多索茶碱联合布地奈德治疗慢阻肺急性加重期的 临床效果研究

Study on clinical effect of doxofylline combined with budesonide in the treatment of acute exacerbation of chronic obstructive pulmonary disease

目的研究多索茶碱联合布地奈德治疗慢性阻塞性肺疾病(慢阻肺)急性加重期的临床效果。方法50例慢阻肺急性加重期患者,按照随机数字表法分为实验组和对照组,每组25例。对照组采用多索茶碱治疗,实验组在对照组基础上加用布地奈德混悬液雾化吸入治疗。对比两组治疗后血气指标[动脉血氧分压(PaO_(2))、血氧饱和度(SpO_(2))、氧合指数(PaO_(2)/FiO_(2))]、治疗前后肺功能指标[第1秒用力呼气容积(FEV1)、第1秒用力呼气容积与用力肺活量的比值(FEV1/FVC)]、咳嗽缓解时间、肺部啰音消失时间、住院时间、治疗后血清炎性因子[白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)]水平。结果治疗后,实验组患者的PaO_(2)(92.58±8.52)mm Hg(1 mm Hg=0.133 kPa)、SpO_(2)(94.25±6.25)%、PaO_(2)/FiO_(2)(305.41±7.25)mm Hg水平均高于对照组的(83.51±4.25)mm Hg、(81.25±3.25)%、(274.25±6.25)mm Hg,差异具有统计学意义(P<0.05)。治疗前,两组患者的FEV1、FEV1/FVC比较差异无统计学意义(P>0.05);治疗后,实验组患者的FEV1、FEV1/FVC均优于对照组,差异具有统计学意义(P<0.05)。实验组咳嗽缓解时间(8.31±1.96)d、肺部啰音消失时间(8.42±1.87)d、住院时间(9.41±2.81)d均短于对照组的(6.38±1.16)、(6.21±1.67)、(7.65±1.71)d,差异具有统计学意义(P<0.05)。实验组IL-6(28.15±3.62)pg/ml、IL-8(33.48±5.14)pg/ml、TNF-α(18.64±3.28)pg/ml,均高于对照组的(23.67±3.18)、(27.29±4.25)、(14.31±3.74)pg/ml,差异具有统计学意义(P<0.05)。结论多索茶碱联合布地奈德用于治疗慢阻肺急性加重期可有效缓解临床症状,改善肺功能,效果确切。

Objective To study the clinical effect of doxofylline combined with budesonide in the treatment of acute exacerbation of chronic obstructive pulmonary disease.Methods A total of 50 patients with acute exacerbation of chronic obstructive pulmonary disease were divided into experimental group and control group according to the random numerical table,with 25 cases in each group.The control group was treated with doxofylline,and the experimental group was additionally treated with budesonide suspension atomization inhalation on the basis of the control group.Both groups were compared in terms of blood gas indexes[arterial partial pressure of oxygen(PaO_(2)),blood oxygen saturation(SpO_(2)),oxygenation index(PaO_(2)/FiO_(2))]after treatment,and pulmonary function indexes[forced expiratory volume in the 1st second(FEV1)before and after treatment,ratio of FEV1 to forced vital capacity(FEV1/FVC)],cough remission time,disappearance time of pulmonary rales,hospitalization time,serum inflammatory factors[interleukin(IL)-6,IL-8,tumor necrosis factor-α(TNF-α)]levels after treatment.Results After treatment,the levels of PaO_(2)(92.58±8.52)mm Hg(1 mm Hg=0.133 kPa),SpO_(2)(94.25±6.25)%and PaO_(2)/FiO_(2)(305.41±7.25)mm Hg in the experimental group were higher than(83.51±4.25)mm Hg,(81.25±3.25)%,and(274.25±6.25)mm Hg in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in FEV1 and FEV1/FVC between the two groups(P>0.05).After treatment,the FEV1 and FEV1/FVC of the experimental group were better than those of the control group,and the difference was statistically significant(P<0.05).The cough remission time(8.31±1.96)d,the disappearance time of pulmonary rales(8.42±1.87)d,and the hospitalization time(9.41±2.81)d in the experimental group were all shorter than(6.38±1.16),(6.21±1.67),and(7.65±1.71)d in the control group,and the difference was statistically significant(P<0.05).The IL-6(28.15±3.62)pg/ml,IL-8(33.48±5.14)pg/ml,and TNF-α(18.64±3.28)pg/ml in the experimental group were higher than(23.67±3.18),(27.29±4.25),and(14.31±3.74)pg/ml in the control group,and the difference was statistically significant(P<0.05).Conclusion Doxofylline combined with budesonide has definite effect in the treatment of acute exacerbation of chronic obstructive pulmonary disease,and can effectively relieve clinical symptoms and improve the pulmonary function of patients.