目的 探討麻芩消咳顆粒聯(lián)合哌拉西林舒巴坦鈉治療慢性支氣管炎急性發(fā)作的臨床療效。方法 選擇2020年3月—2021年8月在天長市中醫(yī)院呼吸內(nèi)科診療的98例慢性支氣管炎急性發(fā)作患者，根據(jù)隨機(jī)數(shù)字法將所有患者分為對(duì)照組和治療組，每組各49例。對(duì)照組患者靜脈滴注注射用哌拉西林鈉舒巴坦鈉，5 g加入0.9%氯化鈉注射液100 mL中，每8小時(shí)用藥1次。治療組在對(duì)照組基礎(chǔ)上口服麻芩消咳顆粒，1袋/次，3次/d。兩組連續(xù)用藥7 d。觀察兩組的臨床療效及癥狀好轉(zhuǎn)時(shí)間；比較兩組圣喬治呼吸問卷（SGRQ）評(píng)分及血清白細(xì)胞介素6（IL-6）、腫瘤壞死因子α（TNF-α）、C反應(yīng)蛋白（CRP）、肺表面活性蛋白A（SP-A）及不良反應(yīng)情況。結(jié)果 治療后，治療組總有效率是97.96%，顯著高于對(duì)照組的81.63%（P＜0.05）。治療后，治療組出現(xiàn)喘息、咳嗽、胸悶、咳痰等癥狀好轉(zhuǎn)時(shí)間均短于對(duì)照組（P＜0.05）。治療后，兩組SGRQ評(píng)分均較治療前顯著降低（P＜0.05）；治療后，治療組SGRQ評(píng)分顯著低于對(duì)照組（P＜0.05）。治療后，兩組IL-6、TNF-α、CRP、SP-A水平均較治療前顯著降低（P＜0.05）；治療后，治療組血清炎癥因子水平低于對(duì)照組（P＜0.05）。治療組不良反應(yīng)發(fā)生率是6.12%，顯著低于對(duì)照組的16.33%（P＜0.05）。結(jié)論 麻芩消咳顆粒聯(lián)合哌拉西林舒巴坦鈉治療慢性支氣管炎急性發(fā)作療效確切，能有效縮短癥狀改善時(shí)間，降低呼吸道的炎性反應(yīng)，值得臨床借鑒。

Objective To investigate the efficacy of Maqin Xiaoke Granules combined with piperacillin sodium and sulbactam sodium in treatment of acute attack of chronic bronchitis. Methods A total of 98 patients with acute attack of chronic bronchitis treated in respiratory medicine Department of Tianchang Hospital of Traditional Chinese Medicine from March 2020 to August 2021 were selected. All patients were divided into control group and treatment group according to random number method, with 49 cases in each group. Patients in the control group were iv administered with Piperacillin Sodium and Sulbactam Sodium for injection, 5 g was added into 100 mL 0.9% sodium chloride injection, once every 8 h. Patients in the treatment group were po administered with Maqin Xiaoke Granules on the basis of the control group, 1 bag/time, three times daily. Both groups were treated for 7 d. The clinical efficacy and symptom improvement time of the two groups were observed. And St. George's Respiratory Questionnaire (SGRQ) score, interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), C-reactive protein (CRP), lung surface active protein A (SP-A) and adverse reactions were compared between the two groups. Results After treatment, the total effective rate of treatment group was 97.96%, significantly higher than that of control group 81.63% (P < 0.05). After treatment, the improvement time of symptoms such as wheezing, cough, chest tightness and expectoration in the treatment group was shorter than that in the control group (P < 0.05). After treatment, SGRQ score in both groups was significantly lower than that before treatment (P < 0.05). After treatment, SGRQ score in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the levels of IL-6, TNF-α, CRP, and SP-A in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the levels of serum inflammatory factors in the treatment group were lower than that in the control group (P < 0.05). The incidence of adverse reactions in treatment group was 6.12%, significantly lower than 16.33% in control group (P < 0.05). Conclusion Maqin Xiaoke Granules combined with piperacillin sodium and sulbactam sodium has curative effect in treatment of acute attack of chronic bronchitis, and can effectively shorten the symptom improvement time, reduce the inflammatory response of respiratory tract, which is worthy of clinical reference.

R974