目的 探讨清开灵注射液联合噻托溴铵治疗慢性阻塞性肺病的临床疗效。方法 选取2013年2月-2015年2月在广州市荔湾区人民医院呼吸内科接受治疗的慢性阻塞性肺疾病患者92例,根据治疗方案的差别分为对照组(46例)和治疗组(46例)。所有患者均给予吸氧、抗感染、止咳化痰和平喘等基础治疗。对照组吸入噻托溴铵粉吸入剂,18 μg放入HandiHaler装置中并刺破,1次/d。治疗组在对照组基础上静脉滴注清开灵注射液,40 mL加入生理盐水100 mL,1次/d。两组患者均治疗2周。观察两组的临床疗效,同时比较两组动脉血气指标、肺功能指标和血清炎性因子水平变化情况。结果 治疗后,对照组和治疗组总有效率分别为82.61%和95.65%,两组比较差异具有统计学意义(P<0.05)。治疗后两组动脉血pH值和氧分压(pO₂)值均较同组治疗前明显增高(P<0.05),动脉血二氧化碳分压(pCO₂)值比同组治疗前明显降低(P<0.05);与对照组比较,治疗组的动脉血气指标改善更明显(P<0.05)。治疗后两组一秒用力呼气容积(FEV₁)、用力肺活量(FVC)和FEV₁/FVC值较同组治疗前增高(P<0.05),但治疗组增高更明显(P<0.05)。治疗后两组白细胞介素-8(IL-8)、基质金属蛋白酶-9(MMP-9)和肿瘤坏死因子-α(TNF-α)均较同组治疗前明显降低,差异具有统计学意义(P<0.05);且治疗组比对照组降低的更明显,差异具有统计学意义(P<0.05)。结论 清开灵注射液联合噻托溴铵治疗慢性阻塞性肺病效果显著,可明显改善患者肺功能和降低血清炎性因子水平,具有一定的临床推广应用价值。

ObjectiveTo evaluate the clinical efficacies of Qingkailing Injection combined with tiotropium bromide in treatment of chronic obstructive pulmonary disease. Methods Patients (92 cases) with chronic obstructive pulmonary disease from February 2013 to February 2015 in Liwan District People's Hospital of Guangzhou were divided into control group (46 cases) and treatment group (46 cases) based on different treatment methods. All patients were given basic treatment with oxygen inhalation, anti-infection, relieving cough, resolving phlegm, relieving asthma, etc. Patients in the control group were inhal administered with Tiotropium Bromide Powder for inhalation, 18 μg put into the HandiHaler device, then punctured, once daily; Patients in the treatment group were iv administered with Qingkailing Injection, 40 mL added into normal saline 100 mL, once daily. The patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the changes of arterial blood gas indexes, pulmonary function indexes and serum inflammatory factors levels in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment group were 82.61% and 95.65%, respectively, and there were differences between two groups (P < 0.05). After treatment, arterial blood pH value and pressure of oxygen (pO₂) in two groups were significantly increased (P < 0.05), and arterial carbon dioxide pressure (pCO₂) was significantly decreased (P < 0.05). In arterial blood gas indexes, the treatment group improved more significantly than those in the control group (P < 0.05). After treatment, forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), and FEV₁/FVC value of two groups were significantly increased (P < 0.05). Compared with the control group, the treatment group increased more obviously (P < 0.05). After treatment, interleukin-8 (IL-8), matrix metalloproteinase-9 (MMP-9), and tumor necrosis factor-α (TNF-α) were decreased more than those before treatment with significant difference (P < 0.05). And these indexes in treatment group were decreased more than those in the control group, and the difference was significant (P < 0.05). Conclusion Qingkailing Injection combined with thiazide supporting bromide has significant efficacy in treatment of chronic obstructive pulmonary disease, can significantly improve lung function and reduce serum inflammatory factors levels, which has a certain clinical application value.