目的 探討橘紅痰咳液聯(lián)合異丙托溴銨治療慢性阻塞性肺疾病急性加重期的臨床效果。方法 選取2017年1月-2019年1月平山縣人民醫(yī)院收治的慢性阻塞性肺疾病急性加重期患者122例，隨機分成對照組（61例）和治療組（61例）。對照組霧化吸入吸入用異丙托溴銨溶液，500 μg/次，3次/d。治療組在對照組基礎(chǔ)上口服橘紅痰咳液，20 mL/次，3次/d。兩組均連續(xù)治療14 d。觀察兩組患者臨床療效，同時比較治療前后兩組患者主要癥狀積分、主要癥狀緩解時間、CAT問卷評分、肺功能以及血清腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-8（IL-8）、白三烯B4（LTB4）、C反應(yīng)蛋白（CRP）水平。結(jié)果 治療后，對照組和治療組臨床有效率分別為83.6%和95.1%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者主要癥狀積分和緩解時間均顯著降低（P<0.05），且治療組患者顯著低于對照組（P<0.05）。治療后，兩組CAT問卷評分、殘氣容積（RV）與肺總量（TLC）比值（RV/TLC）值均顯著降低（P<0.05），第1秒用力呼氣容積（FEV1）與用力肺活量（FVC）比值（FEV1/FVC）、FEV1占預(yù)計值百分比（FEV1占預(yù)計值%）和一氧化碳彌散量（DLCO）與肺泡通氣量（VA）比值（DLCO/VA）值均顯著升高（P<0.05），且治療組患者CAT問卷評分和上述肺功能參數(shù)的改善效果顯著好于對照組（P<0.05）。治療后，兩組患者血清TNF-α、IL-8、LTB4、CRP水平顯著降低（P<0.05），且治療組患者血清TNF-α、IL-8、LTB4、CRP水平顯著低于對照組（P<0.05）。結(jié)論 橘紅痰咳液聯(lián)合異丙托溴銨治療慢性阻塞性肺疾病急性加重期整體療效顯著，能迅速控制患者病情，有效降低相關(guān)炎癥因子的表達(dá)水平，保護肺功能。

Objective To investigate the clinical effect of Juhong Tanke Liquid combined with ipratropium bromide in treatment of acute exacerbation of COPD. Methods Patients (122 cases) with acute exacerbation of COPD in Pingshan People's Hospital from January 2017 to January 2019 were randomly divided into control (61 cases) and treatment (61 cases) groups. Patients in the control group were atomization inhalation administered with Ipratropium Bromide Solution for inhalation, 500 μg/time, three times daily. Patients in the treatment group were po administered with Juhong Tanke Liquid on the basis of the control group, 20 mL/times, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the main symptom scores, the relief time of main symptom, CAT questionnaire scores, pulmonary function index, the levels of TNF-α, IL-8, LTB4, and CRP in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 83.6% and 95.1%, respectively, and there were differences between two groups (P<0.05). After treatment, the scores and relief time of main symptom in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the CAT questionnaire scores and RV/TLC value in two groups were significantly decreased (P<0.05), but the FEV1/FVC value, FEV1 in the predicted value and DLCO/VA value was significantly increased (P<0.05), and these indicators in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the levels of TNF-α, IL-8, LTB4 and CRP in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Juhong Tanke Liquid combined with ipratropium bromide in treatment of acute exacerbation of COPD has significant effect, can quickly control the patient's condition, effectively reduce the expression level of relevant inflammatory factors and protect lung function.

R974