目的探討不同劑量氨溴索對老年慢性阻塞性肺疾病（COPD）患者的療效及肺功能的影響。方法選取200例COPD患者,隨機(jī)分為兩組,大劑量組（102例）給予大劑量（60 mg/次）鹽酸氨溴索靜脈滴注,小劑量組（98例）給予小劑量（30 mg/次）鹽酸氨溴索靜脈滴注,通過比較治療后的療效、腫瘤壞死因子-α（TNF-α）、血清超敏C反應(yīng)蛋白（CRP）、肺功能指標(biāo)及治療期間不良反應(yīng)情況,評價不同劑量氨溴索對老年慢性阻塞性肺疾病患者的療效及肺功能的影響。結(jié)果大劑量組有效率89.2%,小劑量組有效率75.5%,大劑量組的治療有效率高于小劑量組（P<0.05）。治療前,兩組CRP和TNF-α相比無統(tǒng)計學(xué)差異；治療后兩組CRP和TNF-α水平均明顯降低（P<0.05）,且大劑量組CRP和TNF-α水平明顯低于對照組（P<0.05）。治療前,兩組FVC、FEV1和FEV1/FVC%相比,差異無統(tǒng)計學(xué)意義；治療后兩組FVC、FEV1和FEV1/FVC%均明顯升高（P<0.05）,且大劑量組上述肺功能指標(biāo)明顯高于小劑量組（P<0.05）。治療期間,兩組不良反應(yīng)率無明顯差異。結(jié)論大劑量氨溴索對慢性阻塞性肺疾病用藥安全有效,可顯著減小肺部炎癥反應(yīng),提高肺部通氣量,值得臨床推廣使用。

Objective To investigate the effect of different doses of ambroxol on efficacy and lung function of elderly patients with chronic obstructive pulmonary disease. Methods 200 patients with COPD were selected. They were divided into two groups randomly. The high dose group (102 cases) were given anmbroxol hydrochloride in high doses. The low dose group (98 cases) were given anmbroxol hydrochloride in low doses. The effect of different doses of ambroxol on efficacy and lung function of elderly patients with chronic obstructive pulmonary disease was evaluated by the efficacy, TNF-α, CRP, pulmonary function indexes and adverse reaction during treatment. Results The effective rate was 89.2% in the high dose group and 75.5% in the low dose group. The effective rate of high dose group was higher than that of the low dose group (P < 0.05). Before treatment, there were no statistical significance on CRP and TNF-α between two groups. After treatment, the CRP and TNF-α were decreased in two groups and lower in the high dose group (P < 0.05). Before treatment, there were no statistical significance on FVC, FEV1 and FEV1/FVC% between two groups. After treatment, FVC, FEV1 and FEV1/FVC were increased and higher in the high dose group (P < 0.05). During treatment, there were no statistical significance on adverse reaction between two groups. Conclusion High dose of ambroxol was effective and safe for COPD. It could reduce inflammation and improve pulmonary ventilation with clinical use.