余江清

摘 要 目的：观察和评估乙酰半胱氨酸泡腾片合用噻托溴铵吸入剂对COPD合并肺气肿患者的肺功能和临床症状的影响。方法：随机选取我院2013年2月—2014年12月收治的COPD合并肺气肿患者共100例，按治疗方式分为观察组和对照组，观察组用乙酰半胱氨酸泡腾片联合噻托溴铵吸入剂治疗，对照组单纯口服乙酰半胱氨酸泡腾片治疗。对两组患者CRP及IL-18水平，肺功能指标以及临床症状评分，SGRQ的症状分，活动分，影响分的分值等指标进行对比分析。结果：观察组患者CRP及IL-18水平，临床症状评分， SGRQ的症状分，活动分，影响分的分值明显低于对照组（P<0.01） ；观察组肺功能指标明显优于对照组 （P<0.01）。结论：采用乙酰半胱氨酸泡腾片合用噻托溴铵吸入剂临床疗效显著，具有一定的抗炎作用，可以明显降低COPD合并肺气肿患者的CRP及IL-18水平，有效改善患者的肺功能和临床症状，提高患者的生活质量。

关键词 乙酰半胱氨酸泡腾片 噻托溴铵吸入剂 慢性阻塞性肺疾病

中图分类号：R974； R563 文献标识码：B 文章编号：1006-1533（2016）07-0029-03

Clinical efficacy of SG acetylcysteine effervescent tablets combined with tiotropium inhalant in the treatment of 50 cases of COPD with emphysema

YU Jiangqing

（The First Peoples Hospital of Jingdezhen City， jiangxi province， Jingdezhen 333000， China ）

ABSTRACT Objective： To observe and evaluate the effects of the acetylcysteine effervescent tablets combined with tiotropium inhalant on the lung function and clinical symptoms in the treatment of patients with COPD with emphysema. Methods： One hundred cases of patients with COPD with emphysema were randomly selected from our hospital from February， 2013 to December， 2014 and divided into an observation group and a control group based on the therapy. The observation group was treated with acetylcysteine effervescent tablets combined with tiotropium inhalant while the control group simply with oral acetylcysteine effervescent tablets. The levels of CRP and IL - 18 and the pulmonary function indexes and the scores for clinical symptom SGRQ symptom， activity and influence were analyzed. Results： The levels of CRP and IL - 18 and the scores mentioned above were significantly lower in the observation group than the control group （P < 0.01） and the lung function indexes were better in the observation group than the control group （P < 0.01）. Conclusion： The combination therapy has prominent efficacy and certain anti-inflammatory effects and can obviously reduce the levels of CRP and IL - 18 of the patients and effectively improve the clinical symptoms and lung function as well as the life quality of the patients.

KEY WORDS acetylcysteine effervescent tablets； tiotropium inhalant； COPD

慢性阻塞性肺疾病（COPD）是一种持续性气流阻塞的慢性肺疾病，若治疗不当，容易引发异常炎症反应，致残率和病死率很高，其发病率在我国呈逐年上升趋势[1]。故阻止病情的恶化，减缓肺功能的衰退，提高患者的生存质量是当前治疗COPD患者首要考虑的问题。 COPD 全球倡议指南推荐的黏痰溶解剂与支气管扩张剂联合治疗COPD合并肺气肿[2-3]的方案能明显改善患者的临床症状，缓解患者病情的恶化，提高患者的生活质量。故本研究将进一步从临床方面观察黏痰溶解剂乙酰半胱氨酸泡腾片合用支气管扩张剂噻托溴铵吸入剂对COPD合并肺气肿患者肺功能的影响效果以及临床疗效，为临床治疗COPD合并肺气肿患者提供真实可靠的临床依据。……