布地奈德联合氨溴索治疗COPD伴急性下呼吸道感染的疗效观察

Therapeutic of Budesonide Combined with Ambroxol in COPD Patients with Acute Lower Respiratory Tract Infection

目的探讨布地奈德联合氨溴索治疗慢性阻塞性肺疾病(COPD)伴急性下呼吸道感染的临床疗效及其对肺功能和炎性因子的影响。方法选取2016年1月～2017年12月某院收治的283例COPD伴急性下呼吸道感染患者,按随机数字表法分为研究组(n=142)和对照组(n=141),两组均给予常规性治疗,对照组在此基础上给予布地奈德治疗,研究组在对照组基础上给予氨溴索治疗,疗程两周。比较两组治疗前后肺功能指标(FVC、FEV1、PEF)和血清炎性指标(TNF-α、hs-CRP、IL-6、IL-8)的变化,临床疗效及不良反应发生情况。结果治疗后,两组的肺功能指标FVC、FEV1和PEF水平较治疗前均显著改善(P<0.05),且研究组改善更为显著(P<0.05);两组的炎性指标TNF-α、hs-CRP、IL-6、IL-8水平较治疗前均显著降低(P<0.05),且研究组降低更为显著(P<0.05);研究组的临床疗效明显优于对照组,有统计学意义(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论布地奈德联合氨溴索治疗COPD急性下呼吸道感染的疗效显著,可以有效缓解患者的临床症状,改善肺功能,降低炎性反应,且安全性高。

OBJECTIVE To investigate the clinical efficacy of budesonide combined with ambroxol in chronic obstructive pulmonary disease( COPD) with acute lower respiratory tract infection,and its effect on pulmonary function and inflammatory factors.METHODS A total of 283 COPD patients with acute lower respiratory tract infection who were admitted to a hospital from January2016 to January 2017 were randomly divided into study group( n = 142) and control group( n = 141). The two groups were treated by clinical routine treatment,the control group were added with budesonide treatment,the experimental group were added ambroxol on the basis of control group,the course was two weeks. The levels of pulmonary function( FVC,FEV1,PEF) and serum inflammatory markers( TNF-α,hs-CRP,IL-6,IL-8) changes,clinical efficacy and adverse reactions were observed and compared. RESULTS After treatment,the levels of FVC,FEV1 and PEF were significantly improved in both groups( P< 0.05),and the levels of FVC,FEV1 and PEF in the study group were significantly improved in both groups( P< 0.05),the levels of pulmonary function in experimental group were significantly better than those in the control group( P<0.05). The levels of TNF-α,hs-CRP,IL-6 and IL-8 in the two groups were significantly lower than those before treatment( P<0.05) and experimental group were significantly lower than those in the control group( P<0.05). The clinical efficacy of the experimental group was significantly better than control group,and the total effective rate of the two groups was significantly different( P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups( P<0.05). CONCLUSION Budesonide combined with ambroxol treatment of COPD patients with acute lower respiratory tract infection has better clinical efficacy,alleviating the clinical symptoms of patients effectively,improving lung function,reducing inflammatory response,and has higher safety.