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ObjectiveIn view of the problems of large errors and poor accuracy in pulmonary function testing in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), a predictive classification model of pulmonary function in patients with AECOPD was proposed by comparing the prediction performance of different machine learning models to find the optimal model. MethodsFrom January, 2018 to February, 2020, 90 patients with different degrees of COPD from the Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University were collected. Six machine learning model algorithms (K-nearest neighbor, logistic regression, support vector machine, naive Bayes, decision tree and random forest) were used to establish AECOPD predictive classification models. Their area under the curve of receiver operating characteristic (AUC-ROC) and accuracy were compared. Ten-fold cross-validation method was used to validate the data set. ResultsThe model based on random forest worked best in predicting and classifying AECOPD patients, with an accuracy rate of 0.844 and an AUC-ROC of 0.916. ConclusionRandom forest-based predictive model is a powerful tool for identifying patients with AECOPD, providing decision support when it is difficult to give a definitive diagnosis.
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Objective:To explore the application effect of early intervention of pulmonary rehabilitation management in emergency department-ward linkage under multi-disciplinary team (MDT) mode in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:Using convenient sampling method, 124 AECOPD patients admitted to Department of Emergency of Qilu Hospital of Shandong University (Qingdao) were selected as the study objects. According to the admission order, 62 patients admitted from March to October 2020 were taken as the control group, and 62 patients admitted from March to October 2021 were taken as the observation group. The control group was given routine treatment and rehabilitation guidance. On the basis of this, the observation group received the early lung rehabilitation management of emergency-ward linkage under MDT mode. The arterial oxygen saturation, lung function index (FEV 1, FEV 1%Pred, FEV 1/FVC), 6-minute walk test (evaluation only after intervention) and quality of life of patients were evaluated before and after intervention. Results:Finally, 60 patients in each group completed the study. After the intervention, the arterial oxygen saturation, the score of quality of life, 6-minute walk test and FEV 1, FEV 1%Pred, FEV 1/FVC of patients in observation group were 0.93 ± 0.04, (29.68 ± 4.87) points, (341.93 ± 46.55) m, and (1.86 ± 0.68) L, (66.13 ± 8.96)%, (68.2 ± 58.53)%, respectively. And in the control group, they were 0.91 ± 0.04, (35.83 ± 2.94) points, (268.75 ± 50.78) m, and (1.50 ± 0.66) L, (61.70 ± 7.16)%, (64.10 ± 8.42) %, respectively. The observation group was significantly better than the control group ( t values were -8.23 to 8.37, all P<0.01). Conclusions:Early intervention of pulmonary rehabilitation by emergency-ward linkage under MDT mod can effectively improve arterial oxygen saturation, pulmonary function, exercise ability and quality of life of patients with AECOPD.
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OBJECTIVE@#To verify the effect of warm acupuncture combined with western medicine in patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD) with phlegm-turbid obstructing of the lung.@*METHODS@#Ninety patients with AECOPD were randomly divided into a western medicine group, a warm acupuncture group and a sham acupuncture group, 30 cases in each group. Routine treatment according to the Global initiative for chronic obstructive lung disease (GOLD) guidelines was used in the western medicine group. On the basis of the routine treatment, the warm acupuncture was applied at Fenglong (ST 40), Feishu (BL 13), Zusanli (ST 36) and other acupoints in the warm acupuncture group. In the sham acupuncture group, non-acupoints were taken on the basis of conventional treatment, and superficial acupuncture was performed for 1-3 mm, once a day for 2 weeks. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, cough and sputum assessment questionnaire (CASA), COPD assessment test (CAT), and the change of TCM syndrome score were observed before and after treatment in all groups.@*RESULTS@#After treatment, the FEV1, FVC and FEV1/FVC in each group were higher than those before treatment (0.05). The CASA score, CAT score and TCM syndrome score in each group were lower than those before treatment (0.05).@*CONCLUSION@#Warm acupuncture has a significant effect on the improvement of symptoms in patients with AECOPD with phlegm-turbid obstructing of the lung.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Forced Expiratory Volume , Lung , Pulmonary Disease, Chronic Obstructive , TherapeuticsABSTRACT
OBJECTIVE:To systematically review the efficacy and safety of salmeterol and fluticasone propionate aerosol in the treatment of AECOPD and provide evidence-based reference for the clinical treatment. METHODS:CJFD,Wanfang database, VIP,CBM,Cochrane Library,PubMed and EMBase were retrieved to collect the randomized controlled trial(RCT)of efficacy and safety of salmeterol and fluticasone propionate aerosol in the treatment of AECOPD. After information collection and quality evalua-tion,Meta-analysis was performed by using Rev Man 5.1 software. RESULTS:There were totally 17 RCTs,including 2 872 pa-tients. Results of Meta-analysis showed FEV1[SMD=0.47,95%CI(0.41,0.53),P<0.001],FEV1/FVC [SMD=1.08,95%CI(0.76, 1.39),P<0.001],FEV1 percentage of predicted value[SMD=0.83,95%CI(0.60,1.06),P<0.001] and incidence of adverse reac-tions [RR=1.38,95%CI(1.02,1.87),P=0.03] in test group were significantly higher than control group,with significant differenc-es. CONCLUSIONS:Salmeterol and fluticasone propionate aerosol has good efficacy in the treatment of AECOPD,can better im-prove patients’lung function and the safety needs to be improved. Due to the limit of research methodology,it remains to be fur-ther verified by large-sample and high-quality RCT.
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Objective To observe the clinical cure effect of Zhilong Tongluo Decoction on chronic obstructive pulmonary disease in acute exacerbation(AECOPD). [Method] Take prospective research method to randomly divide 70 cases of AECOPD into 2 groups, the control one(35 cases) take routine western medicine(WM) for treatment, the treatment group(35), added with Zhilong Tongluo Decoction on the basis of control one. After being treated for 14d, compare their PH value, PaO2, PaCO2, HCT, ESR, CRP and clinical effect and side effects before and after treatment. [Result] The comparison of both groups had no difference of statistical meaning on PH,PaO2,PaCO2,HCT,ESR,CRP; after treatment, the PH and PaO 2 markedly increased, PaCO2 obviously decreased(P<0.05), so did HCT,ESR,CRP(P<0.05,P<0.01); the treatment group was much better than control one on improvement, so was the effective rate. Both had no marked side effects. [Conclusion] Zhilong Tongluo Decoction controls inflammation and improves ventilation and blood flow with its Tongluo(stretch col aterals), having obvious effect on AECOPD.
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Objective To evaluate the effectiveness and safety of BiPAP non-invasive ventilation on COPD patients during acute exacerbation(AECOPD).Methods 20 COPD patients were ventilated using BiPAP non-inva- sive ventilation through a nose or mouth-nose mask.Their vital signs(RR,HR and BP)and arterial blood gases indi- cators(pH,PaCO_2,PaO_2 and SaO_2)before and after ventilation were monitored and the clinical effectiveness was ob- served.Results The vital signs and arterial blood gases indicators of 17 of the 20 AECOPD patients were improved. PaCO_2 was lowered,pH,PaO_2 and SaO_2 were elevated,and the difference before and after ventilation was statistically significant(P＜0.05).Conclusion BiPAP non-invasive ventilation can improve the vital signs and physiological in- dicators of AECOPD patients,relieve their respiratory muscle fatigue and prevent them from exacerbation of respira- tory failure,thereby lower the need for endotracheal inrubation.