羧甲司坦治疗老年慢性阻塞性肺疾病急性加重期的疗效及对血清IL-8、TNF-α和IgE水平的影响

目的探讨羧甲司坦对老年慢性阻塞性肺疾病急性加重期(AECOPD)的疗效及对血清白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)及免疫球蛋白E(IgE)水平的影响。方法选取2018年8月—2019年8月商丘市中医院肺病科收治的128例老年AECOPD患者,随机分为对照组和治疗组,每组各64例。对照组给予常规治疗,治疗组在对照组基础上口服羧甲司坦口服溶液,10 mL/次,3次/d。两组均治疗1周。观察两组的临床疗效,比较两组肺功能指标、动脉血气指标、呼吸困难程度、运动耐力和1年随访期间第一次急性症状发作时间、发作病例,记录两组治疗前后的血清炎症指标水平和生活质量。结果治疗后,治疗组总有效率为92.19%,显著高于对照组的79.69%,差异有统计学意义(P<0.05)。治疗后,两组肺功能指标中第一秒用力呼气量(FEV1)、FEV1占用力肺活量百分比(FEV1/FVC)、氧分压(pO2)均较治疗前显著升高,但二氧化碳分压(pCO2)较治疗前显著降低(P<0.05);治疗后,治疗组肺功能指标和动脉血气指标均优于对照组(P<0.05)。治疗后,两组患者CAT问卷评分较治疗前显著降低,而6分钟步行距离(6MWT)显著较治疗前增加(P<0.05);治疗后,治疗组以上指标改善效果显著优于对照组(P<0.05)。治疗组第一次发作时间较对照组显著延后,急性发作病例显著少于对照组(P<0.05)。治疗后,两组患者IL-8、TNF-α及IgE水平较治疗前显著降低(P<0.05);治疗后,治疗组患者血清炎症水平显著低于对照组(P<0.05)。治疗后,两组SGRQ量表关于症状、活动、疾病影响3个维度评分及总分较治疗前显著降低(P<0.05);治疗后,治疗组SGRQ评分显著低于对照组(P<0.05)。结论羧甲司坦可明显改善老年AECOPD患者的氧合能力、肺功能及运动耐力,延长急性发作间期,下调炎症因子水平,且用药安全性良好。

Effect of cattle encephalon glycoside and ignotin combined with oxiracetam in treatment of acute cerebral hemorrhage and its effect on serum SF and SAA levels

Objective To investigate the clinical efficacy of cattle encephalon glycoside and ignotin combined with oxiracetam in treatment of acute cerebral hemorrhage, and its effect on SF and SAA levels. Methods A total of 148 patients with acute cerebral hemorrhage who received treatment in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2018 to December 2019 were selected as the research subjects. According to the treatment plan, the patients were divided into control group and observation group, with 74 patients in each group. Patients in the control group were intravenously injected with Oxiracetam Injection, 5 g of Oxiracetam Injection was added into 250 mL normal saline, once daily. Patients in the the observation group was intravenously injected with Cattle Encephalon Glycoside and Ignotin Injection on the basis of the control group, 20 mL added into 250 mL normal saline, once daily. Both groups were given continuous medication for 2 weeks. After treatment, the clinical efficacy of two groups was observed, and hematoma volume, brain edema volume, NIHSS score, BI, MRS, the levels of serum IL-6, IL-10, SF and SAA were compared between two groups. Results After treatment, the total effective rate of observation group was 89.19%, which was significantly higher than 75.68% of control group (P<0.05). After treatment, the amount of cerebral hematoma and brain edema in two groups were significantly decreased (P<0.05), and the amount of cerebral hematoma and brain edema in the observation group were significantly lower than those in the control group (P<0.05). After treatment, NIHSS and MRS scores were significantly decreased, while BI scores were significantly increased (P<0.05). The NIHSS and MRS scores of the observation group were significantly lower than those of the control group, but the BI scores of the observation group were significantly higher than those of the control group (P<0.05). After treatment, the levels of serum IL-6, SF and SAA in two groups were significantly decreased, while the level of IL-10 was significantly increased (P<0.05). The levels of serum IL-6, SF and SAA in observation group were significantly lower than those in control group, and the level of IL-10 was significantly higher than that in control group (P<0.05). Conclusion Cattle encephalon glycoside and ignotin combined with oxiracetam has good therapeutic effect on patients with acute intracerebral hemorrhage, which can significantly reduce serum SF and SAA levels, reduce inflammatory response, and protect and repair nerve damage.