目的 探讨乌美溴铵维兰特罗联合阿奇霉素治疗慢性阻塞性肺疾病稳定期的临床疗效。方法 选取2019年3月—2021年3月在汉中市中心医院治疗的118例慢性阻塞性肺疾病稳定期患者，随机分为对照组（59例）和治疗组（59例）。对照组口服阿奇霉素片，第1天服用0.5 g，第2～7天服用0.25 g，1次/d。治疗组患者在对照组的基础上吸入乌美溴铵维兰特罗吸入粉雾剂，1掀/次，1次/d。两组患者连续治疗7 d。观察两组患者临床疗效，比较治疗前后两组患者临床症状缓解时间，肺功能指标第1秒用力呼气容积（FEV1）、用力肺活量（FVC）和FEV1/FVC，血清炎性因子白细胞介素（IL）-6、IL-8、IL-1β和超敏C反应蛋白（hs-CRP）水平及不良反应情况。结果 治疗后，治疗组患者总有效率明显高于对照组（98.31%vs 83.05%，P<0.05）。治疗后，治疗组临床症状缓解时间均早于对照组（P<0.05）。治疗后，两组患者FEV1、FVC、FEV1/FVC明显升高（P<0.05），且治疗组明显高于对照组（P<0.05）。治疗后，两组IL-6、IL-8、IL-1β、hs-CRP水平显著降低（P<0.05），且治疗组明显低于对照组（P<0.05）。治疗期间，治疗组患者不良反应发生率为6.78%，显著低于对照组的13.56%（P<0.05）。结论 乌美溴铵维兰特罗联合阿奇霉素治疗慢性阻塞性肺疾病稳定期效果确切，可有效改善患者临床症状，能降低炎性反应及恢复肺功能状态。

Objective To investigate the curative effect of umeclidinium bromide and vilanterol trifenatate combined with azithromycin in treatment of chronic obstructive pulmonary disease. Methods Patients (118 cases) with chronic obstructive pulmonary disease in Hanzhong Central Hospital from March 2019 to March 2021 were randomly divided into control (59 cases) and treatment (59 cases) groups. Patients in the control group were po administered with Azithromycin Tablets, 0.5 g for the first day, 0.25 g for 2 — 7 day, once daily. Patients in the treatment group were inhalation administered with Umeclidinium Bromide and Vilanterol Trifenatate Powder for inhalation, 1 press/time, once daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, the relief time of clinical symptom, the relief time of clinical symptom, the levels of lung function indexes FEV1, FVC, and FEV1/FVC, the levels of serum inflammatory factor IL-6, IL-8, IL-1β, and hs-CRP, adverse drug reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was significantly higher than that of the control group (98.31% vs 83.05%, P<0.05). After treatment, the relief time of clinical symptoms in the treatment group was earlier than that in the control group (P<0.05). After treatment, the indexes of FEV1, FVC, and FEV1/FVC in two groups were significantly increased (P<0.05), and which in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the levels of IL-6, IL-8, IL-1β, and hs-CRP in two groups were significantly decreased (P<0.05), and the levels in the treatment group were significantly lower than those in the control group (P<0.05). During the treatment, the incidence of adverse reactions in the treatment group was 6.78%, which was significantly lower than 13.56% in the control group (P<0.05). Conclusion The effect of umeclidinium bromide and vilanterol trifenatate combined with azithromycin in treatment of chronic obstructive pulmonary disease is definite, which can effectively improve the clinical symptoms of the patients, reduce the inflammatory reaction and restore the state of pulmonary function.

R974