目的 探讨老年慢性阻塞性肺疾病急性加重期(AECOPD)患者应用十味龙胆花颗粒联合硫酸特布他林治疗的临床效果。方法 回顾性选取我院收治的116例老年AECOPD患者(选例时间:2024年1月~2026年2月)为研究对象,根据治疗方案将其分为参照组(58例,接受硫酸特布他林治疗)、联合组(58例,接受十味龙胆花颗粒联合硫酸特布他林治疗)。对比两组临床疗效、不良反应及治疗前后中医证候积分、慢性阻塞性肺疾病评估测试(CAT)评分、血气指标[动脉血二氧化碳分压(PaCO2)、血氧饱和度(SpO2)、动脉血氧分压(PaO2)]、免疫功能、炎症相关细胞因子[白细胞介素-8(IL-8)、分泌卷曲相关蛋白1(SFRP1)、肿瘤坏死因子-α(TNF-α)、趋化因子配体9(CXCL9)]水平。结果 联合组总有效率(94.83%)高于参照组(79.31%)(P<0.05);联合组治疗后各中医证候积分均较参照组低(P<0.05);与参照组相比,治疗后联合组CAT评分较低(P<0.05);联合组治疗后PaCO2水平较参照组低,SpO2、PaO2水平较参照组高(P<0.05);联合组治疗后CD3+、CD4+、CD4+/CD8+水平较参照组高,CD8+水平较参照组低(P<0.05);治疗后联合组血清IL-8、SFRP1、TNF-α、CXCL9水平均较参照组低(P<0.05);不良反应发生情况组间比较,无明显差异(P>0.05)。结论 十味龙胆花颗粒联合硫酸特布他林可提高老年AECOPD患者治疗效果,减轻临床症状,改善肺功能、免疫功能及血气指标,降低机体炎症反应程度。
目的 分析布地格福吸入、无创正压通气(NIPPV)联合治疗慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭的效果。方法 本研究采用回顾性对照研究。选取2024-06—2025-05我院96例AECOPD合并呼吸衰竭者,根据治疗方案不同分组,每组48例。对照组接受NIPPV治疗,研究组接布地格福吸入、NIPPV联合治疗,持续治疗1周。观察并对比两组疗效、病情程度、血气指标[动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)]、肺功能[最大呼气压(MEP)、一秒率(FEV1/FVC)]、炎性因子指标[C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、氧化应激指标[超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化脂质(LPO)]及不良反应。结果 研究组治疗有效率为91.67%(44/48),高于对照组75.00%(36/48)(P<0.05);治疗1周后与对照组相比,研究组mMRC分值、CAT分值均较低(P<0.05);治疗1周后,与对照组相比,研究组MEP、FEV1/FVC、PaO2较高,PaCO2较低(P<0.05);治疗1周后与对照组相比,研究组CRP、TNF-α、IL-6较低(P<0.05);治疗1周后与对照组相比,研究组SOD、GSH-Px较高,LPO较低(P<0.05);两组不良反应无明显差异(P>0.05)。结论 布地格福吸入、NIPPV联合治疗AECOPD合并呼吸衰竭,可明显减轻症状,改善血气指标与肺功能,抑制炎症反应,调节氧化应激,且保障安全性。
论著
目的 探讨福莫特罗联合格隆溴铵对慢性阻塞性肺疾病急性加重期(AECOPD)患者的疗效。方法 选择2021年1月—2023年6月廉江市人民医院收治的97例AECOPD患者进行研究,在双方知情基础上,通过单双号抽签方式分组,抽取单号纳入对照组(n=48,予以福莫特罗治疗),抽取双号纳入观察组(n=48,予以福莫特罗联合格隆溴铵治疗),对比两组肺功能指标、血气指标、症状改善情况及出现的不良反应。结果 治疗后两组的肺功能指标均高于治疗前,而观察组各指标高于对照组(P<0.05);治疗后两组PaO2高于治疗前,PaCO2低于治疗前,且观察组上述血气指标与对照组比较差异有统计学意义(P<0.05);治疗后两组的CAT及SGRQ评分均低于治疗前,其中观察组评分低于对照组(P<0.05);观察组(8.33%)与对照组(12.24%)不良反应率比较,差异不显著(P>0.05)。结论 采用福莫特罗联合格隆溴铵治疗AECOPD患者,有助于改善患者肺功能,使其血气指标得到改善,还可有效缓解其呼吸道症状,且安全性得到保障。
Objective To explore the curative effect of formoterol combined with glycopyrronium bromide on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods The research cut-off period was from January 2021 to June 2023.A total of 97 patients with AECOPD were selected from Lianjiang People's Hospital for research.On the basis of mutual knowledge,they were divided into groups by odd and even numbers.The odd numbers were drawn into the control group(n=48,treated with formoterol)and the odd numbers were drawn into the observation group(n=48,treated with formoterol+glycopyrronium bromide),the pulmonary function index,blood gas index,symptom improvement and adverse reactions were compared between the two groups. Results After treatment,the lung function indexes of the two groups were higher than those before treatment,while the indexes of the observation group were higher than those of the control group(P<0.05).PaO2 was higher and PaCO2 was lower in the two groups after treatment,and the blood gas indexes in the observation group were different from those in the control group(P<0.05).The scores of COPD assessment test and St. George's Respiratory Questionaire in the two groups after treatment were lower than those before treatment,while the scores in the observation group were lower than those in the control group(P<0.05);There was no significant difference between the observation group(8.33%)and the control group(12.24%)(P>0.05). Conclusions The choice of formoterol and qualified ammonium bromide for AECOPD is helpful to improve the lung function,blood gas index and respiratory symptoms,And the security is guaranteed.