目的 探討百令膠囊聯(lián)合乙酰半胱氨酸治療慢性阻塞性肺疾病急性加重期的臨床效果。方法 選取2016年1月-2019年1月河南省中醫(yī)藥研究院收治的慢性阻塞性肺疾病急性加重期患者80例，隨機(jī)分成對(duì)照組（40例）和治療組（40例）。對(duì)照組口服乙酰半胱氨酸片，1片/次，2次/d。治療組在對(duì)照組基礎(chǔ)上口服百令膠囊，5粒/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(shí)比較治療前后兩組患者臨床癥狀改善情況、第1秒用力呼氣容積（FEV1）與用力肺活量（FVC）比值（FEV1/FVC）、呼氣峰值流量（PEF）、最大自主通氣量（MVV）、FEV1占預(yù)計(jì)值百分比（FEV1占預(yù)計(jì)值%）、改良版英國(guó)醫(yī)學(xué)研究委員會(huì)呼吸問(wèn)卷（mMRC）評(píng)分、呼出氣一氧化氮（FeNO）濃度及外周血嗜酸細(xì)胞絕對(duì)值（EOS#）、中性粒細(xì)胞與淋巴細(xì)胞比值（NLR）和血清谷胱甘肽過(guò)氧化物酶（GSH-Px）、丙二醛（MDA）水平。結(jié)果 治療后，對(duì)照組臨床有效率為80.00%，顯著低于治療組的95.00%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組主要臨床表現(xiàn)的緩解時(shí)間較對(duì)照組均顯著縮短（P<0.05）。治療后，兩組肺功能參數(shù)FEV1/FVC、PEF、MVV、FEV1占預(yù)計(jì)值%均顯著高于治療前（P<0.05），且治療組改善更明顯（P<0.05）。治療后，兩組mMRC評(píng)分、FeNO濃度及外周血EOS#、NLR和血清MDA含量均顯著降低（P<0.05），而血清GSH-Px水平均顯著升高（P<0.05）；且治療組這些指標(biāo)水平明顯好于對(duì)照組（P<0.05）。結(jié)論 百令膠囊聯(lián)合乙酰半胱氨酸治療慢性阻塞性肺疾病急性加重期能迅速穩(wěn)定病情，緩解氣流受限，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Bailing Capsules combined with acetylcysteine in treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods Patients (80 cases) with acute exacerbation of chronic obstructive pulmonary disease in Henan Academy of Chinese Medicine from January 2016 to January 2019 were randomly divided into control (43 cases) and treatment (43 cases) groups. Patients in the control group were po administered with Acetylcysteine Tablets, 1 tablet/time, twice daily. Patients in the treatment group were po administered with Bailing Capsules 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 remission time of main clinical symptoms, the FEV1/FVC, PEF, MVV, FEV1 of estimated value%, mMRC scores, the concentration of FeNO, EOS# and NLR of peripheral blood, and the serum level of GSH-Px and MDA in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.00%, which was significantly lower than 95.00% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the remission time of main clinical symptoms in the treatment group was significantly shorter than that in the control group (P<0.05). After treatment, the FEV1/FVC, PEF, MVV, FEV1 of estimated value% in two groups were significantly increased (P<0.05), and these indexes in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the mMRC scores, the concentration of FeNO, EOS# and NLR of peripheral blood, and the serum level of MDA in two groups were significantly decreased (P<0.05), but the serum level of GSH-Px 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). Conclusion Bailing Capsules combined with acetylcysteine in treatment of acute exacerbation of chronic obstructive pulmonary disease can rapidly stabilize the patient's condition, relieve airflow limitation, which has a certain clinical application value.

R974