目的 探討金咳息膠囊聯(lián)合厄多司坦分散片治療老年慢性阻塞性肺氣腫（COPE）的臨床療效。方法 選取2015年1月-2016年1月榆林市第一醫(yī)院收治的122例COPE老年患者為研究對(duì)象，隨機(jī)分為對(duì)照組（61例）和治療組（61例）。對(duì)照組口服厄多司坦分散片，2片/次，2次/d。治療組在對(duì)照組的基礎(chǔ)上口服金咳息膠囊，5粒/次，3次/d。兩組均治療14 d。治療后，觀察兩組的臨床療效，同時(shí)比較兩組治療前后血?dú)庵笜?biāo)、肺功能指標(biāo)、免疫功能指標(biāo)的變化情況。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為80.3%、93.4%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組pH值和氧分壓（pO₂）顯著升高，二氧化碳分壓（pCO₂）顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組的血?dú)庵笜?biāo)優(yōu)于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患者用力肺活量（FVC）、第1秒用力呼氣容積（FEV1）和呼氣峰流速值（PEFR）均比治療前明顯升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組的肺功能指標(biāo)顯著高于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組免疫球蛋白IgG、IgA、IgM和T細(xì)胞亞群CD³⁺、CD⁴⁺和CD⁸⁺水平均顯著升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組免疫功能指標(biāo)均高于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 金咳息膠囊聯(lián)合厄多司坦分散片治療COPE臨床療效較好，可顯著改善血?dú)庵笜?biāo)和肺功能，提高免疫功能，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical efficacy of Jinkexi Capsule combined with Erdosteine Dispersible Tablets in treatment of elderly chronic obstructive pulmonary emphysema (COPE). Methods Patients (122 cases) with elderly COPE in Yulin First Hospital from January 2015 to January 2016 were randomly divided into control (61 cases) and treatment (61 cases) groups. Patients in the control group were administered with Erdosteine Dispersible Tablets, 2 tablets/time, twice daily. Patients in the treatment group were po administered with Jinkexi Capsule on the basis of the control group, 5 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the changes of blood gas indexes, lung function indexes, and immune function indexes in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 80.3% and 93.4%, respectively, and there was difference between two groups (P<0.05). After treatment, pH and oxygen partial pressure (pO₂) in two groups significantly increased, but partial pressure of carbon dioxide (pCO₂) was significantly decreased, and the difference was statistically significant in the same group (P<0.05). And after treatment, blood gas indexes in the treatment group were higher than those in the control group, and there was difference between two groups (P<0.05). Forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEFR) in two groups significantly increased, and the difference was statistically significant in the same group (P<0.05). And lung function indexes in the treatment group were higher than those in the control group, and there was difference between two groups (P<0.05). IgG, IgA, IgM and CD³⁺, CD⁴⁺, and CD⁸⁺levels in two groups significantly increased, and the difference was statistically significant in the same group (P<0.05). And immune function indexes in the treatment group were higher than those in the control group, and there was difference between two groups (P<0.05). Conclusion Jinkexi Capsule combined with Erdosteine Dispersible Tablets has a significant effect in treatment of elderly COPD, and can significantly improve blood gas indexes and lung function, and also can improve immune function, which has a certain clinical application value.

陜西省教育廳自然科學(xué)研究項(xiàng)目（09JK819）