目的 探讨沙丁胺醇联合二羟丙茶碱治疗慢性阻塞性肺疾病急性加重期（AECOPD）的临床效果。方法 选取2017年1月—2019年6月亳州市中医院收治的AECOPD患者78例，随机分成对照组（39例）和治疗组（39例）。对照组静脉滴注二羟丙茶碱注射液，0.5 g加入5%葡萄糖液，1次/d。治疗组在对照组基础上吸入吸入用硫酸沙丁胺醇溶液，2.5 mg/次，2次/d。两组均连续治疗7 d。观察两组患者临床疗效，同时比较治疗前后两组患者典型表现缓解时间，咳嗽和咳痰的评估问卷（CASA-Q）、改良版英国医学研究委员会呼吸问卷（mMRC）和CAT评分，第1秒用力呼气容积（FEV1）与用力肺活量比值（FEV1/FVC）、最大自主通气量（MVV）、最大呼气中期流量（MMEF）、FEV1占预计值百分比（FEV1%pred）、残气容积与肺总量比值（RV/TLC）和呼出气一氧化氮（FeNO）浓度。结果 治疗后，对照组和治疗组临床有效率分别为79.49%和94.87%，两组比较差异具有统计学意义（P<0.05）。治疗后，治疗组在典型呼吸道表现的缓解时间上均显著短于对照组（P<0.05）。治疗后，两组CASA-Q总分均显著升高（P<0.05），而mMRC和CAT问卷评分则均显著降低（P<0.05）；且治疗组上述评分改善效果比对照组更明显（P<0.05）。治疗后，两组FEV1/FVC、MVV、MMEF及FEV1占预计值百分比（FEV1%pred）均显著高于治疗前（P<0.05），而残气容积与肺总量比值（RV/TLC）和FeNO浓度均显著下降（P<0.05）；且治疗组上述肺功能参数值和FeNO水平改善程度比对照组更明显（P<0.05）。结论 沙丁胺醇联合二羟丙茶碱治疗AECOPD可迅速缓解气流受限，减轻气道炎症，控制患者急性恶化的呼吸症状，稳定病情。

Objective To investigate the clinical effects of salbutamol combined with diprophylline in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Patients (78 cases) with AECOPD in Bozhou Hospital of Traditional Chinese Medical from January 2017 to June 2019 were randomly divided into control (39 cases) and treatment (39 cases) groups. Patients in the control group were iv administered with Diprophylline Injection, 0.5 g added into 5% glucose injection, once daily. Patients in the treatment group were inhalation administered with Salbutamol Sulfate Inhalation Solution on the basis of the control group, 2.5 mg/time, twice daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the remission time of typical manifestations, the scores of CASA-Q, mMRC and CAT, the level of FEV1/FVC, MVV, MMEF, FEV1%pred, RV/TLC and FeNO in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 79.49% and 94.87% respectively, and there were differences between two groups (P<0.05). After treatment, the remission time of typical manifestations in the treatment group was significantly shorter than that in the control group (P<0.05). After treatment, the CASA-Q scores in two groups were significantly increased (P<0.05), but the mMRC and CAT scores were significantly decreased (P<0.05), and these scores in the treatment group were significantly better than that in the control group (P<0.05). After treatment, the FEV1/FVC, MVV, MMEF and FEV1%pred in two groups were significantly increased (P<0.05), but the RV/TLC and FeNO levels were significantly decreased (P<0.05), and the pulmonary function indexes and FeNO concentration in the treatment group were significantly better than that in the control group (P<0.05). Conclusion Salbutamol combined with diprophylline in treatment of AECOPD can quickly alleviate airflow limitation, reduce airway inflammation, control acute exacerbation of respiratory symptoms and stabilize the disease.

R974