肺力咳合剂联合莫西沙星治疗慢性阻塞性肺疾病急性加重期的临床研究

Clinical study on Feilike Mixture combined with moxifloxacin in treatment of acute exacerbation of chronic obstructive pulmonary disease

目的探讨肺力咳合剂联合莫西沙星治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床效果。方法选取2017年3月—2019年12月天津市第五中心医院收治的116例AECOPD患者,随机分成对照组(58例)和治疗组(58例)。对照组静脉滴注盐酸莫西沙星注射液,0.4 g/次,1次/d。治疗组在对照组基础上口服肺力咳合剂,20 mL/次,3次/d。两组患者均治疗14 d。观察两组患者临床疗效,比较治疗前后两组患者主要症状体征缓解时间、自我评估测试(CAT)问卷、改良版英国医学研究委员会呼吸问卷(mMRC)评分、肺功能参数、呼出气一氧化氮(FeNO)浓度,及血清脂蛋白相关磷脂酶A2(Lp-PLA2)、白细胞介素-1β(IL-1β)、白三烯B4(LTB4)和超敏C反应蛋白(hs-CRP)水平。结果治疗后,治疗组总有效率为94.8%,显著高于对照组的82.8%(P<0.05)。治疗后,治疗组主要症状体征的缓解时间均显著短于对照组(P<0.05)。治疗后,两组患者CAT问卷和mMRC评分较同组治疗前均显著降低,而第1秒用力呼气容积(FEV1)占预计值%、FEV1与用力肺活量(FVC)比值(FEV1/FVC)较治疗前则均显著升高(P<0.05);治疗后,治疗组CAT问卷、mMRC评分、FEV1占预计值%和FEV1/FVC均显著好于对照组(P<0.05)。治疗后,两组FeNO浓度及血清Lp-PLA2、IL-1β、LTB4和hs-CRP水平均显著低于治疗前(P<0.05);且治疗组FeNO浓度及血清Lp-PLA2、IL-1β、LTB4和hs-CRP水平比对照组降低更显著(P<0.05)。结论肺力咳合剂联合莫西沙星能安全、快速地缓解AECOPD患者加重的呼吸道症状,保护肺功能,减轻气道炎症和系统性炎症,利于稳定患者病情。

Objective To explore the clinical effect of Feilike Mixture combined with moxifloxacin in treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods Patients(116 cases) with acute exacerbation of chronic obstructive pulmonary disease in Tianjin Fifth Central Hospital from March 2017 to December 2019 were randomly divided into control(58 cases) and treatment(58 cases) groups. Patients in the control group were iv administered with Moxifloxacin Hydrochloride Injection, 0.4 g/time, once daily. Patients in the treatment group were po administered with Feilike Mixture on the basis of the control group, 20 m L/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 symptoms and signs, CAT questionnaire, mMRC score, lung function parameters, FeNO concentration and the levels of serum Lp-PLA2, IL-1β, LTB4, hs-CRP in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was 94.8%, which was significantly higher than 82.8% of the control group(P < 0.05). After treatment, the remission time of main symptoms and signs in the treatment group was significantly shorter than that in the control group(P < 0.05). After treatment, the CAT questionnaire and m MRC score in two groups were significantly lower than those before treatment, while the percentage of FEV1 and FEV1/FVC were significantly higher than those before treatment(P < 0.05). After treatment, the CAT questionnaire, mMRC score, FEV1% and FEV1/FVC in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the concentration of FeNO and the levels of serum Lp-PLA2, IL-1β, LTB4 and hs-CRP in two groups were significantly lower than those before treatment(P < 0.05), and the concentration of FeNO and the levels of serum Lp-PLA2, IL-1β, LTB4 and hs-CRP in the treatment group were significantly lower than those in the control group(P < 0.05). Conclusion Feilike Mixture combined with moxifloxacin can safely and quickly relieve the acute exacerbation of AECOPD patients, protect lung function, reduce airway inflammation and systemic inflammation, and help to stabilize the condition of patients.