二羟丙茶碱联合乙酰半胱氨酸治疗慢性阻塞性肺疾病急性加重期的效果

The Effect of Diprophylline Combined with Acetylcysteine in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的探讨二羟丙茶碱联合乙酰半胱氨酸治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者的疗效及对肺功能、血清炎症因子、生活质量的影响。方法选择2017年5月~2019年3月彭州市人民医院收治的138例AECOPD患者作为研究对象,采用随机数字表法分为对照组和观察组,各69例。对照组给予常规治疗,观察组在对照组用药基础上给予二羟丙茶碱联合乙酰半胱氨酸治疗,两组总疗程均为2周。比较两组治疗前后的用力肺活量(FVC)、第1秒用力呼气容积(FEV1)占预计值百分比(FEV1pre)、FEV1/FVC,血清超敏C反应蛋白(hs-CRP)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α),生活质量评分及临床疗效。结果治疗后,两组FVC、FEV1pre、FEV1/FVC均高于治疗前,hs-CRP、IL-8、TNF-α均低于治疗前,生活质量的生理、心理、环境及社会关系领域评分均高于治疗前,差异均有统计学意义(P<0.05);治疗后,观察组FVC、FEV1pre、FEV1/FVC升高差值均大于对照组,hs-CRP、IL-8、TNF-α降低差值均大于对照组,生活质量各领域评分升高差值均大于对照组,观察组临床总有效率高于对照组,差异均有统计学意义(P<0.05)。结论二羟丙茶碱联合乙酰半胱氨酸可显著改善AECOPD患者临床症状及肺功能,降低炎症反应水平,提高生存质量,临床疗效显著且无明显不良反应,可在AECOPD的临床治疗中进一步应用和推广。

Objective To investigate the therapeutic effect of diprophylline combined with acetylcysteine on acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its influence on pulmonary function,serum inflammatory factors and quality of life.Methods A total of 138 patients with AECOPD admitted to Pengzhou People′s Hospital from May 2017 to March 2019 were selected as the study subjects and divided into the control group and the observation group by the random number table,with 69 cases in each group.The control group was given conventional treatment,and the observation group was given diprophylline combined with acetylcysteine treatment on the basis of medication in the control group.The total course of treatment in both groups was 2 weeks.Forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1)percentage of predicted value(FEV1pre),FEV1/FVC,serum high-sensitivity C-reactive protein(hs-CRP),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),quality of life score and clinical efficacy were compared between the two groups before and after treatment.Results After treatment,FVC,FEV1pre and FEV1/FV in the two groups were higher than those before treatment,hs-CRP,IL-8 and TNF-αwere lower than those before treatment,and the physical,psychological,environmental and social relationship domain scores of quality of life were higher than those before treatment,and the differences were statistically significant(P0.05);after treatment,the increase differences of FVC,FEV1pre and FEV1/FVC in the observation group were greater than those in the control group,the decrease differences of hs-CRP,IL-8 and TNF-αwere greater than those in the control group,the increase differences of quality of life domain scores were greater than those in the control group,and the overall clinical response rate in the observation group was higher than that in the control group,and the differences were statistically significant(P0.05).Conclusion Diprophylline combined with acetylcysteine can significantly improve the clinical symptoms and pulmonary function of patients with AECOPD,reduce the level of inflammatory response,improve the quality of life,with significant clinical efficacy and no obvious adverse reactions.It can be further applied and popularized in the clinical treatment of AECOPD.