布地奈德联合盐酸氨溴索雾化吸入治疗慢性阻塞性肺疾病急性加重期的效果分析

Effect of inhalation of budesonide combined with ambroxol hydrochloride in the treatment of acute exacerbation of chronic obstructive pulmonary disease

目的探讨布地奈德联合盐酸氨溴索雾化吸入治疗慢性阻塞性肺疾病（COPD）急性加重期的临床效果。方法选择宁波市镇海区人民医院呼吸内科2013年1月至2015年12月收治的COPD急性加重期患者60例为研究对象，采用随机数字表法分为对照组30例、观察组30例，对照组采用常规治疗，观察组在常规治疗基础上加用布地奈德、盐酸氨溴索雾化吸入。治疗1周后，比较两组临床疗效、肺通气功能指标、动脉血气分析指标、症状缓解时间。结果观察组总有效率为100.0%，高于对照组的83.3%（χ2＝5.455，P〈0.05）。治疗后，观察组1秒用力呼吸容积（FEV1）、FEV1与用力肺活量（FVC）比值（FEV1/FVC）、动脉血二氧化碳分压（PaCO2）、动脉血氧分压（PaO2）分别为（2.09±0.69）L、（58.94±15.67）%、（35.08±3.79）mmHg、（85.92±4.97）mmHg，对照组分别为（1.43±0.57）L、（43.12±11.03）%、（48.47±4.24）mmHg、（79.54±4.56）mmHg，两组差异均有统计学意义（t＝4.039、4.522、12.896、5.181，均P〈0.05）；观察组气促、咳嗽、咳痰缓解时间分别为（2.04±0.86）d、（4.49±1.25）d、（4.56±1.34）d，均短于对照组的（3.36±1.08）d、（6.53±1.82）d、（6.78±1.91）d，两组差异均有统计学意义（t＝5.237、5.061、5.212，均P〈0.05）。结论在COPD急性加重期，采用布地奈德联合盐酸氨溴索雾化吸入治疗可有效提高治疗效果，改善肺通气功能和动脉血气指标，缩短临床症状缓解时间，有利于控制病情。

ObjectiveTo investigate the effect of inhalation of budesonide combined with ambroxol hydrochloride in the treatment of chronic obstructive pulmonary disease（COPD） in acute exacerbation stage.Methods60 patients with acute exacerbation of COPD treated in the Department of respiratory medicine of Zhenhai People＇s Hospital from January 2013 to December 2015 were selected as the research subjects in Ningbo, and they were randomly divided into control group and observation group according to the digital table, with 30 cases in each group.The control group received routine treatment, the observation group was given budesonide and ambroxol hydrochloride inhalation on the basis of conventional therapy.After 1 week of treatment, the clinical efficacy indicators of pulmonary function, arterial blood gas analysis index, time of symptoms were compared between the two groups.ResultsThe total effective rate of the observation group was 100.0%, which was higher than 83.3% of the control group （χ2=5.455, P〈0.05）. After treatment, the forced expiratory volume in one second （FEV1）, the ratio of FEV1 and forced vital capacity （FVC） （FEV1/FVC）, arterial partial pressure of carbon dioxide （PaCO2）, arterial oxygen pressure （PaO2） in the observation group were （2.09±0.69）L, （58.94±15.67）%, （35.08±3.79）mmHg, （85.92±4.97）mmHg, respectively, which in the control group were （1.43±0.57）L, （43.12±11.03）%, （48.47±4.24）mmHg, （79.54±4.56）mmHg, respectively, the differences between the two groups were statistically significant （t=4.039, 4.522, 12.896, 5.181, all P〈0.05）. The remission time of shortness of breath, cough, expectoration in the observation group were （2.04±0.86）d, （4.49±1.25）d, （4.56±1.34）d, respectively, which were shorter than those in the control group [（3.36±1.08）d, （6.53±1.82）d, （6.78±1.91）d], the differences between the two groups were statistically significant （t=5.237, 5.061, 5.212, all P〈0.05）.ConclusionInhalation of budesonide combined with ambroxol hydrochloride in the treatment of acute exacerbation of COPD can effectively improve the treatment effect, and the pulmonary ventilation function and arterial blood gas status, and shorten the time of remission, and is benefit to disease control.