CAJ | 학술논문

目的：探究盐酸氨溴索联合定喘止咳汤对慢性阻塞性肺疾病（慢阻肺）合并慢性肺心病的患者治疗效果。方法将患者按照随机数字表法分为观察组70例和对照组73例，观察组患者采用盐酸氨溴索联合定喘止咳汤加减治疗；对照组单独使用盐酸氨溴索治疗；比较患者治疗前后肺功能、血液中炎性因子以及临床症状的变化。结果治疗7 d后，观察组肺功能FVC、VC、PEF、FEV1及MVV％较对照组有明显改善，其中观察组VC和FEV1分别为（2．45±0．38）L、（1．51±0．24）L，对照组 VC 与 FEV1分别为（1．94±0．38）L、（1.01±0.21）L，（肺功能指标t值分别为10．64、15．87、12．14、10．22、14．04，均P＜0．05）；治疗14 d后：观察组肺功能FVC、VC、PEF、FEV1及 MVV％较对照组有明显改善，其中观察组 VC 和 FEV1分别为（2．83±0．35）L、（1.67±0．27）L，对照组 VC 与 FEV1分别为（2．25±0．22）L、（1．21±0．23）L，（t ＝11．02、11．87、12.68、16.41、16．09，均P＜0．05）；治疗7 d、14 d，观察组外周血CRP分别为（14．13±5．21）mg／L、（3．94±2.39）mg／L，PCT分别是（0．31±0．24）μg／L、（0．27±0．09）μg／L，对照组CRP分别为（20．99±9．77）mg／L、（9．94±8.22）mg／L，PCT分别为（0．51±0．21）μg／L、（0.31±0．18）μg／L，治疗7 d观察组患者外周血CRP以及PCT与对照组相比降低幅度更大（t＝16．75、22．05，均P＜0．05）；治疗14 d观察组降低幅度也优于对照组（t＝10.75、12．05，均P＜0．05）；对照组总有效率为86．30％，观察组为97．14％，观察组总有效率高于对照组（χ2＝5．46，P＜0.05）。结论采用盐酸氨溴索联合止咳平喘汤加减有助于慢阻肺合并慢性肺心病的治疗。
목적：탐구염산안추색연합정천지해탕대만성조새성폐질병（만조폐）합병만성폐심병적환자치료효과。방법장환자안조수궤수자표법분위관찰조70례화대조조73례，관찰조환자채용염산안추색연합정천지해탕가감치료；대조조단독사용염산안추색치료；비교환자치료전후폐공능、혈액중염성인자이급림상증상적변화。결과치료7 d후，관찰조폐공능FVC、VC、PEF、FEV1급MVV％교대조조유명현개선，기중관찰조VC화FEV1분별위（2．45±0．38）L、（1．51±0．24）L，대조조 VC 여 FEV1분별위（1．94±0．38）L、（1.01±0.21）L，（폐공능지표t치분별위10．64、15．87、12．14、10．22、14．04，균P＜0．05）；치료14 d후：관찰조폐공능FVC、VC、PEF、FEV1급 MVV％교대조조유명현개선，기중관찰조 VC 화 FEV1분별위（2．83±0．35）L、（1.67±0．27）L，대조조 VC 여 FEV1분별위（2．25±0．22）L、（1．21±0．23）L，（t ＝11．02、11．87、12.68、16.41、16．09，균P＜0．05）；치료7 d、14 d，관찰조외주혈CRP분별위（14．13±5．21）mg／L、（3．94±2.39）mg／L，PCT분별시（0．31±0．24）μg／L、（0．27±0．09）μg／L，대조조CRP분별위（20．99±9．77）mg／L、（9．94±8.22）mg／L，PCT분별위（0．51±0．21）μg／L、（0.31±0．18）μg／L，치료7 d관찰조환자외주혈CRP이급PCT여대조조상비강저폭도경대（t＝16．75、22．05，균P＜0．05）；치료14 d관찰조강저폭도야우우대조조（t＝10.75、12．05，균P＜0．05）；대조조총유효솔위86．30％，관찰조위97．14％，관찰조총유효솔고우대조조（χ2＝5．46，P＜0.05）。결론채용염산안추색연합지해평천탕가감유조우만조폐합병만성폐심병적치료。
Objective To study the clinical effects of Dingchuan zhike decoction with ambroxol hydrochlo-ride on the patients with chronic obstructive pulmonary disease and pulmonary heart disease.Methods According to the random number table,the patients were divided into the observation group (70 cases)and the control group (73 cases).The patients were treated with ambroxol hydrochloride and Dingchuan zhike decoction in the observation group;the control group had a treatment with ambroxol hydrochloride.The lung function,sputum fluid inflammatory cytokines and clinical symptoms were compared between the two groups.Results When the two groups received treatment for 7 days,VC and FEV1 in the observation group were (2.45 ±0.38)L and (1.51 ±0.24)L,those in the control group were (1.94 ±0.38)L,(1.01 ±0.21)L,the patients′lung functions:FVC,VC,PEF,FEV1,and MVV% were improved in the observation group than those in the control group (t=10.64,15.87,12.14,10.22, 14.04,all P<0.05);After 14 days treatment,VC and FEV1 of patients in observation group were (2.83 ±0.35)L and (1.67 ±0.27)L,those in control group were (2.25 ±0.22)L,(1.21 ±0.23)L,the patients in the observation group were better than those in the control group on the lung functions:FVC,VC,PEF,FEV1 ,and MVV% (t =11.02,11.87,12.68,16.41,16.09,all P<0.05).The CRP of the observation group were (14.13 ±5.21)mg/L, (3.94 ±2.39)mg/L,after 7 and 14 days treatment respectively.And these in the control group were (20.99 ±9.77) mg/L,(9.94 ±8.22)mg/L.The PCT of the observation group were (0.31 ±0.24)μg/L,(0.27 ±0.09)μg/L. These in the control group were (0.51 ±0.21)μg/L,(0.31 ±0.18)μg/L.The levels of CRP and PCT on the obser-vation group′patients were better than those on the control group′patients after 7 days treatment (t=16.75,22.05, all P<0.05).When patients received 14 days therapy,the levels of CRP and PCT on the observation group′patients were better than those on the control group′patients (t=10.75,12.05,all P<0.05).The total effective rate was 86.30% in the control group and that of the observation group was 97.14 %.The total effective in the observation group was better than that in the control group.(χ2 =5.46,P<0.05).Conclusion The therapy of ambroxol hydro-chloride with Dingchuan zhike decoction is better than therapy of ambroxol hydrochloride alone.