目的 探讨乙酰半胱氨酸泡腾片联合沙美特罗替卡松粉吸入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2014年12月-2016年12月北部战区总医院和平分院收治的90例慢性阻塞性肺疾病急性加重期患者为研究对象，所有患者按照随机数字表法分为对照组（45例）和治疗组（45例）。对照组给予沙美特罗替卡松粉吸入剂，1吸/次，2次/d。治疗组在对照组治疗的基础上口服乙酰半胱氨酸泡腾片，0.6 g/次，2次/d。两组患者连续治疗14 d。观察两组患者的临床疗效，同时比较两组治疗前后的呼吸功能和炎症因子水平。结果 治疗后，对照组和治疗组的总有效率分别为71.11%、91.11%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组血氧分压（pO₂）、第一秒用力呼气量（FEV1）、肺活量（FVC）、最高呼气流速（PEF）显著升高，二氧化碳分压（pCO₂）显著降低，同组治疗比较差异具有统计学意义（P<0.05）；治疗后，治疗组pO₂、FEV1、FVC、PEF显著高于对照组，pCO₂显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平均显著降低，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组CRP、IL-6、TNF-α水平显著低于对照组，两组比较差异有统计学意义（P<0.05）。结论 乙酰半胱氨酸泡腾片联合沙美特罗替卡松粉吸入剂治疗慢性阻塞性肺疾病急性加重期能显著提高临床疗效，改善患者呼吸功能和炎症因子水平，且安全性良好，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Acetylcysteine Effervescent Tablets combined with Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation in treatment of acute exacerbation of chronic obstructive pulmonary disease.Methods Patients (90 cases) with acute exacerbation of chronic obstructive pulmonary disease in Heping Branch of General Hospital of Northern War Zone from December 2014 to December 2016 were randomly divided into control (45 cases) and treatment (45 cases) groups. Patients in the control group were given Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation, 1 suction/ time, twice daily. Patients in the treatment group po administered with Acetylcysteine Effervescent Tablets on the basis of the control group, 0.6 g/time, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the respiratory function and inflammatory factor in two groups before and after treatment were compared.Results After treatment, the clinical efficacy in the control and treatment groups were 71.11% and 91.11%, respectively, and there were differences between two groups (P<0.05). After treatment,pO₂, FEV1, FVC, and PEF in two groups were significantly increased, but pCO₂ in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). After treatment,pO₂, FEV1, FVC, and PEF in the treatment group were significantly higher than those in the control group, but pCO₂ were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of CRP, IL-6, and TNF-α in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). After treatment, the levels of CRP, IL-6, and TNF-α in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05).Conclusion Acetylcysteine Effervescent Tablets combined with Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation in treatment of acute exacerbation of chronic obstructive pulmonary disease can significantly improve the clinical efficacy, and improve the levels of respiratory function and inflammatory factors in patients, and the safety is good, which has a certain clinical application value.