小剂量阿奇霉素联合信必可都保治疗稳定期慢性阻塞性肺疾病的疗效分析

Creative effect analysis of small dose of azithromycin with symbicort turbuhaler in treatment of patients with chronic obstructive pulmonary disease at steady period

目的探讨小剂量阿奇霉素联合信必可都保治疗稳定期慢性阻塞性肺疾病(COPD)患者的疗效。方法选取濉溪县医院2013年5月至2015年4月收治的稳定期COPD患者120例,按随机数字表法分为A组(对照组)25例,常规治疗;B组(口服阿奇霉素,每日250 mg)32例;C组(吸入信必可都保即布地奈德160μg/吸+福莫特罗45μg/吸,1吸/次)32例;D组(口服250 mg阿奇霉素联合吸入信必可都保,同前述剂量)31例。疗程半年,随访半年。比较4组治疗前后血清C反应蛋白(CRP)、血浆可溶性糖基化终产物受体(sRAGE)和糖基化终末产物(AGEs)含量;肺功能改善情况、每日吐痰量、细菌阳性检出率、有效率及急性加重次数。结果与治疗前相比,B、C、D组治疗后血清CRP和血浆AGEs含量下降,sRAGE升高,差异有统计学意义(P<0.05);D组肺功能得到改善,每日吐痰量和急性加重次数减少,细菌阳性检出率降低,差异有统计学意义(P<0.05);D组总有效率90.32%,大于B、C组,差异有统计学意义(P<0.05)。结论小剂量阿奇霉素联合信必可都保治疗稳定期COPD患者疗效确切,对患者肺功能有所改善。

Objective To explore the creative effect of small dose of azithromycin with symbicort turbuhaler in the treatment of patients with chronic obstructive pulmonary disease （COPD） at stable phase. Methods A total of 120 patients with stable COPD were selected in Suixi County hospital from May 2013 to April 2015, and were randomized into group A （control group, 25 cases）, conventional treatment group B （oral azithromycin, 250 mg/, 32 cases）; group C （symbicort turbuhaler, i.e. 160 g/absorption of budesonide formoterol＋45 μg/1/suction, 32 cases）, and group D （250mg; oral azithromycin combined with inhaled symbicort, with the same dose as before, 31 cases）. The course of treatment was half a year and the follow-up lasted half a year. The levels of C reactive protein （CRP）, plasma soluble glycation end products （sRAGE） and advanced glycation end products （AGEs） were compared between the four groups before and after treatment. The improvement of pulmonary function, daily spitting, the rate of bacterial positive, curative effect and acute exacerbation times for all patients before and after treatment were contrasted as well. Results Compared with pre-treatment, the content of CRP and AGEs decreased significantly in group B, C, D after treatment, while sRAGE increased （P〈0.05）. The lung function was greatly improved in group D, Daily spitting volume and the times of acute exacerbation were significantly reduced, and bacterial positive rate decreased markedly （P〈0.05）. The total efficiency was up to 90.32% in group D, significantly greater than azithromycin alone or simply symbicort treatment group （P〈0.05）. Conclusion Low dose azithromycin combined with symbicort is effective in the treatment of patients with stable COPD, with apparent improvement in the lung function of patients.