川贝枇杷胶囊联合噻托溴铵治疗慢性阻塞性肺疾病急性加重期的临床研究

Clinical study on Chuanbei Pipa Capsules combined with tiotropium bromide in treatment of acute exacerbation of chronic obstructive pulmonary disease

目的研究川贝枇杷胶囊联合噻托溴铵粉吸入剂治疗慢性阻塞性肺疾病急性加重期的临床疗效。方法选取2016年5月-2019年5月涿州市医院收治的100例慢性阻塞性肺病急性加重期患者为研究对象,将所有患者随机分为对照组和治疗组,每组各50例。对照组患者给予噻托溴铵粉吸入剂,1粒/次,1次/d;治疗组患者在对照组治疗的基础上口服川贝枇杷胶囊,3粒/次,3次/d。两组患者持续治疗14 d。观察两组的临床疗效,比较两组的临床症状缓解时间、肺功能指标、血气指标、血清炎性因子水平。结果治疗后,对照组和治疗组的总有效率分别为84.00%、96.00%,两组比较差异有统计学意义(P<0.05)。治疗后,治疗组患者喘息、哮鸣音、咳嗽消失时间明显短于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者第一秒用力呼气容积(FEV1)、最大呼气流速(PEF)和FEV1/用力肺活量(FVC)显著升高,同组治疗前后比较差异有统计学意义(P<0.05);并且治疗组患者肺功能指标水平明显高于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者二氧化碳分压(p CO2)水平显著降低,氧分压(p O2)水平显著升高,同组治疗前后比较差异有统计学意义(P<0.05);并且治疗组患者血气指标水平明显优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);并且治疗组患者血清炎性因子水平明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论川贝枇杷胶囊联合噻托溴铵粉吸入剂治疗慢性阻塞性肺疾病急性加重期具有较好的治疗效果,能改善患者肺功能和血气指标,降低血清炎性因子水平,具有一定的临床推广应用价值。

Objective To study the efficacy of Chuanbei Pipa Capsules combined with Tiotropium Bromide Powder for inhalation in treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods Patients(100 cases) with acute exacerbation of chronic obstructive pulmonary disease in Zhuozhou City Hospital from May 2016 to May 2019 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were given Tiotropium Bromide Powder for inhalation, 1 grain/time, once daily. Patients in the treatment group were po administered with Chuanbei Pipa Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and clinical symptom remission time, pulmonary function indexes, blood gas indexes, and serum levels of inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 84.00% and 96.00%, respectively, and there was difference between two groups(P < 0.05). After treatment, the disappearancetime of wheeze, wheeze and cough in the treatment group were shorter than those in the control group, and there was difference between two groups(P < 0.05). After treatment, FEV1, PEF, and FEV1/FVC in two groups were significantly increased, and the difference was statistically significant in the same group(P < 0.05). And the pulmonary function indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the levels of p CO2 in two groups were significantly decreased, but the levels of p O2 in two groups were significantly increased, and the difference was statistically significant in the same group(P < 0.05). And the blood gas indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the levels of CRP, TNF-α, and IL-6 in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the serum levels of inflammatory factors in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). Conclusion Chuanbei Pipa Capsules combined with Tiotropium Bromide Powder for inhalation has clinical curative effect in treatment of acute exacerbation of chronic obstructive pulmonary disease, can improve the pulmonary function and blood gas index of patients, and reduce the serum level of inflammatory factors, which has a certain clinical application value.