAR、NLR、PLR均低于對照組（P＜0.05）。結(jié)論 丹參川芎嗪注射液聯(lián)合尼可剎米注射液可提高慢性呼吸衰竭的療效，進(jìn)一步減輕病情嚴(yán)重程度，改善健康狀況，提高肺功能，降低炎癥反應(yīng)。

Objective To investigate the clinical effect of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with Nikethamide Injection in treatment of acute exacerbation of chronic respiratory failure. Methods Selecting 70 patients with chronic respiratory failure admitted to Linquan County People’s Hospital from January 2022 to December 2023, all patients were divided into a control group and a treatment group using computer randomization method, with 35 patients in each group. Patients of the control group was intravenously injected with Nikethamide Injection, 1 tube/time, and if necessary, repeated administration within 1—2 h. Patients of the treatment group received intravenous infusion of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection on the basis of the control group, 10 mL was added to 250 mL of physiological saline and fully diluted, 10 mL/time, once daily. Patients of two groups received continuous treatment for 10 d. The clinical efficacy, the severity of the condition, health status, lung function indicators, blood gas analysis indicators, and serum indicators in two groups were compared. Results The total effective rates of the treatment group and the control group were 94.29% and 77.14%, with statistically significant differences between the groups (P < 0.05). After treatment, APACHE II scores and CAT scores of two groups significantly decreased (P < 0.05), and APACHE II scores and CAT scores of the treatment group were lower than those of the control group (P < 0.05). After treatment, FEV1/FVC and PEF% pre of two groups were higher than before treatment, while RV/TLC was lower than before treatment (P < 0.05). FEV1/FVC and PEF% pre in the treatment group were higher than those in the control group, while RV/TLC was lower than those in the control group (P < 0.05). After treatment, the oxygenation index, blood oxygen saturation, and oxygen partial pressure of two groups significantly increased (P < 0.05), and the oxygenation index, blood oxygen saturation, and oxygen partial pressure of the treatment group were significantly higher than those of the control group (P < 0.05). After treatment, HCAR, NLR, and PLR of two groups were significantly decreased (P < 0.05), and HCAR, NLR, and PLR of the treatment group were lower than those of the control group (P < 0.05). Conclusion The combination of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection and Nikethamide Injection can improve the therapeutic effect of chronic respiratory failure, further reduce the severity of the condition, improve health status, enhance lung function, and reduce inflammatory reactions.

R974

安徽省紅十字基金會中醫(yī)藥傳承創(chuàng)新發(fā)展研究項(xiàng)目（2022ZYYD25）