盐酸氨溴索辅助治疗老年社区获得性肺炎的临床分析

Clinical analysis of ambroxol hydrochloride in the adjuvant treatment of elderly community acquired pneumonia

目的探讨盐酸氨溴索辅助治疗老年社区获得性肺炎患者的效果。方法本研究为前瞻性研究, 选取2016年4月至2020年10月潞城区中医院内科收治的76例老年社区获得性肺炎患者, 男29例, 女47例, 年龄(71.02±2.44)岁, 年龄范围为60~80岁。采用随机数表法将患者随机分为单药注射组与联合注射组, 每组38例。所有患者入院后均给予吸氧、补液、抗感染及维持酸碱平衡等常规治疗, 单药注射组在此基础上给予注射用头孢哌酮舒巴坦钠静脉滴注治疗, 联合注射组在单药注射组基础上给予盐酸氨溴索氯化钠注射液静脉滴注治疗。比较两组患者治疗7 d后的临床治疗效果, 比较治疗前、治疗7 d后两组患者痰液嗜酸性粒细胞(EOS)百分比、中性粒细胞(NEU)百分比、酸性粒细胞趋化因子(ChEF)水平、血清C反应蛋白(CRP)、降钙素原、N末端脑利钠肽(NT-proBNP)水平及治疗期间不良反应发生情况。结果治疗7 d后, 联合注射组有效率[92.1%(35/38)]高于单药注射组[73.7%(28/38)], 差异有统计学意义(P<0.05)。治疗7 d后, 联合注射组痰液EOS百分比[(2.35±0.46)%]、NEU百分比[(25.41±4.28)%]、ChEF水平[(2.44±0.34)ng/L]均低于单药注射组[(3.67±0.57)%、(30.88±5.31)%、(3.18±0.56)ng/L], 联合注射组血清CRP[(51.44±4.22)mg/L]、降钙素原[(0.14±0.01)μg/L]、NT-proBNP[(468.93±48.57)pg/ml]均低于单药注射组[(81.45±7.93)mg/L、(0.32±0.04)μg/L、(1 123.74±121.55)pg/ml], 差异有统计学意义(P<0.05)。单药注射组不良反应发生率[13.2%(5/38)]与联合注射组不良反应发生率[5.3%(2/38)]比较, 差异无统计学意义(P>0.05)。结论盐酸氨溴索辅助治疗可减少老年社区获得性肺炎患者痰液堵塞, 改善患者炎症反应, 进而提高临床治疗效果, 且安全性良好。

Objective To investigate the efficacy of ambroxol hydrochloride in the adjuvant treatment of elderly patients with community-acquired pneumonia.Methods This study was a retrospective study,from April 2016 to October 2020,a total of 76 elderly patients with community-acquired pneumonia were selected from the department of Internal Medicine,Lucheng District Hospital of Traditional Chinese Medicine,including 29 males and 47 females,aged(71.02±2.44)years old,ranging from 60 to 80 years old.The patients were randomly divided into the single drug injection group and the combined injection group with 38 patients in each group using random number table method.After admission,all patients were given routine treatment such as oxygen inhalation,fluid replacement,anti-infection and acid-base balance.The single-drug injection group was given intravenous infusion of cefoperazone sulbactam sodium for injection,while the combined injection group was given intravenous infusion of ambroxol hydrochloride and sodium chloride injection on the basis of the single-drug injection group.The clinical therapeutic effects of the two groups were compared after 7 days of treatment.The eosino granulocyte(EOS)percentage,neutrophil granulocyte(NEU)percentage,chemotactic factor for eosinophils(ChEF)level,serum C-reactive protein(CRP),procalcitonin,N-terminal brain natriuretic peptide(NT-proBNP)levels and adverse reactions during treatment were compared before and after 7 days of treatment.Results After 7 days of treatment,the total effective rate of combined injection group[92.1%(35/38)]was higher than that of single drug injection group[73.7%(28/38)],and the difference was statistically significant(P<0.05).After 7 days of treatment,the EOS percentage[(2.35±0.46)%],NEU percentage[(25.41±4.28)%]and ChEF level[(2.44±0.34)ng/L]in the combined injection group were lower than those in the single drug injection group[(3.67±0.57)%,(30.88±5.31)%,(3.18±0.56)ng/L],serum CRP[(51.44±4.22)mg/L],procalcitonin[(0.14±0.01)μg/L]and NT-proBNP[(468.93±48.57)pg/ml]in the combined injection group were lower than those in the single drug injection group[(81.45±7.93)mg/L,(0.32±0.04)μg/L,(1123.74±121.55)pg/ml],and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the single injection group[13.2%(5/38)]compared with that in the combined injection group[5.3%(2/38)],there was no significant difference(P>0.05).Conclusions Ambroxol hydrochloride adjuvant therapy could reduce sputum blockage in elderly patients with community-acquired pneumonia,improve inflammatory response,and improve clinical efficacy,with good safety.