目的 探討慢性阻塞性肺疾病急性加重期應(yīng)用桂龍咳喘寧膠囊聯(lián)合福多司坦治療的效果。方法 2015年2月-2018年4月天津市寶坻區(qū)人民醫(yī)院呼吸科收治的114例慢性阻塞性肺疾病急性加重期患者，隨機(jī)分成對(duì)照組（n=57）和治療組（n=57）。對(duì)照組口服福多司坦片，0.4 g/次，3次/d，餐后服用。治療組患者在對(duì)照組基礎(chǔ)上口服桂龍咳喘寧膠囊，3粒/次，3次/d。兩組均連續(xù)治療14 d。比較兩組臨床療效和呼吸系統(tǒng)癥狀體征的緩解時(shí)間，治療前后肺功能參數(shù)[第1秒用力呼氣容積（FEV1）占預(yù)計(jì)值百分比（FEV1占預(yù)計(jì)值%）、FEV1與用力肺活量（FVC）比值（FEV1/FVC）、呼氣峰值流量（PEF）]值、慢性阻塞性肺疾病患者自我評(píng)估測(cè)試問(wèn)卷（CAT）評(píng)分、外周血嗜酸性粒細(xì)胞絕對(duì)值（EOS#）及中性粒細(xì)胞（NEUT）與淋巴細(xì)胞（LYM）比值（NLR）和血清學(xué)相關(guān)指標(biāo)[嗜酸性粒細(xì)胞陽(yáng)離子蛋白（ECP）、白介素（IL）-13、8-羥基脫氧鳥苷（8-OHdG）、總抗氧化能力（TAC）]水平變化，不良反應(yīng)發(fā)生情況。結(jié)果 對(duì)照組和治療組的總有效率分別是86.0%、96.5%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。與對(duì)照組相比，治療組咳嗽、咳痰等急性加重的呼吸系統(tǒng)癥狀體征的緩解時(shí)間均顯著更短（P<0.05）。與治療前對(duì)比，兩組治療后FEV1占預(yù)計(jì)值%、FEV1/FVC及PEF值均顯著增高（P<0.05），CAT評(píng)分則均顯著降低（P<0.05）；但治療后，治療組上述肺功能參數(shù)值較對(duì)照組同期均顯著更高（P<0.05），而CAT評(píng)分顯著更低（P<0.05）。兩組治療后外周血EOS#、NLR值及血清ECP、IL-13、8-OHdG水平均顯著低于治療前（P<0.05），血清TAC水平則均顯著升高（P<0.05）；且治療后，治療組以上指標(biāo)（EOS#、NLR、ECP、IL-13、8-OHdG、TAC）的改善效果均更顯著（P<0.05）。兩組均無(wú)嚴(yán)重不良反應(yīng)發(fā)生。結(jié)論 桂龍咳喘寧膠囊聯(lián)合福多司坦治療慢性阻塞性肺疾病急性加重期的整體療效顯著，能有效縮短穩(wěn)定患者病情的時(shí)間，改善肺通氣功能，緩解氣道炎癥及全身炎癥狀態(tài)，糾正氧化/抗氧化失衡，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Guilong Kechuanning Capsules combined with Fidostatin in treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods 114 Patients with acute exacerbation of chronic obstructive pulmonary disease admitted to Tianjin Baodi District People's Hospital from February 2015 to April 2018 were randomly divided into control group (n=57) and treatment group (n=57).). The control group was po administered with Fudosteine Tablets, 0.4 g/time, three times daily. The treatment group was po administered with Shufeng Jiedu Capsules on the basis of the control group, 3 grains/time, three times daily. All patients were treated for 14 days. The clinical efficacy and remission time of respiratory symptoms and signs was compared between the two groups. The lung function parameters[1 second forced expiratory volume (FEV1) as a percentage of predicted value (FEV1 accounted for the predicted value), FEV1 and forced vital capacity (FVC) ratio (FEV1/FVC), peak expiratory flow (PEF) values, self-assessment test questionnaire (CAT) scores for patients with chronic obstructive pulmonary disease, absolute eosinophils in peripheral blood (EOS#), and neutrophils (NEUT)) to lymphocyte (LYM) ratio (NLR) and serologically relevant indicators[eosinophilic cationic protein (ECP), interleukin (IL)-13, 8-hydroxydeoxyguanosine (8-OHdG), total antioxidant capacity) (TAC)] in two groups were compared. Results The total effective rate of the treatment group was 96.5%, which was significantly higher than that of the control group 86.0% (P<0.05). Compared with the control group, the remission time of respiratory symptoms and signs of acute exacerbation such as cough and cough was significantly shorter in the treatment group (P<0.05). Compared with pre-treatment, FEV1 accounted for the predicted value, FEV1/FVC and PEF values were significantly increased (P<0.05), and CAT scores were significantly lower (P<0.05). However, after treatment, the functional parameter values were significantly higher than the control group (P<0.05), while the CAT score was significantly lower (P<0.05). The levels of EOS#, NLR and serum ECP, IL-13 and 8-OHdG in the two groups were significantly lower than those before treatment (P<0.05), and serum TAC levels were significantly increased (P<0.05). After treatment, the improvement of the above indicators (EOS#, NLR, ECP, IL-13, 8-OHdG, TAC) was more significant (P<0.05). There were no serious adverse events in either group. Conclusion Guilong Kechuanning Capsules combined with fidostatin has a significant overall effect in the treatment of acute exacerbation of chronic obstructive pulmonary disease, and can effectively shorten the time of stable patients, improve lung ventilation, and relieve airway inflammation and systemic inflammation. and also can correct oxidation/antioxidant imbalance, which has a certain clinical application value.

R974