妥布霉素雾化吸入联合氨溴索维持治疗稳定期支气管扩张症临床观察

Clinical Observation on Tobramycin Combined with Ambroxol in the Maintenance Treatment of Bronchiectasis at Stable Stage

目的探讨妥布霉素雾化吸入联合氨溴索维持治疗稳定期支气管扩张症的临床疗效。方法选取医院2015年7月至2017年7月收治的支气管扩张症患者98例,按随机数字表法分为对照组和观察组,各49例。两组患者均予硫酸妥布霉素注射液雾化吸入,观察组患者加服盐酸氨溴索口服液,两组均维持治疗6个月。结果治疗1个月后,两组患者痰量均显著减少,且观察组减少更明显(P <0. 05或P <0. 01);痰培养阳性率均显著降低(P <0. 01);随着维持治疗时间的延长,观察组痰量持续减少,痰培养阳性率也逐渐降低,对照组无明显变化;两组患者急性加重次数均显著减少,且观察组减少更明显(P <0. 01);治疗后,两组患者圣乔治呼吸调查量表(SGRQ)评分均明显下降,且观察组下降更明显(P <0. 05);治疗后,两组患者第1秒用力呼气容积(FEV1)及FEV1/用力肺活量(FVC)水平均明显升高,且观察组升高更明显(P <0. 05);维持治疗期间,两组均未出现严重肝肾毒性等不良反应。结论妥布霉素雾化吸入联合盐酸氨溴索维持治疗稳定期支气管扩张症疗效确切,能有效降低痰培养阳性率,改善肺功能,减少急性加重次数。

Objective To investigate the clinical effect of aerosol inhalation of tobramycin combined with ambroxol in the maintenance treatment of bronchiectasis at stable stage. Methods Totally 98 patients with bronchiectasis admitted to our hospital from July 2015 to July 2017 were selected and randomly divided into the control group and the observation group,49 cases in each group. The patients in the two groups were given aerosol inhalation of Tobramycin Sulfate Injection,on this basis,the patients in the observation group were given Ambroxol Hydrochloride Oral Solution. Both groups were given maintenance treatment for 6 months. Results After 1 month of treatment,the sputum volume of the two groups was significantly decreased,especially in the observation group( P < 0. 05 or P < 0. 01),the positive rate of sputum culture in the two groups was significantly decreased( P < 0. 01). With the extension of maintenance treatment period,the sputum volume continued to decrease,the positive rate of sputum culture gradually decreased in the observation group,but there was no significant change in the control group. The frequency of acute exacerbation in the two groups was significantly decreased,and the decrease in the observation group was more obvious( P < 0. 01). After treatment,the SGRQ scores in the two groups were significantly decreased( P < 0. 05),and the decrease in the observation group was more obvious( P < 0. 05). After treatment,the levels of forced expiratory volume in the first second( FEV1) and FEV1/forced vital capacity( FVC) in the two groups were significantly increased,and the increase in the observation group was more obvious( P < 0. 05). During the maintenance treatment,there were no serious adverse reactions such as hepatic and renal toxicity in the two groups. Conclusion Aerosol inhalation of tobramycin combined with ambroxol hydrochloride is effective in the maintenance treatment of bronchiectasis at stable stage,which can effectively reduce the positive rate of sputum culture,improve lung function and reduce the frequency of acute exacerbation.