目的 研究热毒宁注射液联合复方异丙托溴铵治疗慢性阻塞性肺疾病急性加重期的临床疗效。方法 选取2020年1月—2020年6月在郑州大学附属洛阳中心医院治疗的86例慢性阻塞性肺疾病急性加重期患者为研究对象，随机分为对照组和治疗组，每组各43例。对照组患者给予吸入用复方异丙托溴铵溶液，2.5 mL加入雾化器氧气驱动雾化吸入，3次/d；治疗组在对照组的基础上静脉滴注热毒宁注射液，20 mL加入0.9%氯化钠注射液250 mL稀释，1次/d。两组均连续治疗10 d。两组均连续治疗10 d。比较两组患者的临床疗效、血气分析及肺功能指标、炎症及氧化应激指标、前白蛋白（PA）水平变化。结果 治疗后，对照组和治疗组的总有效率分别为81.40%、95.35%，治疗组的临床疗效显著高于对照组（P<0.05）。治疗后，两组动脉血氧分压（pO₂）显著升高，但动脉血二氧化碳分压（pCO₂）显著降低（P<0.05）；且治疗后治疗组pO₂高于对照组，而pCO₂低于对照组（P<0.05）。治疗后，两组第1秒用力呼气容积（FEV₁）、FEV₁/用力肺活量（FVC）均显著升高，同组治疗前后差异显著（P<0.05）；且治疗组肺功能指标上升更为明显（P<0.05）。治疗后，对照组与治疗组患者超敏C反应蛋白（hs-CRP）、降钙素原（PCT）水平均显著降低（P<0.05）；且治疗组降低更为明显，两组比较差异存在统计学意义（P<0.05）。治疗后，两组患者丙二醛（MDA）、过氧化脂质（LPO）水平均显著降低，而谷胱甘肽-S转移酶（GSH-ST）、血清PA水平显著升高（P<0.05）；治疗后，治疗组MDA、LPO水平低于对照组，而GSH-ST、PA水平高于对照组（P<0.05）。结论 热毒宁注射液联合复方异丙托溴铵可显著促进慢性阻塞性肺疾病急性加重期患者的恢复，降低机体炎性反应，恢复氧化–抗氧化平衡，提高机体营养状态，值得临床推广应用。

Objective To investigate the clinical effects of Reduning Injection combined with compound ipratropium bromide in treatment of acute exacerbations of chronic obstructive pulmonary disease. Methods A total of 86 patients with acute exacerbation of chronic obstructive pulmonary disease treated in Luoyang Central Hospital Affiliated to Zhengzhou University from January 2020 to June 2020 were selected as research objects and randomly divided into control group and treatment group, with 43 patients in each group. Patients in the control group were given Compound Ipratropium Bromide Solution for inhalation, and 2.5 mL was added to the atomizer to drive oxygen inhalation for 3 times daily. Patients in the treatment group were iv administered with Reduning Injection on the basis of the control group, and 20 mL added into 0.9% Sodium Chloride Injection 250 mL, once daily. Patients in two groups were treated for 10 d. After treatment, clinical efficacy, blood gas analysis, lung function indicators, inflammatory and oxidative stress indicators, and changes in prealbumin levels were compared between the two groups. Results After treatment, the total effective rate of the control group and the treatment group were 81.40% and 95.35%, respectively, and the clinical efficacy of the treatment group was significantly higher than that of the control group (P<0.05). After treatment, pO₂ was significantly increased in both groups, but pCO₂ was significantly decreased (P<0.05). After treatment, pO₂ of the treatment group was higher than the control group, while pCO₂ was lower than the control group (P<0.05). After treatment, FEV₁ and FEV₁/FVC in both groups were significantly increased, with significant difference before and after treatment in the same group (P<0.05). In addition, the lung function indexes increased significantly in the treatment group (P<0.05). After treatment, the levels of hs-CRP and PCT in the control group and the treatment group were significantly decreased (P<0.05). The reduction was more significant in the treatment group, and the difference between the two groups was statistically significant (P<0.05). After treatment, MDA and LPO levels were significantly decreased in both groups, while GSH-ST and serum PA levels were significantly increased (P<0.05). After treatment, MDA and LPO levels in the treatment group were lower than those in the control group, while GSH-ST and PA levels were higher than those in the control group (P<0.05). Conclusion Reduning Injection combined with compound ipratropium bromide can significantly promote the recovery of patients with acute exacerbation of chronic obstructive pulmonary disease, and reduce the body's inflammatory response, restore the oxidation-antioxidant balance, and also can improve the body's nutritional status, which is worthy of clinical application.

R974