目的 探討鹽酸溴己新片聯(lián)合噻托溴銨粉霧劑治療慢性阻塞性肺疾病穩(wěn)定期的臨床療效。方法 選取2018年2月-2019年2月在新鄉(xiāng)市中心醫(yī)院治療的100例慢性阻塞性肺疾病穩(wěn)定期患者為研究對(duì)象，將所有患者隨機(jī)分為對(duì)照組和治療組，每組各50例。對(duì)照組患者給予噻托溴銨粉霧劑，1粒/次，1次/d；治療組在對(duì)照組基礎(chǔ)上口服鹽酸溴己新片，2片/次，3次/d。兩組患者持續(xù)治療3個(gè)月。觀察兩組的臨床療效，比較兩組的mMRC評(píng)分、慢性阻塞性肺病評(píng)估測(cè)試量表（CAT）評(píng)分、6 min步行距離（6 MWT）、肺功能、血清炎性因子水平。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為76.00%、92.00%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組mMRC評(píng)分和CAT評(píng)分顯著降低，6 MWT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）；并且治療組mMRC評(píng)分、CAT評(píng)分、6 MWT明顯優(yōu)于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組第1秒用力呼氣容積（FEV₁）/用力肺活量（FVC）、FEV₁、FVC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）；并且治療組肺功能指標(biāo)明顯高于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者C反應(yīng)蛋白（CRP）、白細(xì)胞介素-6（IL-6）、白細(xì)胞介素-4（IL-4）水平顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；并且治療組患者血清炎性因子水平明顯低于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 鹽酸溴己新片聯(lián)合噻托溴銨粉霧劑治療慢性阻塞性肺疾病穩(wěn)定期具有較好臨床療效，能改善肺功能和生活質(zhì)量，降低血清炎性因子水平，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the effect of Bromhexine Hydrochloride Tablets combined with Tiotropium Bromide Powder for inhalation in treatment of chronic obstructive pulmonary disease in stable stage. Methods Patients (100 cases) with chronic obstructive pulmonary disease in stable stage in Xinxiang Central Hospital from February 2018 to February 2019 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were given Tiotropium Bromide Powder for inhalation, 1 grains/time, once daily. Patients in the treatment group were po administered with Bromhexine Hydrochloride Tablets on the basis of the control group, 2 tablets/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and mMRC scores, CAT scores, 6 MWT, pulmonary function, and serum levels of inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.00% and 92.00%, respectively, and there was difference between two groups (P<0.05). After treatment, mMRC scores and CAT scores in two groups were significantly decreased, but 6 MWT in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, FEV₁/FVC, FEV₁, and FVC in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the pulmonary function indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of CRP, IL-4, and IL-6 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the serum levels of inflammatory factors in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Bromhexine Hydrochloride Tablets combined with Tiotropium Bromide Powder for inhalation has clinical curative effect in treatment of chronic obstructive pulmonary disease in stable stage, can improve lung function and quality of life, and decrease the serum levels of inflammatory factors, which has a certain clinical application value.

R974