Abstract:

Objective　To explore the effect of traditional Chinese medicine application combined with standard nursing on the prognosis of elderly patients with severe pneumonia. Methods　A randomized controlled trial was conducted on 94 elderly patients with severe pneumonia admitted to Henan Provincial Hospital of Traditional Chinese Medicine from August 2020 to July 2022. They were randomly divided into an experimental group and a conventional group with the random number table method, with 47 patients in each group. There were 29 males and 18 females in the conventional group, aged (70.96±6.22) years, and they received routine treatment and nursing. There were 27 males and 20 females in the experimental group, aged (71.84±6.12) years, and they received traditional Chinese medicine application combined with standard nursing on the basis of the conventional group. The remission time of symptoms and signs, hospitalization time, pulmonary function indexes [including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow (PEF)], arterial blood gas indexes [including partial pressure of blood oxygen (PaO₂), partial pressure of carbon dioxide (PaCO₂), and saturation of blood oxygen (SaO₂)], clinical efficacy, and complication rates of the two groups were compared. The statistical methods adopted were t test and χ² test. Results　The disappearance time of cough, shortness of breath, and lung moist rales, and hospitalization time in the experimental group were shorter than those in the conventional group [(5.41±1.26) d vs. (6.73±1.46) d, (2.76±0.92) d vs. (3.44±1.13) d, (5.95±0.60) d vs. (7.22±1.63) d, (19.74±3.02) d vs. (23.48±5.16) d], with statistically significant differences (t=4.692, 3.199, 3.346, and 4.289; all P<0.05). After 14 days of treatment, the FVC, FEV1, PEF, PaO₂, and SaO₂ in the experimental group were higher than those in the conventional group [(2.92±0.65) L vs. (2.55±0.51) L, (2.78±0.60) L vs. (2.48±0.47) L, (7.05±0.88) L/s vs. (6.17±0.79) L/s, (85.29±5.57) mmHg vs. (81.72±4.23) mmHg (1 mmHg = 0.133 kPa), (95.72±8.84)% vs. (90.41±7.52)%], and the PaCO₂ was lower than that in the conventional group [(44.83±5.32) mmHg vs. (47.45±6.19) mmHg], with statistically significant differences (t=3.070, 2.698, 5.102, 3.499, 3.174, and 2.201; all P<0.05). The total effective rates of the experimental group and the conventional group were 89.36% (42/47) and 72.34% (34/47), respectively, and the total incidences of complications were 10.64% (5/47) and 27.66% (13/47), respectively, with statistically significant differences (both χ²=4.398, both P=0.036). Conclusion　Traditional Chinese medicine application combined with standard nursing can promote the disappearance of symptoms and signs in elderly patients with severe pneumonia, improve the lung function, blood oxygen, and curative effect, reduce the complications, shorten the hospital stay, and has a definite effect.

Key words:

Pneumonia, Severe, Elderly, Traditional Chinese medicine application, Standard nursing

摘要：

目的　探讨中药贴敷联合达标式护理对老年重症肺炎患者病情转归的影响。方法　选取河南省中医院2020年8月至2022年7月收治的94例老年重症肺炎患者开展随机对照试验，采用随机数字表法分为试验组和常规组，各47例。常规组男29例、女18例，年龄（70.96±6.22）岁，给予常规治疗和护理；试验组男27例、女20例，年龄（71.84±6.12）岁，在常规组基础上给予中药贴敷联合达标式护理。比较两组症状、体征缓解时间、住院时间、肺功能指标［包括用力肺活量（FVC）、第1秒最大呼吸容积（FEV1）、呼气峰值流量（PEF）］、动脉血气指标［包括血氧分压（PaO₂）、二氧化碳分压（PaCO₂）、血氧饱和度（SaO₂）］、临床疗效和并发症发生率。统计学方法采用t检验、χ²检验。结果　试验组的咳嗽、气促、肺部湿啰音消失时间和住院时间均短于常规组［（5.41±1.26）d比（6.73±1.46）d、（2.76±0.92）d比（3.44±1.13）d、（5.95±0.60）d比（7.22±1.63）d、（19.74±3.02）d比（23.48±5.16）d］，差异均有统计学意义（t=4.692、3.199、3.346、4.289，均P<0.05）。治疗14 d后，试验组的FVC、FEV1、PEF、PaO₂和SaO₂均高于常规组［（2.92±0.65）L比（2.55±0.51）L、（2.78±0.60）L比（2.48±0.47）L、（7.05±0.88）L/s比（6.17±0.79）L/s、（85.29±5.57）mmHg（1 mmHg =0.133 kPa）比（81.72±4.23）mmHg、（95.72±8.84）%比（90.41±7.52）%］，PaCO₂低于常规组［（44.83±5.32）mmHg比（47.45±6.19）mmHg］，差异均有统计学意义（t=3.070、2.698、5.102、3.499、3.174、2.201，均P<0.05）。试验组、常规组的治疗总有效率分别为89.36%（42/47）、72.34%（34/47），并发症总发生率分别为10.64%（5/47）、27.66%（13/47），差异均有统计学意义（均χ²=4.398，均P=0.036）。结论　中药贴敷联合达标式护理能够促进老年重症肺炎患者症状、体征消退，提高肺功能、血氧以及疗效，减少并发症，缩短住院时间，效果确切。

关键词:

肺炎, 重症, 老年, 中药贴敷, 达标护理