目的 探讨十味龙胆花胶囊联合噻托溴铵粉雾剂治疗慢性阻塞性肺疾病急性加重期的临床疗效。方法 选取2017年5月-2019年11月郑州大学第五附属医院收治的103例慢性阻塞性肺疾病急性加重期患者作为研究对象，按照随机数字表法将患者分为对照组（51例）和治疗组（52例）。对照组患者给予噻托溴铵粉雾剂，18 μg/次，1次/d。治疗组患者在对照组的基础上口服十味龙胆花胶囊，3粒/次，3次/d。两组患者均治疗14 d。观察两组的临床疗效，比较两组肺功能、炎性因子。结果 治疗后，治疗组的临床总有效率90.38%高于对照组的74.51%（P<0.05）。治疗后，两组用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、第1秒用力呼气容积占用力肺活量之比（FEV1/FVC）均较治疗前升高（P<0.05），且治疗组肺功能指标高于对照组（P<0.05）。治疗后，两组白细胞介素-6（IL-6）、降钙素原（PCT）、C反应蛋白（CRP）水平均较治疗前降低（P<0.05），且治疗组炎性因子水平低于对照组（P<0.05）。结论 十味龙胆花胶囊联合噻托溴铵粉雾剂治疗慢性阻塞性肺疾病急性加重期的疗效显著，可改善患者肺功能，降低机体炎性因子水平，安全性较好，具有一定的临床推广应用价值。

Objective To investigate the effect of Shiwei Longdanhua Capsules combined with Tiotropium Bromide Powder for inhalation in treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods Patients (103 cases) with acute exacerbation of chronic obstructive pulmonary disease in the Fifth Affiliated Hospital of Zhengzhou University from May 2017 to November 2019 were randomly divided into the control group (52 cases) and the treatment group (51 cases). Patients in the control group were given Tiotropium Bromide Powder for inhalation, 18 μg/time, once daily. Patients in the treatment group were po administered with Shiwei Longdanhua Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and pulmonary function and inflammatory factor levels in two groups were compared. Results After treatment, the total clinical effective rate of the treatment group was 90.38% higher than that of the control group (74.51%) (P<0.05). After treatment, FVC, FEV1, and FEV1/FVC of the two groups were higher than those before treatment (P<0.05), and pulmonary function indexes of the treatment group was higher than that of the control group (P<0.05). After treatment, the levels of IL-6, PCT, and CRP in two groups were lower than those before treatment (P<0.05), and the indexes of inflammatory factors in the treatment group were lower than those in the control group (P<0.05). Conclusion Shiwei Longdanhua Capsules combined with Tiotropium Bromide Powder for inhalation has clinical curative effect in treatment of acute exacerbation of chronic obstructive pulmonary disease, can improve pulmonary function of patients, reduce the levels of inflammatory factors in the body, with good safety, which has a certain clinical application value.

R974

河南省医学科技攻关计划项目（2017T03091）