N-乙酰半胱氨酸联合小剂量茶碱治疗稳定期COPD的疗效观察

Observation of Treatment Effect in COPD with N-acetyl Cysteine and Small Dose of Theophylline

目的:旨在探讨抗氧化剂N-乙酰半胱氨酸联合小剂量茶碱治疗轻中度稳定期COPD患者的疗效及安全性。方法:将133例稳定期轻中度COPD患者随机分为试验组63例和对照组70例,试验组服用茶碱缓释片(0.1 g,每12小时一次)+N-乙酰半胱氨酸(NAC)(600 mg,1次/d);对照组服用茶碱缓释片(0.1 g,每12小时一次)。疗程均为24周。治疗前、治疗24周后,对患者行肺功能检测及CAT评分,治疗期间记录疾病急性加重的次数及是否出现不良事件。结果:治疗24周后与治疗前比较,两组的肺功能各项指标均无明显改变(P<0.05)。两组CAT评分较治疗前均有所改善,试验组CAT评分改善情况优于对照组,且试验组AECOPD发生次数明显少于对照组,差异均有统计学意义(P<0.05)。安全性方面,用药期间的不良事件主要表现为胃肠道不适、手震、心悸、皮疹等。以上症状均较轻,两组间不良事件发生率比较差异均无统计学意义(P>0.05)。结论:N-乙酰半胱氨酸联合小剂量茶碱能有效改善COPD患者的生活质量,对于轻中度稳定期的COPD患者来说,是行之有效的安全的治疗方法。

Objective： To explore the treatment effect in COPD with N-acetyl cysteine and small dose of theophylline. Method： 133 mild-to-moderate COPD patients were randomly divided into the treatment group for 63 cases and the control group for 70 cases. The treatment group patients taken theophylline 0.1 g q12 h ＋ N -acetylcysteine （ NAC ） 600 mg qd. The control group was given theophylline 0.1 g q12 h. Before and after 24 weeks treatment pulmonary function test and CAT scores of the two groups were detected. The numbers of AECOPD and adverse events were recorded. Result： In terms of lung function index, two groups of 24 weeks after treatment was compared with before treatment, there was no significant difference between the two groups （ P〉0.05 ） . The quality of life, CAT score of two groups after treatment were improved, CAT score in the treatment group were superior to those in the control group, and the incidences of AECOPD in the treatment group significantly less than those in the control group （ P〈0.05 ） . The main adverse e^ents were gastrointestinal discomfort, hand shake, heart palpitations, skin rash, etc. These symptoms were lighter, incidence of adverse events between the two groups was no statistically significant difference （P〉0.05） .Conclusion： N-acetyl cysteine in combination with small dose of theophyllinc can effectively improve the quality of life of patients with COPD. For patients with mild-to-moderate COPD, N-acetyl cysteine in combination with small dose of theophylline is a safe and effective treatment method.