目的 探讨金咳息胶囊联合厄多司坦分散片治疗老年慢性阻塞性肺气肿（COPE）的临床疗效。方法 选取2015年1月-2016年1月榆林市第一医院收治的122例COPE老年患者为研究对象，随机分为对照组（61例）和治疗组（61例）。对照组口服厄多司坦分散片，2片/次，2次/d。治疗组在对照组的基础上口服金咳息胶囊，5粒/次，3次/d。两组均治疗14 d。治疗后，观察两组的临床疗效，同时比较两组治疗前后血气指标、肺功能指标、免疫功能指标的变化情况。结果 治疗后，对照组和治疗组的总有效率分别为80.3%、93.4%，两组比较差异有统计学意义（P<0.05）。治疗后，两组pH值和氧分压（pO₂）显著升高，二氧化碳分压（pCO₂）显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组的血气指标优于对照组，两组比较差异有统计学意义（P<0.05）。两组患者用力肺活量（FVC）、第1秒用力呼气容积（FEV1）和呼气峰流速值（PEFR）均比治疗前明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组的肺功能指标显著高于对照组，两组比较差异有统计学意义（P<0.05）。两组免疫球蛋白IgG、IgA、IgM和T细胞亚群CD³⁺、CD⁴⁺和CD⁸⁺水平均显著升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组免疫功能指标均高于对照组，两组比较差异有统计学意义（P<0.05）。结论 金咳息胶囊联合厄多司坦分散片治疗COPE临床疗效较好，可显著改善血气指标和肺功能，提高免疫功能，具有一定的临床推广应用价值。

Objective To explore the clinical efficacy of Jinkexi Capsule combined with Erdosteine Dispersible Tablets in treatment of elderly chronic obstructive pulmonary emphysema (COPE). Methods Patients (122 cases) with elderly COPE in Yulin First Hospital from January 2015 to January 2016 were randomly divided into control (61 cases) and treatment (61 cases) groups. Patients in the control group were administered with Erdosteine Dispersible Tablets, 2 tablets/time, twice daily. Patients in the treatment group were po administered with Jinkexi Capsule on the basis of the control group, 5 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the changes of blood gas indexes, lung function indexes, and immune function indexes in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 80.3% and 93.4%, respectively, and there was difference between two groups (P<0.05). After treatment, pH and oxygen partial pressure (pO₂) in two groups significantly increased, but partial pressure of carbon dioxide (pCO₂) was significantly decreased, and the difference was statistically significant in the same group (P<0.05). And after treatment, blood gas indexes in the treatment group were higher than those in the control group, and there was difference between two groups (P<0.05). Forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEFR) in two groups significantly increased, and the difference was statistically significant in the same group (P<0.05). And lung function indexes in the treatment group were higher than those in the control group, and there was difference between two groups (P<0.05). IgG, IgA, IgM and CD³⁺, CD⁴⁺, and CD⁸⁺levels in two groups significantly increased, and the difference was statistically significant in the same group (P<0.05). And immune function indexes in the treatment group were higher than those in the control group, and there was difference between two groups (P<0.05). Conclusion Jinkexi Capsule combined with Erdosteine Dispersible Tablets has a significant effect in treatment of elderly COPD, and can significantly improve blood gas indexes and lung function, and also can improve immune function, which has a certain clinical application value.

陕西省教育厅自然科学研究项目（09JK819）