目的 探討沙丁胺醇聯(lián)合二羥丙茶堿治療慢性阻塞性肺疾病急性加重期（AECOPD）的臨床效果。方法 選取2017年1月—2019年6月亳州市中醫(yī)院收治的AECOPD患者78例，隨機分成對照組（39例）和治療組（39例）。對照組靜脈滴注二羥丙茶堿注射液，0.5 g加入5%葡萄糖液，1次/d。治療組在對照組基礎上吸入吸入用硫酸沙丁胺醇溶液，2.5 mg/次，2次/d。兩組均連續(xù)治療7 d。觀察兩組患者臨床療效，同時比較治療前后兩組患者典型表現(xiàn)緩解時間，咳嗽和咳痰的評估問卷（CASA-Q）、改良版英國醫(yī)學研究委員會呼吸問卷（mMRC）和CAT評分，第1秒用力呼氣容積（FEV1）與用力肺活量比值（FEV1/FVC）、最大自主通氣量（MVV）、最大呼氣中期流量（MMEF）、FEV1占預計值百分比（FEV1%pred）、殘氣容積與肺總量比值（RV/TLC）和呼出氣一氧化氮（FeNO）濃度。結果 治療后，對照組和治療組臨床有效率分別為79.49%和94.87%，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，治療組在典型呼吸道表現(xiàn)的緩解時間上均顯著短于對照組（P<0.05）。治療后，兩組CASA-Q總分均顯著升高（P<0.05），而mMRC和CAT問卷評分則均顯著降低（P<0.05）；且治療組上述評分改善效果比對照組更明顯（P<0.05）。治療后，兩組FEV1/FVC、MVV、MMEF及FEV1占預計值百分比（FEV1%pred）均顯著高于治療前（P<0.05），而殘氣容積與肺總量比值（RV/TLC）和FeNO濃度均顯著下降（P<0.05）；且治療組上述肺功能參數(shù)值和FeNO水平改善程度比對照組更明顯（P<0.05）。結論 沙丁胺醇聯(lián)合二羥丙茶堿治療AECOPD可迅速緩解氣流受限，減輕氣道炎癥，控制患者急性惡化的呼吸癥狀，穩(wěn)定病情。

Objective To investigate the clinical effects of salbutamol combined with diprophylline in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Patients (78 cases) with AECOPD in Bozhou Hospital of Traditional Chinese Medical from January 2017 to June 2019 were randomly divided into control (39 cases) and treatment (39 cases) groups. Patients in the control group were iv administered with Diprophylline Injection, 0.5 g added into 5% glucose injection, once daily. Patients in the treatment group were inhalation administered with Salbutamol Sulfate Inhalation Solution on the basis of the control group, 2.5 mg/time, twice daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the remission time of typical manifestations, the scores of CASA-Q, mMRC and CAT, the level of FEV1/FVC, MVV, MMEF, FEV1%pred, RV/TLC and FeNO in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 79.49% and 94.87% respectively, and there were differences between two groups (P<0.05). After treatment, the remission time of typical manifestations in the treatment group was significantly shorter than that in the control group (P<0.05). After treatment, the CASA-Q scores in two groups were significantly increased (P<0.05), but the mMRC and CAT scores were significantly decreased (P<0.05), and these scores in the treatment group were significantly better than that in the control group (P<0.05). After treatment, the FEV1/FVC, MVV, MMEF and FEV1%pred in two groups were significantly increased (P<0.05), but the RV/TLC and FeNO levels were significantly decreased (P<0.05), and the pulmonary function indexes and FeNO concentration in the treatment group were significantly better than that in the control group (P<0.05). Conclusion Salbutamol combined with diprophylline in treatment of AECOPD can quickly alleviate airflow limitation, reduce airway inflammation, control acute exacerbation of respiratory symptoms and stabilize the disease.

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