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目的比较痰热清注射液和血必净注射液治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效。方法选取2013年10月—2015年5月在黄石市中心医院呼吸科治疗的AECOPD患者150例,随机分为对照组、痰热清组和血必净组,每组各50例。对照组给予吸氧、注射用多索茶碱止咳、吸入糖皮质激素平喘、注射用头孢哌酮钠舒巴坦抗感染、纠正电解质和酸碱失衡等常规治疗。痰热清组在对照组的基础上静脉滴注痰热清注射液,20 m L加入到0.9%氯化钠注射液250 m L中,1次/d。血必净组在对照组的基础上静脉滴注血必净注射液,30 m L加入到0.9%氯化钠注射液250 m L中,1次/d。3组均治疗7 d。观察3组临床疗效,比较3组肺功能和炎性因子。结果治疗后,对照组、血必净组和痰热清组的总有效率分别为52.0%、76.0%、82.0%,血必净组和痰热清组的总有效率均显著高于对照组,3组比较差异性具有统计学意义(P<0.05);但痰热清组和血必净组的总有效率比较差异无统计学意义。治疗后,3组用力肺活量(FVC)、第1秒用力呼气容积(FEV1)和FEV1/FVC均显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且痰热清组和血必净组这些观察指标的上升程度明显优于对照组,3组比较差异具有统计学意义(P<0.05);但痰热清组和血必净组这些观察指标比较差异无统计学意义。治疗后,3组白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子(TNF-α)和C-反应蛋白(CRP)均显著下降,而白细胞介素-10(IL-10)均显著上升,同组治疗前后比较差异有统计学意义(P<0.05);且痰热清组和血必净组这些观察指标的改善程度明显优于对照组,3组比较差异具有统计学意义(P<0.05);且血必净组这些观察指标的改善程度明显优于痰热清组,两组比较差异具有统计学意义(P<0.05)。结论痰热清注射液和血必净注射液均能显著提高AECOPD患者的临床疗效,改善肺功能和抑制炎性因子释放,但血必净注射液抑制炎性因子释放更显著,具有一定的临床推广应用价值。
Objective To compare the clinical effects of Tanreqing Injection and Xuebijing injection in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods 150 patients with AECOPD who were treated in Department of Respiratory Department of Central Hospital of Huangshi from October 2013 to May 2015 were randomly divided into control group, Tanreqing group and Xuebijing group, 50 cases in each group. Control group was given oxygen, Doxofylline injection cough, inhaled glucocorticoid asthma, injection of cefoperazone sodium and sulbactam anti-infection, to correct electrolyte and acid-base imbalance and other conventional treatment. On the basis of the control group, the Tanreqing injection group was given Tanreqing Injection 20ml, added to 250ml of 0.9% sodium chloride injection once a day. Xuebijing group in the control group on the basis of intravenous Xuebijing injection, 30 m L added to 0.9% sodium chloride injection 250 m L, 1 / d. Three groups were treated for 7 days. The clinical efficacy was observed in 3 groups. The lung function and inflammatory factors in 3 groups were compared. Results After treatment, the total effective rate of the control group, Xuebijing group and Tanreqing group were 52.0%, 76.0% and 82.0% respectively. The total effective rates of Xuebijing group and Tanreqing group were significantly higher than those of the control group (P <0.05). However, there was no significant difference in the total effective rate between Tanreqing and Xuebijing groups. After treatment, FVC, FEV1 and FEV1 / FVC of 3 groups were significantly increased, the difference was statistically significant before and after treatment (P <0.05); and Tanreqing (P <0.05). However, there was no significant difference between the Tanreqing and Xuebijing groups in these indexes (P> 0.05). The difference between the Tanreqing and Xuebijing groups was statistically significant significance. After treatment, the levels of IL-6, IL-8, TNF-α and C-reactive protein (CRP) were significantly decreased in all three groups, while the levels of interleukin (IL-10) were significantly increased in the same group before and after treatment, the difference was statistically significant (P <0.05); and Tanreqing and Xuebijing group of these indicators improved significantly better than the control group, The differences between the three groups were statistically significant (P <0.05). The improvement of these indexes in Xuebijing group was better than that in Tanreqing group, the difference was statistically significant (P <0.05). Conclusion Tanreqing injection and Xuebijing injection can significantly improve the clinical efficacy of AECOPD patients, improve lung function and inhibit the release of inflammatory cytokines, but Xuebijing injection inhibit the release of inflammatory cytokines more significantly, with a certain clinical Promote the value of application.