目的 探究福多司坦聯(lián)合復(fù)方異丙托溴銨治療慢性阻塞性肺疾病急性加重期（AECOPD）的治療效果。方法 選取2023年6月—2024年12月于南陽(yáng)市中心醫(yī)院確診并接受規(guī)范治療的90例AECOPD患者為研究對(duì)象，采用隨機(jī)數(shù)字表法分為對(duì)照組（45例）和治療組（45例）。對(duì)照組患者給予吸入用復(fù)方異丙托溴銨溶液霧化，2.5 mL/次，每次取2.5 mL加入2.5 mL生理鹽水稀釋后使用，每日3次。治療組在對(duì)照組治療基礎(chǔ)上口服福多司坦片，單次劑量為0.4 g，每日3次，均為餐后服用。兩組AECOPD患者均接受為期7 d的連續(xù)治療。觀察兩組的臨床療效和癥狀緩解時(shí)間，比較兩組治療前后慢性阻塞性肺疾病評(píng)估測(cè)試（CAT）評(píng)分、慢性阻塞性肺疾病晨間癥狀量表（COPD-MSD）評(píng)分，血清CC趨化因子受體7（CCR7），分泌型磷脂酶A2-X（sPLA2-X）和血管緊張素轉(zhuǎn)化酶2（ACE2）水平變化。結(jié)果 治療結(jié)果顯示，治療組總有效率是93.33%，顯著高于對(duì)照組的75.56%（P＜0.05）。治療組咳嗽、咳痰及呼吸困難的緩解時(shí)間均較對(duì)照組顯著縮短（P＜0.05）。兩組患者CAT評(píng)分和COPD-MSD評(píng)分均顯著降低（P＜0.05）；而治療后，治療組患者CAT評(píng)分和COPD-MSD評(píng)分均顯著低于對(duì)照組（P＜0.05）。治療后，治療組血清CCR7、sPLA2-X顯著降低，而ACE2水平顯著升高（P＜0.05）；治療后，治療組血清CCR7、sPLA2-X低于對(duì)照組，而ACE2水平高于對(duì)照組（P＜0.05）。結(jié)論 福多司坦聯(lián)合復(fù)方異丙托溴銨治療AECOPD療效顯著，不但可顯著縮短患者臨床癥狀的緩解時(shí)間并改善其生活質(zhì)量，而且能促進(jìn)血清學(xué)指標(biāo)的修復(fù)，具有臨床推廣價(jià)值。

Objective To investigate the clinical efficacy of fudosteine combined with compound ipratropium bromide in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 90 AECOPD patients diagnosed and receiving standard treatment in Nanyang Central Hospital from June 2023 to December 2024 were selected as the study objects, and were divided into control group (45 cases) and treatment group (45 cases) by random number table method. Patients in control group were given atomization of Compound Ipratropium Bromide Solution for inhalation, 2.5 mL/time, each time 2.5 mL was taken and diluted with 2.5 mL normal saline, 3 times daily. Patients in treatment group were po administered with Fudosteine Tablets after meals on basis of the control group, a single dosage of 0.4 g, 3 times daily. Both groups of AECOPD patients received continuous treatment for 7 d. Clinical efficacy and symptom remission time of the two groups were observed, changes of CAT scores, COPD-MSD scores, serum CCR7, sPLA2-X, and ACE2 before and after treatment were compared between two groups. Results The results showed that the total effective rate of treatment group was 93.33%, which was significantly higher than that of control group (75.56%, P < 0.05). The remission time of cough, sputum and dyspnea in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, CAT scores and COPD-MSD scores in treatment group were significantly decreased (P < 0.05). After treatment, CAT scores and COPD-MSD scores in treatment group were significantly lower than those in the control group (P < 0.05). After treatment, serum CCR7 and sPLA2-X in treatment group were significantly decreased, but the level of ACE2 was significantly increased (P < 0.05). After treatment, the serum CCR7 and sPLA2-X levels in treatment group were lower than those in control group, but the serum ACE2 levels were higher than those in control group (P < 0.05). Conclusion Fodosteine combined with compound ipratropium bromide is effective in the treatment of AECOPD, not only can significantly shorten the remission time of clinical symptoms and improve the quality of life of patients, but also can promote the repair of serological indicators, which has clinical promotion value.

R974

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃聯(lián)合共建項(xiàng)目（LHGJ20230970）