目的 分析乙酰半胱氨酸溶液聯(lián)合氨茶堿治療慢性喘息性支氣管炎急性發(fā)作的療效。方法 選取2021年12月—2023年6月西安市第八醫(yī)院收治的156例慢性喘息性支氣管炎急性發(fā)作患者，按隨機(jī)數(shù)字表法分為對照組和治療組，每組各78例。對照組靜脈滴注氨茶堿注射液，0.25 g溶于5%葡萄糖溶液250 mL中，3次/d。治療組對照組治療基礎(chǔ)上霧化吸入吸入用乙酰半胱氨酸溶液，3 mL/次，2次/d。兩組療程7 d。觀察兩組的臨床療效和主要表現(xiàn)緩解時(shí)間，比較兩組治療前后肺功能指標(biāo)、呼出氣一氧化氮（FeNO）、誘導(dǎo)痰中嗜酸性粒細(xì)胞（EOS）比例、血清C反應(yīng)蛋白（CRP）、內(nèi)皮素-1（ET-1）、白細(xì)胞介素-8（IL-8）的變化情況。結(jié)果 治療后，治療組總有效率是96.15%，顯著高于對照組的87.18%（P＜0.05）。治療后，治療組喘息、咳痰、咳嗽、哮鳴音緩解時(shí)間顯著短于治療組（P＜0.05）。治療后，兩組用力肺活量（FVC）、用力呼氣中期流速（MMEF）、第1秒用力呼氣量（FEV₁）、深吸氣量與肺總量比值（IC/TLC）均較同組治療前顯著升高（P＜0.05）；治療后，治療組肺功能指標(biāo)改善優(yōu)于對照組（P＜0.05）。治療后，兩組FeNO、誘導(dǎo)痰中EOS比例和血清CRP、ET-1、IL-8水平均顯著下降（P＜0.05）；治療后，治療組FeNO、誘導(dǎo)痰中EOS比例和血清CRP、ET-1、IL-8水平改善優(yōu)于對照組（P＜0.05）。結(jié)論 乙酰半胱氨酸溶液聯(lián)合氨茶堿治療慢性喘息性支氣管炎急性發(fā)作的效果及安全性較佳，能快速緩解患者主要臨床表現(xiàn)，抑制氣道炎癥及機(jī)體炎性損傷，降低呼吸道阻力，促進(jìn)肺功能改善，值得推廣應(yīng)用。

Objective To analyze the clinical efficacy of inhaled acetylcysteine solution combined with aminophylline in the treatment of acute attack of chronic asthmatic bronchitis. Method: 156 patients with acute exacerbations of chronic asthmatic bronchitis admitted to Xi’an Eighth Hospital from December 2021 to June 2023 were randomly divided into two groups using a random number table method, 78 cases in each group. Patients in the control group were iv administered with Aminophylline Injection, 0.25 g was dissolved in 5% glucose solution 250 mL, 3 times daily. Patients in treatment group were atomized inhalation Acetylcysteine Solution for inhalation on the basis of the control group, 3 mL/time, twice daily. Both groups were treated for 7 d. The clinical effects of two groups and the main performance time were observed, and the lung function index, breath (FeNO), nitric oxide in induced sputum eosinophils (EOS), serum c-reactive protein (CRP), endothelin 1 (ET 1), interleukin 8 (IL-8) in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 96.15%, which was significantly higher than that of the control group (87.18%, P < 0.05). After treatment, the remission time of wheezing, phlegm, cough and wheezing in the treatment group was significantly shorter than that in the treatment group (P < 0.05). After treatment, forced vital capacity (FVC),forced expiratory flow rate (MMEF), forced expiratory volume in the first second (FEV1), ratio of deep inspiratory volume to total lung volume (IC/TLC) in 2 groups were significantly increased compared with before treatment (P < 0.05). After treatment, the improvement of lung function indexes in the treatment group was better than that in the control group (P < 0.05). After treatment, FeNO, EOS proportion in induced sputum and serum CRP, ET-1 and IL-8 levels were significantly decreased in both groups (P < 0.05). After treatment, FeNO, EOS ratio in induced sputum and serum CRP, ET-1 and IL-8 levels in the treatment group were better than those in the control group (P < 0.05). Conclusion: Inhaled acetylcysteine solution combined with aminophylline has good effect and safety in the treatment of acute attack of chronic asthmatic bronchitis, and can quickly alleviate the main clinical manifestations of patients, inhibit airway inflammation and body inflammatory injury, reduce respiratory resistance, and promote the improvement of lung function, which is worthy of promotion and application.

R974

西安市科技計(jì)劃項(xiàng)目（21YXYJ0063）