葡萄籽原花青素对慢性阻塞性肺疾病合并睡眠呼吸暂停综合征患者呼吸功能及焦虑情绪的影响(1)
[摘要] 目的 观察葡萄籽原花青素(GSPE)对慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者呼吸功能及焦虑情绪的影响。 方法 采用随机数字表法将2013年6月～2014年6月河北省玉田县中医医院呼吸内科收治的90例稳定期COPD合并OSAHS患者随机分为对照组和观察组，每组各45例。对照组给予综合治疗(常规氧疗+药物+呼吸机治疗+肺康复锻炼)，观察组在此基础上应用GSPE。比较分析治疗前后两组患者动脉血气分析[脉血氧分压(PaO2)、二氧化碳分压(PaCO2)]、肺功能检测[第1秒用力呼气量(FEV1)、每分钟最大通气量(MVV)]、呼吸肌耐力测定[吸气时间比例(Ti/Ttot)、呼吸浅快指数(f/VT)]、HAMA焦虑评分、多导睡眠图(PSG)监测[低通气指数(AHI)、夜间最低血氧饱和度(LSpO2)]指标。 结果 治疗前，两组患者各项监测指标比较差异均无统计学意义(P > 0.05)。治疗后，观察组FEV1、MVV、PaO2、PaCO2、AHI、LSpO2[(0.98±0.18)L、(41.97±4.13)L、(80.44±4.53)mmHg、(30.54±5.22)mmHg、(5.07±1.12)次/h、(90.01±1.76)%]均优于对照组[(0.71±0.20)L、(36.42±4.21)L、(75.37±5.40)mmHg、(36.65±4.50)mmHg、(9.07±1.65)次/h、(81.01±1.45)%]，差异均有统计学意义(P < 0.05)；观察组f/VT、Ti/Ttot[(15.58±3.81)、(0.24±0.03)]均明显高于对照组[(11.37±3.54)、(0.30±0.07)]，差异均有统计学意义(P < 0.05)；观察组患者HAMA评分[(10.04±2.15)分]低于对照组[(12.25±2.02)分]，差异有统计学意义(P < 0.05)。 结论 GSPE对COPD合并OSAHS有一定的治疗作用，可稳定改善患者呼吸功能和心理状态。
[关键词] 葡萄籽原花青素；慢性阻塞性肺疾病；阻塞性睡眠呼吸暂停；焦虑
[中图分类号] R562 [文献标识码] A [文章编号] 1673-7210(2015)08(a)-0136-04
Effect of Grape seed proanthocyanidin extract on respiratory function and anxiety of patients with COPD combined OSAHS
SUN Lizhu1 GE Yanlei2▲ GUO Xia2 WANG Hongyang2
1.Department of Neurology， Yutian County Traditional Chinese Medicine Hospital， Hebei Province， Yutian 064200， China； 2.Department of Respiration， Affiliated Hospital of North China University of Science and Technology University， Hebei Province， Tangshan 063000， China
[Abstract] Objective To explore the effect of grape seed proanthocyanidin extract (GSPE) on respiratory function and anxiety in patients with COPD combined OSAHS. Methods From June 2013 to June 2014， 90 patients with COPD combined with OSAHS from the Yutian County Traditional Chinese Medicine Hospital were randomly divided into the observation group and the control group， with 45 cases in each group. Patients of the the control group were given comprehensive treatment (routine oxygen therapy+drugs+respirator therapy+individualized functional exercise)； patients of the observation group were treated by GSPE on the basis of the comprehensive treatment. The indexes of arterial blood gas analysis (PaO2， PaCO2)， pulmonary function testing (FEV1， MVV)， respiratory muscle endurance [Ti/Ttot， rapid shallow breathing index (f/VT)]， HAMA anxiety score， and PSG， AHI， the LSpO2 before and after treatment of two groups were compared and analyzed. Results The monitoring indicators before treatment had no significant differences between the two groups (P > 0.05). After treatment， FEV1， MVV， PaO2， PaCO2， AHI， LSpO2 in the observation group [(0.98±0.18) L， (41.97±4.13) L， (80.44±4.53) mmHg， (30.54±5.22) mmHg， (5.07±1.12) times/h， (90.01±1.76)%] were better than those of the control group [(0.71±0.20) L， (36.42±4.21) L， (75.37±5.40) mmHg， (36.65±4.50) mmHg， (9.07±1.65) times/h， (81.01±1.45)%]， the differences were statistically significant (P < 0.05). The f/VT and Ti/Ttot of the observation group [(15.58±3.81)， (0.24±0.03)] were all better than those of the control group [(11.37±3.54)， (0.30±0.07)]， the differences were statistically significant (P < 0.05)； but HAMA score [(10.04±2.15) scores] in the observation group was lower than that in the control group [(12.25±2.02) scores]， the difference was statistically significant (P < 0.05). Conclusion GSPE have a certain therapeutic effect on patients with overlap syndrome， and GSPE can improve respiratory function and anxiety. (孙利柱 戈艳蕾 郭霞 王红阳)
[关键词] 葡萄籽原花青素；慢性阻塞性肺疾病；阻塞性睡眠呼吸暂停；焦虑
[中图分类号] R562 [文献标识码] A [文章编号] 1673-7210(2015)08(a)-0136-04
Effect of Grape seed proanthocyanidin extract on respiratory function and anxiety of patients with COPD combined OSAHS
SUN Lizhu1 GE Yanlei2▲ GUO Xia2 WANG Hongyang2
1.Department of Neurology， Yutian County Traditional Chinese Medicine Hospital， Hebei Province， Yutian 064200， China； 2.Department of Respiration， Affiliated Hospital of North China University of Science and Technology University， Hebei Province， Tangshan 063000， China
[Abstract] Objective To explore the effect of grape seed proanthocyanidin extract (GSPE) on respiratory function and anxiety in patients with COPD combined OSAHS. Methods From June 2013 to June 2014， 90 patients with COPD combined with OSAHS from the Yutian County Traditional Chinese Medicine Hospital were randomly divided into the observation group and the control group， with 45 cases in each group. Patients of the the control group were given comprehensive treatment (routine oxygen therapy+drugs+respirator therapy+individualized functional exercise)； patients of the observation group were treated by GSPE on the basis of the comprehensive treatment. The indexes of arterial blood gas analysis (PaO2， PaCO2)， pulmonary function testing (FEV1， MVV)， respiratory muscle endurance [Ti/Ttot， rapid shallow breathing index (f/VT)]， HAMA anxiety score， and PSG， AHI， the LSpO2 before and after treatment of two groups were compared and analyzed. Results The monitoring indicators before treatment had no significant differences between the two groups (P > 0.05). After treatment， FEV1， MVV， PaO2， PaCO2， AHI， LSpO2 in the observation group [(0.98±0.18) L， (41.97±4.13) L， (80.44±4.53) mmHg， (30.54±5.22) mmHg， (5.07±1.12) times/h， (90.01±1.76)%] were better than those of the control group [(0.71±0.20) L， (36.42±4.21) L， (75.37±5.40) mmHg， (36.65±4.50) mmHg， (9.07±1.65) times/h， (81.01±1.45)%]， the differences were statistically significant (P < 0.05). The f/VT and Ti/Ttot of the observation group [(15.58±3.81)， (0.24±0.03)] were all better than those of the control group [(11.37±3.54)， (0.30±0.07)]， the differences were statistically significant (P < 0.05)； but HAMA score [(10.04±2.15) scores] in the observation group was lower than that in the control group [(12.25±2.02) scores]， the difference was statistically significant (P < 0.05). Conclusion GSPE have a certain therapeutic effect on patients with overlap syndrome， and GSPE can improve respiratory function and anxiety. (孙利柱 戈艳蕾 郭霞 王红阳)