目的 探讨橘红痰咳液联合异丙托溴铵治疗慢性阻塞性肺疾病急性加重期的临床效果。方法 选取2017年1月-2019年1月平山县人民医院收治的慢性阻塞性肺疾病急性加重期患者122例，随机分成对照组（61例）和治疗组（61例）。对照组雾化吸入吸入用异丙托溴铵溶液，500 μg/次，3次/d。治疗组在对照组基础上口服橘红痰咳液，20 mL/次，3次/d。两组均连续治疗14 d。观察两组患者临床疗效，同时比较治疗前后两组患者主要症状积分、主要症状缓解时间、CAT问卷评分、肺功能以及血清肿瘤坏死因子-α（TNF-α）、白细胞介素-8（IL-8）、白三烯B4（LTB4）、C反应蛋白（CRP）水平。结果 治疗后，对照组和治疗组临床有效率分别为83.6%和95.1%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者主要症状积分和缓解时间均显著降低（P<0.05），且治疗组患者显著低于对照组（P<0.05）。治疗后，两组CAT问卷评分、残气容积（RV）与肺总量（TLC）比值（RV/TLC）值均显著降低（P<0.05），第1秒用力呼气容积（FEV1）与用力肺活量（FVC）比值（FEV1/FVC）、FEV1占预计值百分比（FEV1占预计值%）和一氧化碳弥散量（DLCO）与肺泡通气量（VA）比值（DLCO/VA）值均显著升高（P<0.05），且治疗组患者CAT问卷评分和上述肺功能参数的改善效果显著好于对照组（P<0.05）。治疗后，两组患者血清TNF-α、IL-8、LTB4、CRP水平显著降低（P<0.05），且治疗组患者血清TNF-α、IL-8、LTB4、CRP水平显著低于对照组（P<0.05）。结论 橘红痰咳液联合异丙托溴铵治疗慢性阻塞性肺疾病急性加重期整体疗效显著，能迅速控制患者病情，有效降低相关炎症因子的表达水平，保护肺功能。

Objective To investigate the clinical effect of Juhong Tanke Liquid combined with ipratropium bromide in treatment of acute exacerbation of COPD. Methods Patients (122 cases) with acute exacerbation of COPD in Pingshan People's Hospital from January 2017 to January 2019 were randomly divided into control (61 cases) and treatment (61 cases) groups. Patients in the control group were atomization inhalation administered with Ipratropium Bromide Solution for inhalation, 500 μg/time, three times daily. Patients in the treatment group were po administered with Juhong Tanke Liquid on the basis of the control group, 20 mL/times, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the main symptom scores, the relief time of main symptom, CAT questionnaire scores, pulmonary function index, the levels of TNF-α, IL-8, LTB4, and CRP in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 83.6% and 95.1%, respectively, and there were differences between two groups (P<0.05). After treatment, the scores and relief time of main symptom in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the CAT questionnaire scores and RV/TLC value in two groups were significantly decreased (P<0.05), but the FEV1/FVC value, FEV1 in the predicted value and DLCO/VA value was significantly increased (P<0.05), and these indicators in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the levels of TNF-α, IL-8, LTB4 and CRP in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Juhong Tanke Liquid combined with ipratropium bromide in treatment of acute exacerbation of COPD has significant effect, can quickly control the patient's condition, effectively reduce the expression level of relevant inflammatory factors and protect lung function.

R974