穿心莲内酯治疗支气管扩张急性加重期疗效观察

目的观察穿心莲内酯治疗支气管扩张急性加重期的临床疗效,探索其作用机制。方法选取我院2012年1月-2014年6月呼吸内科门诊78例支气管扩张急性发作期患者,随机分为治疗组和对照组。对照组予口服头孢克肟胶囊150 mg,2次/d,左氧氟沙星胶囊0.2 g,2次/d,右美沙芬愈创甘油醚糖浆20 m L,3次/d;在对照组基础上治疗组加用穿心莲内酯0.99 g,3次/d。各组均治疗14天。所有入组对象采用视觉模拟评分,于入组前和治疗后由患者自主对咳嗽症状、咳痰多少进行评分,治疗前后检测血清hs-CRP、IL-6。结果治疗后治疗组咳嗽、咳痰视觉模拟评分较对照组降低（咳嗽P〈0.05,咳痰P〈0.01）,治疗组较对照组炎性指标下降（hs-CRP,P〈0.01;IL-6,P〈0.01）。结论对于支气管扩张急性加重期患者,穿心莲内酯与抗生素有协同效应,可明显缓解咳嗽、咳痰症状,降低炎性标志物hs-CRP、IL-6水平,改善生活质量。

The effect of andrographolide in the treatment of acute aggravating period of bronchiectasis

Objective To observe the clinical effects of andrographolide to cure acute aggravating period of bronchiec- tasis and explore possible mchanism. Methods A total of seventy-eight patients with acute exacerbation of bronchiecta- sia from respiratory medicine from January 2012 to June 2014 were randomly divided into the treatment group and the contol group, all patients received cefixime capsule 150 mg, twice one day, levofloxacin capsule 0.2 g, twice one day, dextromethorphan guaifenesin syrup 20 mL, three times one day orally; On the basis of control group, patients in treat- ment group received andrographolide 0.99 g, three times one day. The control group and the treatment group were all treated for 14 days. Using the method of visual analogue scale, all patients scored cough, sputum before and after treatment, meanwhile, the level of hs-CRP, IL- 6 were tested before and after treatment. Results The VAS of cough, sputum in treatment group were reduced than those in control group（cough P〈0.05; sputum P〈0.01）, meanwhile, inflam- matory index in treatment group were declined than those in control group（hs-CRP, P〈0.01; IL-6, P〈0.01）. Conclusion Andrographolide combined with antibiotics in patients with acute aggravating period of bronchiectasis has a synergistic effect, can alleviate symptoms of cough, sputum, and improve the quality of life and decrease the level of hs＇CRP, IL-6.