溴己新联合噻托溴铵治疗慢性阻塞性肺疾病稳定期的临床研究

目的探讨盐酸溴己新片联合噻托溴铵粉雾剂治疗慢性阻塞性肺疾病稳定期的临床疗效。方法选取2018年2月—2019年2月在新乡市中心医院治疗的100例慢性阻塞性肺疾病稳定期患者为研究对象,将所有患者随机分为对照组和治疗组,每组各50例。对照组患者给予噻托溴铵粉雾剂,1粒/次,1次/d;治疗组在对照组基础上口服盐酸溴己新片,2片/次,3次/d。两组患者持续治疗3个月。观察两组的临床疗效,比较两组的mMRC评分、慢性阻塞性肺病评估测试量表(CAT)评分、6 min步行距离(6 MWT)、肺功能、血清炎性因子水平。结果治疗后,对照组和治疗组的总有效率分别为76.00%、92.00%,两组比较差异有统计学意义(P0.05)。治疗后,两组mMRC评分和CAT评分显著降低,6MWT显著升高,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组m MRC评分、CAT评分、6 MWT明显优于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组第1秒用力呼气容积(FEV1)/用力肺活量(FVC)、FEV1、FVC显著升高,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组肺功能指标明显高于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患者C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-4(IL-4)水平显著降低,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组患者血清炎性因子水平明显低于对照组,两组比较差异有统计学意义(P0.05)。结论盐酸溴己新片联合噻托溴铵粉雾剂治疗慢性阻塞性肺疾病稳定期具有较好临床疗效,能改善肺功能和生活质量,降低血清炎性因子水平,具有一定的临床推广应用价值。

Clinical study on bromhexine combined with tiotropium bromide in treatment of chronic obstructive pulmonary disease in stable stage

Objective To investigate the effect of Bromhexine Hydrochloride Tablets combined with Tiotropium Bromide Powder for inhalation in treatment of chronic obstructive pulmonary disease in stable stage. Methods Patients (100 cases) with chronic obstructive pulmonary disease in stable stage in Xinxiang Central Hospital from February 2018 to February 2019 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were given Tiotropium Bromide Powder for inhalation, 1 grains/time, once daily. Patients in the treatment group were po administered with Bromhexine Hydrochloride Tablets on the basis of the control group, 2 tablets/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and mMRC scores, CAT scores, 6 MWT, pulmonary function, and serum levels of inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.00% and 92.00%, respectively, and there was difference between two groups (P<0.05). After treatment, mMRC scores and CAT scores in two groups were significantly decreased, but 6 MWT in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, FEV₁/FVC, FEV₁, and FVC in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the pulmonary function indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of CRP, IL-4, and IL-6 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the serum levels of inflammatory factors in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Bromhexine Hydrochloride Tablets combined with Tiotropium Bromide Powder for inhalation has clinical curative effect in treatment of chronic obstructive pulmonary disease in stable stage, can improve lung function and quality of life, and decrease the serum levels of inflammatory factors, which has a certain clinical application value.