CAJ | 학술논문

目的：探讨不同剂量盐酸氨溴索辅助治疗老年人肺炎的临床疗效。方法选取2010年1月～2013年12月我院呼吸科收治的老年肺炎患者160例，随机分为盐酸氨溴索小剂量组[3mg/（kg·d）]、盐酸氨溴索中剂量组[9mg/（kg·d）]、盐酸氨溴索大剂量组[15mg/（kg·d）]及16mg盐酸溴已新组（对照组），记录治疗后各组患者的临床症状（痰液性质、咳痰量及咳嗽程度）变化情况，以及中剂量盐酸氨溴索组与盐酸溴已新组治疗后痰液中白介素-8（IL-8）、肿瘤坏死因子α（TNF-α）及血中的C反应蛋白（CRP）水平。结果在不同剂量组盐酸氨溴索治疗后的单项症状改善情况比较中，大剂量组的对痰液性质、咳痰量及咳嗽程度的有效率分别为97.5%、92.5%与95.0%，高于其他两组，差异具有统计学意义（P＜0.05）；不同剂量盐酸氨溴索组的治疗后的综合临床疗效为55.0%、72.5%及90.0%，大剂量组明显高于其他两组，差异有统计学意义（P＜0.05）；中剂量盐酸氨溴索组改善三项症状的有效率分别为82.5%、82.5%与77.5%，高于盐酸溴已新组，差异具有统计学意义（P＜0.05）；中剂量盐酸氨溴索组的痰IL-8、TNF-α及血液中的CRP水平均低于盐酸溴已新组，差异具有统计学意义（P＜0.05）。结论盐酸氨溴索在辅助治疗老年人肺炎方面临床疗效显著，且其用量与治疗效果呈正相关。
목적：탐토불동제량염산안추색보조치료노년인폐염적림상료효。방법선취2010년1월～2013년12월아원호흡과수치적노년폐염환자160례，수궤분위염산안추색소제량조[3mg/（kg·d）]、염산안추색중제량조[9mg/（kg·d）]、염산안추색대제량조[15mg/（kg·d）]급16mg염산추이신조（대조조），기록치료후각조환자적림상증상（담액성질、해담량급해수정도）변화정황，이급중제량염산안추색조여염산추이신조치료후담액중백개소-8（IL-8）、종류배사인자α（TNF-α）급혈중적C반응단백（CRP）수평。결과재불동제량조염산안추색치료후적단항증상개선정황비교중，대제량조적대담액성질、해담량급해수정도적유효솔분별위97.5%、92.5%여95.0%，고우기타량조，차이구유통계학의의（P＜0.05）；불동제량염산안추색조적치료후적종합림상료효위55.0%、72.5%급90.0%，대제량조명현고우기타량조，차이유통계학의의（P＜0.05）；중제량염산안추색조개선삼항증상적유효솔분별위82.5%、82.5%여77.5%，고우염산추이신조，차이구유통계학의의（P＜0.05）；중제량염산안추색조적담IL-8、TNF-α급혈액중적CRP수평균저우염산추이신조，차이구유통계학의의（P＜0.05）。결론염산안추색재보조치료노년인폐염방면림상료효현저，차기용량여치료효과정정상관。
Objective To discuss the clinical effect of different dosages of ambroxol HCL in adjuvant treatment for pneumonia in the elderly. Methods 160 elderly patients with pneumonia in respiratory department of our hospital from January 2010 to December 2013 were chosen and randomly divided into small dosage of ambroxol HCL group [3mg/(kg·d)], medium dosage of ambroxol HCL group [9mg/(kg·d)], large dosage of ambroxol HCL group [15mg/(kg·d)] and 16mg bromhexime HCL group (control group). Changes of clinical symptoms (sputum nature, sputum volume and cough degree) of patients after treatments and levels of IL-8, TNF-α and CRP in sputum of medium dosage of ambroxol HCL group and bromhexime HCL group after treatments were recorded. Results On comparison of developments of individual symptoms of different dosages of ambroxol HCL groups after treatment, effective rates of large dosage group towards sputum nature, sputum volume and cough degree were separately 97.5%, 92.5% and 95.0% obviously higher than the other 2 groups (P<0.05); Comprehensive clinical efficiencies of different dosages of ambroxol HCL group were 55.0%, 72.5%and 90.0%, the large dosage group was obviously higher than the other 2 groups (P<0.05). Effective rates of medium dosage of ambroxol HCL group in improving 3 symptoms were separately 82.5%, 82.5% and 77.5% higher than bromhexime HCL group (P < 0.05); IL-8 and TNF-α level in sputum and CRP level in blood of medium dosage of ambroxol HCL group were lower than bromhexime HCL group (P<0.05). Conclusion Ambroxol HCL has significant clinical effect in adjuvant treatment for pneumonia in the elderly and there is a positive correlation between its dosage and clinical effect.