目的 观察蛤蚧定喘丸联合复方硫酸沙丁胺醇气雾剂治疗老年支气管哮喘稳定期的临床疗效。方法 纳入淄博一四八医院2022年3月—2024年5月收治的94例老年支气管哮喘患者，采用随机数字表法将患者分为对照组（47例）和治疗组（47例）。对照组接受复方硫酸沙丁胺醇气雾剂治疗，2揿/次，4次/d。治疗组患者在对照组基础上口服蛤蚧定喘丸，1丸/次，2次/d。两组连续治疗14 d。对比两组临床疗效、临床症状消失时间、哮喘控制情况、肺功能指标、血清炎性因子和免疫功能指标。结果 治疗组的总有效率为95.74%，高于对照组的总有效率74.47%（P＜0.05）。治疗组咳嗽、咯痰、气短、喘息、肺内哮鸣音消失时间短于对照组（P＜0.05）。两组治疗后哮喘控制测试（ACT）评分升高，哮喘控制问卷（ACQ-7）评分下降（P＜0.05），且治疗后治疗组的ACT评分高于对照组，ACQ-7评分低于对照组（P＜0.05）。两组治疗后用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、FEV1/FVC升高（P＜0.05），治疗组患者的FVC、FEV1、FEV1/FVC高于对照组（P＜0.05）。两组治疗后白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、嗜酸性粒细胞计数（EOS）、转化生长因子-β1（TGF-β1）显著下降（P＜0.05），治疗组IL-6、TNF-α、EOS、TGF-β1低于对照组（P＜0.05）。两组治疗后CD8⁺下降，CD3⁺、CD4⁺、CD4⁺/CD8⁺升高（P＜0.05），且治疗组的免疫功能指标优于对照组（P＜0.05）。结论 蛤蚧定喘丸联合复方硫酸沙丁胺醇气雾剂治疗老年支气管哮喘可缩短临床症状缓解时间，有效控制哮喘，改善肺功能和免疫功能，减轻炎症反应。

Objective To observe clinical efficacy of Gejie Dingchuan Pills combine with Compound Salbutamol Sulfate Aerosol in treatment of elderly bronchial asthma in the stable stage. Methods A total of 94 elderly patients with bronchial asthma admitted to Zibo 148 Hospital from March 2022 to May 2024 were divided into control group (47 cases) and treatment group (47 cases) using random number table method. The control group received treatment with Compound Salbutamol Sulfate Aerosol, 2 sprays/time, 4 times daily. The treatment group took Gejie Dingchuan Pills orally on the basis of the control group, 1 pill per time, twice daily. Two groups were treated continuously for 14 d. The clinical efficacy, disappearance time of clinical symptoms, asthma control, lung function indicators, serum inflammatory factors, and immune function indicators were compared between two groups. Results The total effective rate of the treatment group was 95.74%, which was higher than the total effective rate of 74.47% in the control group (P < 0.05). The disappearance time of cough, sputum, shortness of breath, wheezing, and wheezing in the treatment group was shorter than that in the control group (P < 0.05). After treatment, ACT scores in two groups were increased, but ACQ-7 scores were decreased (P < 0.05). And the ACT scores of the treatment group were higher than those of the control group, while the ACQ-7 scores were lower than those of the control group (P < 0.05). After treatment, FVC, FEV1, and FEV1/FVC increased in two groups (P < 0.05). The FVC, FEV1, and FEV1/FVC in the treatment group were higher than those in the control group (P < 0.05). After treatment, the levels of IL-6, TNF-α, EOS, and TGF-β1 significantly decreased in two groups (P < 0.05). The levels of IL-6, TNF-α, EOS, and TGF-β 1 in the treatment group were lower than those in the control group (P < 0.05). After treatment, CD8⁺ in two groups decreased, while CD3⁺, CD4⁺, and CD4⁺/CD8⁺ increased (P < 0.05), and The immune function indicators of the treatment group were superior to those of the control group (P < 0.05). Conclusion The combination of Gejie Dingchuan Pills and Compound Salbutamol Sulfate Aerosol can shorten the clinical symptom relief time in elderly patients with bronchial asthma, effectively control asthma, improve lung function and immune function, and alleviate inflammatory reactions.

R974

国家卫生健康委医药卫生科技发展研究中心课题（W2022ZT642）