[关键词]
[摘要]
目的 探讨慢性阻塞性肺疾病急性加重期应用桂龙咳喘宁胶囊联合福多司坦治疗的效果。方法 2015年2月-2018年4月天津市宝坻区人民医院呼吸科收治的114例慢性阻塞性肺疾病急性加重期患者,随机分成对照组(n=57)和治疗组(n=57)。对照组口服福多司坦片,0.4 g/次,3次/d,餐后服用。治疗组患者在对照组基础上口服桂龙咳喘宁胶囊,3粒/次,3次/d。两组均连续治疗14 d。比较两组临床疗效和呼吸系统症状体征的缓解时间,治疗前后肺功能参数[第1秒用力呼气容积(FEV1)占预计值百分比(FEV1占预计值%)、FEV1与用力肺活量(FVC)比值(FEV1/FVC)、呼气峰值流量(PEF)]值、慢性阻塞性肺疾病患者自我评估测试问卷(CAT)评分、外周血嗜酸性粒细胞绝对值(EOS#)及中性粒细胞(NEUT)与淋巴细胞(LYM)比值(NLR)和血清学相关指标[嗜酸性粒细胞阳离子蛋白(ECP)、白介素(IL)-13、8-羟基脱氧鸟苷(8-OHdG)、总抗氧化能力(TAC)]水平变化,不良反应发生情况。结果 对照组和治疗组的总有效率分别是86.0%、96.5%,两组比较差异有统计学意义(P<0.05)。与对照组相比,治疗组咳嗽、咳痰等急性加重的呼吸系统症状体征的缓解时间均显著更短(P<0.05)。与治疗前对比,两组治疗后FEV1占预计值%、FEV1/FVC及PEF值均显著增高(P<0.05),CAT评分则均显著降低(P<0.05);但治疗后,治疗组上述肺功能参数值较对照组同期均显著更高(P<0.05),而CAT评分显著更低(P<0.05)。两组治疗后外周血EOS#、NLR值及血清ECP、IL-13、8-OHdG水平均显著低于治疗前(P<0.05),血清TAC水平则均显著升高(P<0.05);且治疗后,治疗组以上指标(EOS#、NLR、ECP、IL-13、8-OHdG、TAC)的改善效果均更显著(P<0.05)。两组均无严重不良反应发生。结论 桂龙咳喘宁胶囊联合福多司坦治疗慢性阻塞性肺疾病急性加重期的整体疗效显著,能有效缩短稳定患者病情的时间,改善肺通气功能,缓解气道炎症及全身炎症状态,纠正氧化/抗氧化失衡,具有一定的临床推广应用价值。
[Key word]
[Abstract]
Objective To investigate the clinical effect of Guilong Kechuanning Capsules combined with Fidostatin in treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods 114 Patients with acute exacerbation of chronic obstructive pulmonary disease admitted to Tianjin Baodi District People's Hospital from February 2015 to April 2018 were randomly divided into control group (n=57) and treatment group (n=57).). The control group was po administered with Fudosteine Tablets, 0.4 g/time, three times daily. The treatment group was po administered with Shufeng Jiedu Capsules on the basis of the control group, 3 grains/time, three times daily. All patients were treated for 14 days. The clinical efficacy and remission time of respiratory symptoms and signs was compared between the two groups. The lung function parameters[1 second forced expiratory volume (FEV1) as a percentage of predicted value (FEV1 accounted for the predicted value), FEV1 and forced vital capacity (FVC) ratio (FEV1/FVC), peak expiratory flow (PEF) values, self-assessment test questionnaire (CAT) scores for patients with chronic obstructive pulmonary disease, absolute eosinophils in peripheral blood (EOS#), and neutrophils (NEUT)) to lymphocyte (LYM) ratio (NLR) and serologically relevant indicators[eosinophilic cationic protein (ECP), interleukin (IL)-13, 8-hydroxydeoxyguanosine (8-OHdG), total antioxidant capacity) (TAC)] in two groups were compared. Results The total effective rate of the treatment group was 96.5%, which was significantly higher than that of the control group 86.0% (P<0.05). Compared with the control group, the remission time of respiratory symptoms and signs of acute exacerbation such as cough and cough was significantly shorter in the treatment group (P<0.05). Compared with pre-treatment, FEV1 accounted for the predicted value, FEV1/FVC and PEF values were significantly increased (P<0.05), and CAT scores were significantly lower (P<0.05). However, after treatment, the functional parameter values were significantly higher than the control group (P<0.05), while the CAT score was significantly lower (P<0.05). The levels of EOS#, NLR and serum ECP, IL-13 and 8-OHdG in the two groups were significantly lower than those before treatment (P<0.05), and serum TAC levels were significantly increased (P<0.05). After treatment, the improvement of the above indicators (EOS#, NLR, ECP, IL-13, 8-OHdG, TAC) was more significant (P<0.05). There were no serious adverse events in either group. Conclusion Guilong Kechuanning Capsules combined with fidostatin has a significant overall effect in the treatment of acute exacerbation of chronic obstructive pulmonary disease, and can effectively shorten the time of stable patients, improve lung ventilation, and relieve airway inflammation and systemic inflammation. and also can correct oxidation/antioxidant imbalance, which has a certain clinical application value.
[中图分类号]
R974
[基金项目]