在氨茶碱和氨溴特罗基础上联用甲泼尼龙和特布他林对支气管哮喘患者的治疗作用

Therapeutic Effects of Aminophylline and Ambroterol Combined with Methylprednisolone and Terbutaline on Bronchial Asthma

目的:探讨在氨茶碱和氨溴特罗基础上联用甲泼尼龙和特布他林对支气管哮喘患者的治疗作用。方法:选取2016年1-7月重庆建设医院收治的支气管哮喘住院患者128例,根据治疗方案分为对照组和观察组,每组64例。对照组患者口服氨茶碱片和氨溴特罗口服溶液;观察组患者在对照组的基础上静脉滴注注射用甲泼尼龙琥珀酸钠+雾化吸入硫酸特布他林雾化液,均按药品说明书用药,两组患者均治疗7 d。比较两组患者咳嗽、气促、肺部湿啰音、肺部哮鸣音等临床症状持续时间,以及治疗前、后肺功能指标[第1秒用力呼气容积(FEV_1)、最大呼气流速峰值(PEF)]和炎症因子[白细胞介素6(IL-6)、IL-10、IL-17]变化,以及不良反应发生情况。结果:治疗前,两组患者肺功能指标及炎症因子水平比较差异均无统计学意义(P>0.05)。与治疗前比较,两组患者FEV_1和PEF均明显增加,IL-6、IL-10、IL-17水平均明显降低,差异均有统计学意义(P<0.05)。与对照组比较,观察组患者治疗后咳嗽、气促、肺部湿啰音、肺部哮鸣音等持续时间均更短,FEV_1和PEF均更高,IL-6、IL-10、IL-17水平均更低,差异均有统计学意义(P<0.05)。两组患者的不良反应发生率差异无统计学意义(P>0.05)。结论:在氨茶碱和氨溴特罗基础上联用甲泼尼龙和特布他林治疗支气管哮喘能更好地缓解临床症状,改善患者的肺功能和炎症反应。

OBJECTIVE:To investigate the therapeutic effects of aminophylline and ambroterol combined with methylprednisolone and terbutaline on bronchial asthma patients.METHODS:A total of 128 hospitalizedy patients with bronchial asthma admitted in Chongqing Jianshe Hospital during Jan.-Jul.2016 were divided into observation group and control group according to therapy plan,with 64 cases in each group.Control group received Aminophylline tablet and Ambroterol oral solution.Observation group was additionally given intravenous dripping of Methylprednisolone sodium succinate for injection+aerosol inhalation of Terbutaline sulfate solution for nebulization,on the basis of control group.Both groups received treatment for 7 d according to drug package inserts.The duration of cough,shortness of breath,pulmonary rales and wheezing were compared between 2 groups.Lung function indexes(FEV1,PEF)and inflammatory factors(IL-6,IL-10,IL-17)of 2 groups were observed before and after treatment.The occurrence of ADR was also observed.RESULTS:Before treatment,there was no statistical significance in lung function indexes or inflammatory factors between 2 groups(P>0.05).Compared with before treatment,the levels of FEV1 and PEF in 2 groups were increased significantly,while the levels of IL-6,IL-10 and IL-17 were decreased significantly,with statistical significance(P<0.05).Compared with control group,the duration of cough,shortness of breath,pulmonary rales and wheezing in observation group were shorter;the levels of FEV1 and PEF were higher,while IL-6,IL-10 and IL-17 were lower,with statistical significance(P<0.05).There was no statistical significance in the incidence of ADR between 2 groups(P>0.05).CONCLUSIONS:Aminophylline and ambroterol combined with methylprednisolone and terbutaline can better alleviate clinical symptoms,and can significantly improve lung function and inflammatory factors.