目的 探討肺力咳合劑聯合布地奈德福莫特羅治療慢性阻塞性肺疾病急性加重期（AECOPD）的臨床效果。方法 選取2018年10月—2020年9月天津醫(yī)科大學寶坻臨床學院收治的102例AECOPD患者，隨機分為對照組（51例）和治療組（51例）。對照組吸入布地奈德福莫特羅吸入劑，2吸/次，2次/d。治療組口服肺力咳合劑，20 mL/次，3次/d。兩組連續(xù)治療2周。觀察兩組患者臨床療效，比較治療前后兩組患者肺部哮鳴音、呼吸癥狀緩解時間，肺功能參數第1秒用力呼氣容積與用力肺活量比值（FEV1/FVC）、深吸氣量與肺總量比值（IC/TLC）、一氧化碳彌散量與肺泡通氣量比值（DLCO/VA）和FEV1占預計值%，咳痰的評估問卷（CASA-Q）總分，中性粒細胞與淋巴細胞比值（NLR）和呼出氣一氧化氮（FeNO）濃度及血清白細胞介素-17（IL-17）、淀粉樣蛋白A（SAA）和肺表面活性蛋白D（SP-D）水平。結果 治療后，治療組臨床有效率為96.1%，顯著高于對照組的84.3%（P<0.05）。治療后，治療組肺部哮鳴音和呼吸癥狀緩解時間均顯著短于對照組（P<0.05）。治療后，兩組肺功能參數FEV1/FVC、IC/TLC、DLCO/VA、FEV1占預計值%和CASA-Q總分均顯著升高（P<0.05），并均以治療組改善更顯著（P<0.05）。治療后，兩組患者NLR和FeNO濃度及血清IL-17、SAA、SP-D水平均顯著低于治療前（P<0.05），且治療組對NLR和FeNO濃度及血清IL-17、SAA、SP-D水平的降低作用較對照組更顯著（P<0.05）。結論 肺力咳合劑聯合布地奈德福莫特羅治療AECOPD的整體療效確切，可安全、有效且迅速地緩解患者癥狀，改善氣流受限，抑制體內炎癥反應。

Objective To investigate the clinical effect of Feilike Mixture combined with budesonide formoterol in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Patients (102 cases) with acute exacerbation of chronic obstructive pulmonary disease in Baodi Clinical Medical College of Tianjin Medical University from October 2018 to September 2020 were randomly divided into control (51 cases) and treatment (51 cases) groups. Patients in the control group were inhalation administered with Budesonide and Formoterol Fumarate Powder for inhalation, 2 press/time, twice daily. Patients in the treatment group were po administered with Feilike Mixture, 20 mL/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical evaluation was evaluated, the remission time of lung wheeze, respiratory symptoms, lung function parameters of FEV1/FVC, IC/TLC, DLCO/VA and FEV1% of estimated value, and CASA-Q total scores, the concentration of NLR and FeNO, the levels of serum IL-17, SAA, and SP-D in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 96.1%, which was significantly higher than that of the control group (84.3%) (P<0.05). After treatment, the relief time of pulmonary wheezing and respiratory symptoms in the treatment group was significantly shorter than that in the control group (P<0.05). After treatment, the pulmonary function parameters FEV1/FVC, IC/TLC, DLCO/VA, FEV1% and the total score of CASA-Q in two groups were significantly increased (P<0.05), and the improvement in the treatment group was more significant (P<0.05). After treatment, the concentrations of NLR and FeNO and the levels of serum IL-17, SAA and SP-D in two groups were significantly lower than those before treatment (P<0.05), and which in the treatment group were more significantly lower than those in the control group (P<0.05). Conclusion The overall curative effect of Feilike Mixture combined with budesonide formoterol in treatment of acute exacerbation of chronic obstructive pulmonary disease is definite, which can safely, effectively and quickly relieve patients' symptoms, improve airflow limitation and inhibit inflammatory reaction in vivo.

R974

天津醫(yī)科大學科學基金資助項目（2019KYM08）