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目的观察长期应用氨溴索联合小剂量阿奇霉素治疗稳定期慢性阻塞性肺疾病(COPD)的临床效果。方法选取COPD稳定期门诊患者69例,随机分为2组,对照组34例仅用常规治疗(吸氧、戒烟、按需吸入沙美特罗和氟替卡松),治疗组35例在常规治疗基础上加服阿奇霉素片(250mg,口服,隔日1次)和氨溴索缓释胶囊(75mg,每日2次),疗程及随诊时间为1年。动态观察患者治疗前后24h痰量、肺功能的变化及治疗期间慢性阻塞性肺疾病急性加重期(AECO-PD)次数、住院次数和天数,并进行圣乔治医院呼吸问题调查问卷(SGRQ)评分;治疗结束后进行痰菌培养及药敏试验。结果 69例稳定期COPD患者均完成了12个月的治疗过程,治疗6个月后,治疗组24h痰量明显少于对照组,肺功能明显改善,1秒钟用力呼气容积(FEV1)高于对照组,治疗12个月后肺功能进一步改善。治疗期间治疗组AECOPD次数、住院次数和天数明显低于对照组,2组之间痰菌培养及药敏试验结果无明显差异。结论氨溴索联合小剂量阿奇霉素长期应用能明显改善COPD患者的肺功能,减少患者的AECOPD次数、住院次数和天数,提高生活质量。
Objective To observe the long-term use of ambroxol combined with low-dose azithromycin in the treatment of patients with stable chronic obstructive pulmonary disease (COPD). Methods Sixty-nine outpatients with stable COPD were selected and randomly divided into two groups. The control group, 34 cases, were treated with conventional therapy (oxygen inhalation, smoking cessation, inhalation of salmeterol and fluticasone on demand). 35 cases in the treatment group were treated with conventional therapy Azithromycin tablets (250mg, orally, every other day) and ambroxol slow release capsules (75mg, 2 times a day), treatment and follow-up time of 1 year. The changes of sputum volume, lung function and the number of acute exacerbation of chronic obstructive pulmonary disease (AECO-PD), the number of hospitalizations and the number of days during treatment were observed dynamically before and after treatment. The SGRQ score of St George’s Hospital was also scored. After the treatment of sputum culture and susceptibility testing. Results Sixty-nine patients with stable COPD achieved a 12-month course of treatment. After 6 months of treatment, the volume of sputum in the treatment group was significantly less than that in the control group. The lung function was significantly improved and forced expiratory volume in one second (FEV1) In the control group, lung function was further improved 12 months after treatment. The number of AECOPD, the number of hospitalizations and the number of days of treatment in the treatment group were significantly lower than those in the control group during the treatment. There was no significant difference in the results of sputum culture and drug sensitivity test between the two groups. Conclusion Long-term use of ambroxol in combination with low-dose azithromycin can significantly improve lung function in patients with COPD, reduce the number of patients with AECOPD, the number of hospitalizations and days, and improve the quality of life.