乙酰半胱氨酸与布地奈德联合治疗COPD的临床疗效及对炎性因子的影响

Study on the Clinical Efficacy of Acetylcysteine Combined with Budesonide in the Treatment of COPD and its Influence on Inflammatory Factors

目的探讨乙酰半胱氨酸与布地奈德联合治疗慢性阻塞性肺疾病(COPD)的临床疗效及对炎性因子的影响。方法于2021年1月至2022年12月济南市第四人民医院呼吸内科收治的共计COPD患者106例。两组患者入院后,均按照医嘱要求,提供面罩吸氧。同时,积极维持水电解质稳定,加以对症治疗,包括解痉、平喘、止咳、抗炎等。在此基础上,对照组给予布地奈德吸入气雾剂,观察组给予布地奈德吸入气雾剂联合乙酰半胱氨酸片治疗,连用3周。对比两组患者临床疗效,使用肺功能检测仪(比利时麦迪HYP-Air)检测呼气流量峰值(PEF)、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)。对比两组患者炎性因子及不良反应情况。结果观察组治疗总有效率比对照组高(94.34%vs.81.13%,χ^(2)=4.296,P=0.038);治疗后,观察组PEF、FEV1、FVC、FEV1/FVC水平比对照组高(P<0.05);治疗后,观察组超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)水平比对照组低(P<0.05);观察组不良反应发生率比对照组低(7.55%vs.22.64%,χ^(2)=4.711,P=0.030)。结论对于COPD患者行乙酰半胱氨酸联合布地奈德治疗效果显著,不仅能提高肺功能,还能减轻机体炎性反应,且安全性较高。

Objective To investigate the clinical efficacy of acetylcysteine combined with budesonide in the treatment of COPD and its influence on inflammatory factors.Methods A total of 106 COPD patients were admitted to the Respiratory Department of Ji'nan Fourth People's Hospital from January 2021 to December 2022.After admission,both groups of patients provided masks for oxygen inhalation in accordance with medical instructions.At the same time,actively maintain the stability of water and electrolytes,and provide targeted treatment,including spasmolysis,asthma relief,cough relief,anti-inflammatory,etc.On this basis,the control group was given budesonide inhalation aerosol and the observation group was given budesonide inhalation aerosol combined with acetylcysteine tablets for 3 weeks.Comparing the clinical efficacy of two groups of patients,PEF,FEV1,FVC,and FEV1/FVC were detected using a lung function testing device(Belgium Maddie HYP-Air).Compare the inflammatory factors and adverse reactions between the two groups of patients.Results The total effective rate of the observation group was higher than that of the control group(94.34%vs.81.13%,χ^(2)=4.296,P=0.038).After treatment,the levels of PEF,FEV1,FVC,and FEV1/FVC in the observation group were higher than those in the control group(P<0.05),and before treatment(P>0.05);After treatment,CRP and TNF in the observation group-α,The IL-6 level was lower than the control group(P<0.05),and the incidence of adverse reactions in the observation group was lower than that in the control group(7.55%vs.22.64%,χ^(2)=4.711,P=0.030).Conclusion For COPD patients,acetylcysteine combined with budesonide is effective and safe,which can not only improve lung function,but also reduce the inflammatory reaction of the body,with high safety.