目的 探讨班布特罗联合噻托溴铵粉治疗慢性阻塞性肺气肿的临床疗效。方法 以2017年6月—2018年6月在平煤神马医疗集团总医院进行治疗的100例慢性阻塞性肺气肿患者为研究对象，根据住院号的先后分为对照组（50例）和治疗组（50例）。对照组用吸入器吸入噻托溴铵粉吸入剂，18 μg/次，1次/d；治疗组在对照组的基础上口服盐酸班布特罗片，初始10 mg/次，1次/d，根据临床效果，在用药1～2周后可增加到20 mg/次，1次/d。两组患者均连续治疗2周。观察两组患者的临床疗效，同时比较两组的肺功能、血气指标、血清学指标、圣乔治呼吸问卷（SGRQ）评分和慢性阻塞性肺疾病（CAT）评分。结果 治疗后，对照组和治疗组总有效率分别为80.00%、96.00%，两组比较差异具有统计学意义（P<0.05）。两组患者的一秒用力呼气容积（FEV₁）、用力肺活量（FVC）和FEV₁/FVC水平均显著升高，同组治疗前后比较差异具有统计学意义（P<0.05）；且治疗后治疗组肺功能指标水平显著高于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者的动脉血氧分压（pO₂）、血氧饱和度（SaO₂）显著升高，二氧化碳分压（pCO₂）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，治疗组的血气指标水平显著优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组血清白细胞介素-4（IL-4）、转化生长因子-β1（TGF-β1）、人分泌型卷曲相关蛋白-1（SFRP-1）、肿瘤坏死因子-α（TNF-α）、基质金属蛋白酶-9（MMP-9）、血管黏附蛋白-1（VAP-1）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）；且治疗后治疗组血清学指标均显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者的SGRQ评分显著降低，CAT评分显著升高，同组治疗前后比较差异具有统计学意义（P<0.05）；且治疗后治疗组SGRQ评分、CAT评分均显著优于对照组，两组比较差异具有统计学意义（P<0.05）。结论 班布特罗联合噻托溴铵粉治疗慢性阻塞性肺气肿疗效显著，能够有效改善患者肺功能，促进机体炎症因子水平降低，提高患者生活质量，具有一定临床推广应用价值。

Objective To investigate the clinical efficacy of bambuterol hydrochloride tablets combined with tiotropium bromide in treatment of chronic obstructive pulmonary emphysema. Methods Patients (100 cases) with chronic obstructive pulmonary emphysema treated in Pingdingshan Shenma Medical Group General Hospital from June 2017 to June 2018 were divided into treatment group (50 cases) and control group (50 cases) according to the number of hospitalization. The patients in the control group were inhalated Tiotropium Bromide Powder for inhalation with inhaler suction, 18 μg/time, once daily. The patients in the treatment group were po administered with Bambuterol Hydrochloride Tablets on the basis of the control group, 10 mg/time, once daily. The dosage was added to 20 mg/time, once daily, according to the clinical efficacy. The patients in two groups were treated for two weeks.After treatment, the efficacy was evaluated, and lung function, blood gas indexes, serological indicator, SGRQ score, and CAT score in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 96.00%, respectively, and there was difference between two groups (P < 0.05). After treatment, the levels of FEV₁, FVC, and FEV₁/FVC in two groups were significantly increased, and the difference was statistically significant in the same group (P< 0.05). And after treatment the lung function indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P< 0.05). After treatment, pO₂ and SaO₂ in the two groups were significantly increased, but pCO₂ was significantly decreased, and there were differences in the same group (P < 0.05). And after treatment the blood gas indexes in the treatment group were better than those in the control group, and there were differences between two groups (P < 0.05). After treatment, the levels of IL-4, TGF-β1, SFRP-1, TNF-α, MMP-9, and VAP-1 in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). And after treatment the serological indicator in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P< 0.05). After treatment, SGRQ score in the two groups was significantly decreased, but CAT score was significantly increased, and there were differences in the same group (P < 0.05). And after treatment SGRQ score and CAT score in the treatment group were better than those in the control group, and there were differences between two groups (P < 0.05).Conclusion Bambuterol combined with tiotropium bromide has a good clinical efficacy in treatment of chronic obstructive pulmonary emphysema, and can effectively improve the lung function of patients, promote the reduction of inflammatory factors in the body, improve the quality of life of patients, which has a certain clinical application value.