目的 探討十味龍膽花膠囊聯(lián)合噻托溴銨粉霧劑治療慢性阻塞性肺疾病急性加重期的臨床療效。方法 選取2017年5月-2019年11月鄭州大學(xué)第五附屬醫(yī)院收治的103例慢性阻塞性肺疾病急性加重期患者作為研究對(duì)象，按照隨機(jī)數(shù)字表法將患者分為對(duì)照組（51例）和治療組（52例）。對(duì)照組患者給予噻托溴銨粉霧劑，18 μg/次，1次/d。治療組患者在對(duì)照組的基礎(chǔ)上口服十味龍膽花膠囊，3粒/次，3次/d。兩組患者均治療14 d。觀察兩組的臨床療效，比較兩組肺功能、炎性因子。結(jié)果 治療后，治療組的臨床總有效率90.38%高于對(duì)照組的74.51%（P<0.05）。治療后，兩組用力肺活量（FVC）、第1秒用力呼氣容積（FEV1）、第1秒用力呼氣容積占用力肺活量之比（FEV1/FVC）均較治療前升高（P<0.05），且治療組肺功能指標(biāo)高于對(duì)照組（P<0.05）。治療后，兩組白細(xì)胞介素-6（IL-6）、降鈣素原（PCT）、C反應(yīng)蛋白（CRP）水平均較治療前降低（P<0.05），且治療組炎性因子水平低于對(duì)照組（P<0.05）。結(jié)論 十味龍膽花膠囊聯(lián)合噻托溴銨粉霧劑治療慢性阻塞性肺疾病急性加重期的療效顯著，可改善患者肺功能，降低機(jī)體炎性因子水平，安全性較好，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the effect of Shiwei Longdanhua Capsules combined with Tiotropium Bromide Powder for inhalation in treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods Patients (103 cases) with acute exacerbation of chronic obstructive pulmonary disease in the Fifth Affiliated Hospital of Zhengzhou University from May 2017 to November 2019 were randomly divided into the control group (52 cases) and the treatment group (51 cases). Patients in the control group were given Tiotropium Bromide Powder for inhalation, 18 μg/time, once daily. Patients in the treatment group were po administered with Shiwei Longdanhua Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and pulmonary function and inflammatory factor levels in two groups were compared. Results After treatment, the total clinical effective rate of the treatment group was 90.38% higher than that of the control group (74.51%) (P<0.05). After treatment, FVC, FEV1, and FEV1/FVC of the two groups were higher than those before treatment (P<0.05), and pulmonary function indexes of the treatment group was higher than that of the control group (P<0.05). After treatment, the levels of IL-6, PCT, and CRP in two groups were lower than those before treatment (P<0.05), and the indexes of inflammatory factors in the treatment group were lower than those in the control group (P<0.05). Conclusion Shiwei Longdanhua Capsules combined with Tiotropium Bromide Powder for inhalation has clinical curative effect in treatment of acute exacerbation of chronic obstructive pulmonary disease, can improve pulmonary function of patients, reduce the levels of inflammatory factors in the body, with good safety, which has a certain clinical application value.

R974

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（2017T03091）