目的 探讨龙香平喘胶囊联合噻托溴铵喷雾剂治疗老年支气管哮喘的临床疗效。方法 选取2017年10月—2019年10月在平煤神马医疗集团总医院治疗的80例老年支气管哮喘患者，随机分为对照组（40例）和治疗组（40例）。对照组患者吸入噻托溴铵喷雾剂，2揿/次，1次/d。治疗组在对照组的基础上口服龙香平喘胶囊，3粒/次，3次/d。两组患者治疗10 d。观察两组患者临床疗效，比较治疗前后两组患者临床症状消失时间，肺功能指标第1秒用力呼气量（FEV1）、用力肺活量（FVC）、FEV1/FVC和最大呼气流速峰值（PEFR），血清白细胞介素4（IL-4）、IL-18、肿瘤坏死因子α（TNF-α）、C反应蛋白（CRP）和干扰素γ（INF-γ）水平及不良反应情况。结果 治疗后，治疗组临床总有效率明显高于对照组（P<0.05）。治疗后，治疗组患者临床症状消失时间均显著早于对照组（P<0.05）。治疗后，两组患者FEV1、FVC、FEV1/FVC、PEFR指标均显著升高（P<0.05），且治疗组明显高于对照组（P<0.05）；治疗后，两组患者IL-4、IL-18、TNF-α、CRP水平显著降低，而INF-γ水平显著升高（P<0.05），且治疗组患者血清炎性因子水平明显好于对照组（P<0.05）。治疗后，治疗组患者药物不良反应总发生率明显低于对照组（P<0.05）。结论 龙香平喘胶囊联合噻托溴铵喷雾剂治疗老年支气管哮喘临床效果显著，可有效减轻患者症状，改善肺功能状态及降低炎性因子反应。

Objective To investigate the efficacy of Longxiang Pingchuan Capsules combined with tiotropium bromide in treatment of senile bronchial asthma.Methods Patients (80 cases) with bronchial asthma in General Hospital of Pingmei Shenma Medical Group from October 2017 to October 2019 were randomly divided into control (40 cases) and treatment (40 cases) groups. Patients in the control group were inhalation administered with Tiotropium Bromide Spray, 2 press/time, once daily. Patients in the treatment group were po administered with Longxiang Pingchuan Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacy was evaluated, and the disappearance time of clinical symptoms, the lung function indexes of FEV1, FVC, FEV1/FVC and PEFR, the levels of serum IL-4, IL-18, TNF-α, CRP, and INF-γ, and adverse reaction in two groups before and after treatment were compared.Results After treatment, the total clinical effective rate of the treatment group was significantly higher than that of the control group (P<0.05). After treatment, the disappearance time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, the indexes of FEV1, FVC, FEV1/FVC and PEFR in two groups were significantly increased (P<0.05), and which in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the levels of IL-4, IL-18, TNF-α and CRP in the two groups were significantly decreased, while the level of INF-γ was significantly higher (P<0.05). After treatment, the levels of serum inflammatory factors in the treatment group were significantly better than that in the control group (P<0.05). After treatment, the total incidence of adverse drug reactions in the treatment group was significantly lower than that in the control group (P<0.05).Conclusion Longxiang Pingchuan Capsules combined with tiotropium bromide is effective in treatment of senile bronchial asthma, can effectively relieve symptoms, improve lung function and reduce inflammatory response.

R974