乙酰半胱氨酸联合氨茶碱治疗慢性喘息性支气管炎急性发作的临床研究

目的 分析乙酰半胱氨酸溶液联合氨茶碱治疗慢性喘息性支气管炎急性发作的疗效。方法 选取2021年12月—2023年6月西安市第八医院收治的156例慢性喘息性支气管炎急性发作患者，按随机数字表法分为对照组和治疗组，每组各78例。对照组静脉滴注氨茶碱注射液，0.25 g溶于5%葡萄糖溶液250 mL中，3次/d。治疗组对照组治疗基础上雾化吸入吸入用乙酰半胱氨酸溶液，3 mL/次，2次/d。两组疗程7 d。观察两组的临床疗效和主要表现缓解时间，比较两组治疗前后肺功能指标、呼出气一氧化氮（FeNO）、诱导痰中嗜酸性粒细胞（EOS）比例、血清C反应蛋白（CRP）、内皮素-1（ET-1）、白细胞介素-8（IL-8）的变化情况。结果 治疗后，治疗组总有效率是96.15%，显著高于对照组的87.18%（P＜0.05）。治疗后，治疗组喘息、咳痰、咳嗽、哮鸣音缓解时间显著短于治疗组（P＜0.05）。治疗后，两组用力肺活量（FVC）、用力呼气中期流速（MMEF）、第1秒用力呼气量（FEV₁）、深吸气量与肺总量比值（IC/TLC）均较同组治疗前显著升高（P＜0.05）；治疗后，治疗组肺功能指标改善优于对照组（P＜0.05）。治疗后，两组FeNO、诱导痰中EOS比例和血清CRP、ET-1、IL-8水平均显著下降（P＜0.05）；治疗后，治疗组FeNO、诱导痰中EOS比例和血清CRP、ET-1、IL-8水平改善优于对照组（P＜0.05）。结论 乙酰半胱氨酸溶液联合氨茶碱治疗慢性喘息性支气管炎急性发作的效果及安全性较佳，能快速缓解患者主要临床表现，抑制气道炎症及机体炎性损伤，降低呼吸道阻力，促进肺功能改善，值得推广应用。

Clinical study of acetylcysteine combined with aminophylline in treatment of acute attack of chronic asthmatic bronchitis

Objective To analyze the clinical efficacy of inhaled acetylcysteine solution combined with aminophylline in the treatment of acute attack of chronic asthmatic bronchitis. Method: 156 patients with acute exacerbations of chronic asthmatic bronchitis admitted to Xi’an Eighth Hospital from December 2021 to June 2023 were randomly divided into two groups using a random number table method, 78 cases in each group. Patients in the control group were iv administered with Aminophylline Injection, 0.25 g was dissolved in 5% glucose solution 250 mL, 3 times daily. Patients in treatment group were atomized inhalation Acetylcysteine Solution for inhalation on the basis of the control group, 3 mL/time, twice daily. Both groups were treated for 7 d. The clinical effects of two groups and the main performance time were observed, and the lung function index, breath (FeNO), nitric oxide in induced sputum eosinophils (EOS), serum c-reactive protein (CRP), endothelin 1 (ET 1), interleukin 8 (IL-8) in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 96.15%, which was significantly higher than that of the control group (87.18%, P < 0.05). After treatment, the remission time of wheezing, phlegm, cough and wheezing in the treatment group was significantly shorter than that in the treatment group (P < 0.05). After treatment, forced vital capacity (FVC),forced expiratory flow rate (MMEF), forced expiratory volume in the first second (FEV1), ratio of deep inspiratory volume to total lung volume (IC/TLC) in 2 groups were significantly increased compared with before treatment (P < 0.05). After treatment, the improvement of lung function indexes in the treatment group was better than that in the control group (P < 0.05). After treatment, FeNO, EOS proportion in induced sputum and serum CRP, ET-1 and IL-8 levels were significantly decreased in both groups (P < 0.05). After treatment, FeNO, EOS ratio in induced sputum and serum CRP, ET-1 and IL-8 levels in the treatment group were better than those in the control group (P < 0.05). Conclusion: Inhaled acetylcysteine solution combined with aminophylline has good effect and safety in the treatment of acute attack of chronic asthmatic bronchitis, and can quickly alleviate the main clinical manifestations of patients, inhibit airway inflammation and body inflammatory injury, reduce respiratory resistance, and promote the improvement of lung function, which is worthy of promotion and application.