目的 探讨羧甲司坦口服溶液联合盐酸莫西沙星片治疗慢性支气管炎急性发作的临床疗效。方法 选取2019年10月—2022年1月在山东省泰山医院进行治疗的112例慢性支气管炎急性发作患者为研究对象，根据用药差别将所有患者分为对照组和治疗组，每组各56例。对照组患者口服盐酸莫西沙星片，0.4 g/次，1次/d；治疗组在此基础上口服羧甲司坦口服溶液，10 mL/次，3次/d。两组均连续治疗7 d。观察两组的临床疗效，比较两组临床症状改善时间、相关评分、血气分析指标、细胞因子水平。结果 治疗后，治疗组总有效率为98.21%%，显著高于对照组82.14%（P<0.05）。治疗后，治疗组咳嗽、咳痰、喘息改善时间显著短于对照组（P<0.05）。治疗后，两组患者圣乔治呼吸问卷（SGRQ）评分、咳嗽视觉模拟评分均较治疗前显著降低，而莱赛斯特生活质量问卷（LCQ）评分、EORTC生命质量测定量表（QLQ-C30）评分均显著升高（P<0.05），并以治疗组改善更明显（P<0.05）。治疗后，两组血氧分压（pO₂）显著升高，而二氧化碳分压（pCO₂）均显著降低（P<0.05），并以治疗组改善更明显（P<0.05）。治疗后，两组C反应蛋白（CRP）、白细胞介素-4（IL-4）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平均较治疗前显著下降（P<0.05），且治疗后，治疗组CRP、IL-4、IL-6、TNF-α水平低于对照组（P<0.05）。结论 羧甲司坦口服溶液联合盐酸莫西沙星片治疗慢性支气管炎急性发作具有较好的临床疗效，可促进患者症状改善及生活质量的提高，调节患者血气指标，降低CRP、IL-4、IL-6、TNF-α水平，值得临床推广应用。

Objective To investigate the clinical efficacy of Carbocysteine Oral Solution combined with moxifloxacin in treatment of acute attack of chronic bronchitis. Methods A total of 112 patients with acute exacerbation of chronic bronchitis treated in Shandong Provincial Taishan Hospital from October 2019 to January 2022 were selected as the research objects. All patients were divided into the control group and the treatment group according to the difference in medication, with 56 cases in each group. Patients in the control group were po administered with Moxifloxacin Hydrochloride Tablets, 0.4 g/time, once daily. Patients in the treatment group were po administered with Carbocysteine Oral Solution on the basis of the control group, 10 mL/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and improvement time of clinical symptoms, correlation scores, blood gas analysis indexes and cytokine levels were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 98.21%, which was significantly higher than 82.14% of the control group (P < 0.05). After treatment, the improvement time of cough, expectoration and wheezing in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the St. George's Respiratory Questionnaire (SGRQ) score and cough visual analogue score of the two groups were significantly lower than those before treatment, while the Lyceste Quality of Life Questionnaire (LCQ) score and EORTC Quality of Life Scale (QLQ-C30) score were significantly higher in the two groups (P < 0.05), and the improvement was more obvious in the treatment group (P < 0.05). After treatment, the blood partial pressure of oxygen (pO₂) was significantly increased, while the blood partial pressure of carbon dioxide (pCO₂) was significantly decreased in both groups (P < 0.05), and the improvement was more obvious in the treatment group (P < 0.05). After treatment, the levels of C-reactive protein (CRP), interleukin-4 (IL-4), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the two groups were significantly decreased compared with those before treatment (P < 0.05). The levels of CRP, IL-4, IL-6 and TNF-α in the treatment group were lower than those in the control group (P < 0.05). Conclusion Carbocysteine Oral Solution combined with moxifloxacin has good clinical efficacy in treatment of acute attack of chronic bronchitis, and can promote the improvement of symptoms and quality of life of patients, regulate the blood gas index of patients, reduce the levels of CRP, IL-4, IL-6 and TNF-α, which is worthy of clinical application.

R974

泰安市科技计划项目（2015NS2098）