目的 比較痰熱清注射液和血必凈注射液治療慢性阻塞性肺疾病急性加重期（AECOPD）的臨床療效。方法 選取2013年10月-2015年5月在黃石市中心醫(yī)院呼吸科治療的AECOPD患者150例，隨機分為對照組、痰熱清組和血必凈組，每組各50例。對照組給予吸氧、注射用多索茶堿止咳、吸入糖皮質(zhì)激素平喘、注射用頭孢哌酮鈉舒巴坦抗感染、糾正電解質(zhì)和酸堿失衡等常規(guī)治療。痰熱清組在對照組的基礎(chǔ)上靜脈滴注痰熱清注射液，20 mL加入到0.9%氯化鈉注射液250 mL中，1次/d。血必凈組在對照組的基礎(chǔ)上靜脈滴注血必凈注射液，30 mL加入到0.9%氯化鈉注射液250 mL中，1次/d。3組均治療7 d。觀察3組臨床療效，比較3組肺功能和炎性因子。結(jié)果 治療后，對照組、血必凈組和痰熱清組的總有效率分別為52.0%、76.0%、82.0%，血必凈組和痰熱清組的總有效率均顯著高于對照組，3組比較差異性具有統(tǒng)計學意義（P<0.05）；但痰熱清組和血必凈組的總有效率比較差異無統(tǒng)計學意義。治療后，3組用力肺活量（FVC）、第1秒用力呼氣容積（FEV1）和FEV1/FVC均顯著升高，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且痰熱清組和血必凈組這些觀察指標的上升程度明顯優(yōu)于對照組，3組比較差異具有統(tǒng)計學意義（P<0.05）；但痰熱清組和血必凈組這些觀察指標比較差異無統(tǒng)計學意義。治療后，3組白細胞介素-6（IL-6）、白細胞介素-8（IL-8）、腫瘤壞死因子（TNF-α）和C-反應(yīng)蛋白（CRP）均顯著下降，而白細胞介素-10（IL-10）均顯著上升，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且痰熱清組和血必凈組這些觀察指標的改善程度明顯優(yōu)于對照組，3組比較差異具有統(tǒng)計學意義（P<0.05）；且血必凈組這些觀察指標的改善程度明顯優(yōu)于痰熱清組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。結(jié)論 痰熱清注射液和血必凈注射液均能顯著提高AECOPD患者的臨床療效，改善肺功能和抑制炎性因子釋放，但血必凈注射液抑制炎性因子釋放更顯著，具有一定的臨床推廣應(yīng)用價值。

Objective To compare the clinical effect of Tanreqing Injection and Xuebijing Injection in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Patients (150 cases) with AECOPD in Department of Respiration of Huangshi Central Hospital from October 2013 to May 2015 were randomly divided into control, Tanreqing, and Xuebijing groups, and each group had 50 cases. Patients in the control group were given the conventional treatment, including oxygen inhalation, injection administration with doxofylline for cough, inhalation administration with corticosteroids for asthma, injection administration with cefoperazone sodium and sulbactam sodium for infection, and correcting electrolyte and acid-base imbalance. Patients in the Tanreqing group were iv administered with Tanreqing Injection on the basis of the control group, 20 mL added into normal saline 250 mL, once daily. Patients in the Xuebijing group were iv administered with Xuebijing Injection on the basis imbalance. Patients in the Tanreqing group were iv administered with Tanreqing Injection on the basis of the control group, 20 mL added into normal saline 250 mL, once daily. Patients in the Xuebijing group were iv administered with Xuebijing Injection on the basis of the control group, 30 mL added into normal saline 250 mL, once daily. Patients in three groups were treated for 7 d. After treatment, the clinical efficacies were evaluated, and lung function and inflammatory factors in three groups were compared. Results After treatment, the clinical efficacies in the control, Tanreqing, and Xuebijing groups were 52.0%, 76.0%, and 82.0%, respectively, and the clinical efficacies of Tanreqing and Xuebijing groups were significantly higher than those in the control group, and there was difference among three groups (P<0.05). But there was no difference between Tanreqing and Xuebijing groups. After treatment, FVC, FEV1, and FEV1/FVC in three groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the Tanreqing and Xuebijing groups were significantly higher than those in the control group, with significant difference among three groups (P<0.05). But there was no difference between Tanreqing and Xuebijing groups. After treatment, IL-6, IL-8, TNF-α, and CRP in three groups were significantly decreased, but IL-10 in three groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the Tanreqing and Xuebijing groups were significantly better than those in the control group, with significant difference among three groups (P<0.05). And the observational indexes in the Xuebijing group were significantly better than those in the Tanreqing group, with significant difference between two groups (P<0.05). Conclusion Tanreqing Injection and xuebijing Injection both can significantly increase the clinical curative effect in treatment of AECOPD, and improve lung function, inhibit the release of inflammatory factors, but the effect of Xuebijing Injection on inhibiting the release of proinflammatory cytokines is more significant, which has a certain clinical application value.