目的 探讨肺力咳合剂联合布地奈德福莫特罗治疗慢性阻塞性肺疾病急性加重期（AECOPD）的临床效果。方法 选取2018年10月—2020年9月天津医科大学宝坻临床学院收治的102例AECOPD患者，随机分为对照组（51例）和治疗组（51例）。对照组吸入布地奈德福莫特罗吸入剂，2吸/次，2次/d。治疗组口服肺力咳合剂，20 mL/次，3次/d。两组连续治疗2周。观察两组患者临床疗效，比较治疗前后两组患者肺部哮鸣音、呼吸症状缓解时间，肺功能参数第1秒用力呼气容积与用力肺活量比值（FEV1/FVC）、深吸气量与肺总量比值（IC/TLC）、一氧化碳弥散量与肺泡通气量比值（DLCO/VA）和FEV1占预计值%，咳痰的评估问卷（CASA-Q）总分，中性粒细胞与淋巴细胞比值（NLR）和呼出气一氧化氮（FeNO）浓度及血清白细胞介素-17（IL-17）、淀粉样蛋白A（SAA）和肺表面活性蛋白D（SP-D）水平。结果 治疗后，治疗组临床有效率为96.1%，显著高于对照组的84.3%（P<0.05）。治疗后，治疗组肺部哮鸣音和呼吸症状缓解时间均显著短于对照组（P<0.05）。治疗后，两组肺功能参数FEV1/FVC、IC/TLC、DLCO/VA、FEV1占预计值%和CASA-Q总分均显著升高（P<0.05），并均以治疗组改善更显著（P<0.05）。治疗后，两组患者NLR和FeNO浓度及血清IL-17、SAA、SP-D水平均显著低于治疗前（P<0.05），且治疗组对NLR和FeNO浓度及血清IL-17、SAA、SP-D水平的降低作用较对照组更显著（P<0.05）。结论 肺力咳合剂联合布地奈德福莫特罗治疗AECOPD的整体疗效确切，可安全、有效且迅速地缓解患者症状，改善气流受限，抑制体内炎症反应。

Objective To investigate the clinical effect of Feilike Mixture combined with budesonide formoterol in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Patients (102 cases) with acute exacerbation of chronic obstructive pulmonary disease in Baodi Clinical Medical College of Tianjin Medical University from October 2018 to September 2020 were randomly divided into control (51 cases) and treatment (51 cases) groups. Patients in the control group were inhalation administered with Budesonide and Formoterol Fumarate Powder for inhalation, 2 press/time, twice daily. Patients in the treatment group were po administered with Feilike Mixture, 20 mL/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical evaluation was evaluated, the remission time of lung wheeze, respiratory symptoms, lung function parameters of FEV1/FVC, IC/TLC, DLCO/VA and FEV1% of estimated value, and CASA-Q total scores, the concentration of NLR and FeNO, the levels of serum IL-17, SAA, and SP-D in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 96.1%, which was significantly higher than that of the control group (84.3%) (P<0.05). After treatment, the relief time of pulmonary wheezing and respiratory symptoms in the treatment group was significantly shorter than that in the control group (P<0.05). After treatment, the pulmonary function parameters FEV1/FVC, IC/TLC, DLCO/VA, FEV1% and the total score of CASA-Q in two groups were significantly increased (P<0.05), and the improvement in the treatment group was more significant (P<0.05). After treatment, the concentrations of NLR and FeNO and the levels of serum IL-17, SAA and SP-D in two groups were significantly lower than those before treatment (P<0.05), and which in the treatment group were more significantly lower than those in the control group (P<0.05). Conclusion The overall curative effect of Feilike Mixture combined with budesonide formoterol in treatment of acute exacerbation of chronic obstructive pulmonary disease is definite, which can safely, effectively and quickly relieve patients' symptoms, improve airflow limitation and inhibit inflammatory reaction in vivo.

R974

天津医科大学科学基金资助项目（2019KYM08）