百令胶囊联合乙酰半胱氨酸治疗慢性阻塞性肺疾病急性加重期的临床研究

Clinical study on Bailing Capsules combined with acetylcysteine in treatment of acute exacerbation of chronic obstructive pulmonary disease

目的探讨百令胶囊联合乙酰半胱氨酸治疗慢性阻塞性肺疾病急性加重期的临床效果。方法选取2016年1月-2019年1月河南省中医药研究院收治的慢性阻塞性肺疾病急性加重期患者80例,随机分成对照组(40例)和治疗组(40例)。对照组口服乙酰半胱氨酸片,1片/次,2次/d。治疗组在对照组基础上口服百令胶囊,5粒/次,3次/d。两组均连续治疗14d。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状改善情况、第1秒用力呼气容积(FEV1)与用力肺活量(FVC)比值(FEV1/FVC)、呼气峰值流量(PEF)、最大自主通气量(MVV)、FEV1占预计值百分比(FEV1占预计值%)、改良版英国医学研究委员会呼吸问卷(mM RC)评分、呼出气一氧化氮(FeNO)浓度及外周血嗜酸细胞绝对值(EOS#)、中性粒细胞与淋巴细胞比值(NLR)和血清谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)水平。结果治疗后,对照组临床有效率为80.00%,显著低于治疗组的95.00%,两组比较差异有统计学意义(P<0.05)。治疗后,治疗组主要临床表现的缓解时间较对照组均显著缩短(P<0.05)。治疗后,两组肺功能参数FEV1/FVC、PEF、MVV、FEV1占预计值%均显著高于治疗前(P<0.05),且治疗组改善更明显(P<0.05)。治疗后,两组mM RC评分、FeNO浓度及外周血EOS#、NLR和血清MDA含量均显著降低(P<0.05),而血清GSH-Px水平均显著升高(P<0.05);且治疗组这些指标水平明显好于对照组(P<0.05)。结论百令胶囊联合乙酰半胱氨酸治疗慢性阻塞性肺疾病急性加重期能迅速稳定病情,缓解气流受限,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Bailing Capsules combined with acetylcysteine in treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods Patients(80 cases) with acute exacerbation of chronic obstructive pulmonary disease in Henan Academy of Chinese Medicine from January 2016 to January 2019 were randomly divided into control(43 cases) and treatment(43 cases) groups. Patients in the control group were po administered with Acetylcysteine Tablets, 1 tablet/time, twice daily. Patients in the treatment group were po administered with Bailing Capsules on the basis of the control group, 5 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the remission time of main clinical symptoms, the FEV1/FVC, PEF, MVV, FEV1 of estimated value %, mM RC scores, the concentration of FeNO, EOS# and NLR of peripheral blood, and the serum level of GSH-Px and MDA in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.00%, which was significantly lower than 95.00% in the treatment group, and there were differences between two groups(P < 0.05). After treatment, the remission time of main clinical symptoms in the treatment group was significantly shorter than that in the control group(P < 0.05). After treatment, the FEV1/FVC, PEF, MVV, FEV1 of estimated value % in two groups were significantly increased(P < 0.05), and these indexes in the treatment group were significantly higher than those in the control group(P < 0.05). After treatment, the mMRC scores, the concentration of FeNO, EOS# and NLR of peripheral blood, and the serum level of MDA in two groups were significantly decreased(P < 0.05), but the serum level of GSH-Px was significantly increased(P < 0.05), and these indicators in the treatment group were significantly better than those in the control group(P < 0.05). Conclusion Bailing Capsules combined with acetylcysteine in treatment of acute exacerbation of chronic obstructive pulmonary disease can rapidly stabilize the patient’s condition, relieve airflow limitation, which has a certain clinical application value.