1、世界中西医结合杂志 2023 年第 18 卷第 1 期World Journal of Integrated Traditional and Western Medicine2023，Vol.18，No.1临床研究DOI:10 13935/j cnki sjzx 230114基金项目;江苏省科技项目(BE2018669)作者单位:江苏省淮安市肿瘤医院，淮安市淮安医院呼吸科，江苏 淮安 223200通信作者:邵星星，Email:huanxiaoyunxi2013163 com热毒宁注射液联合沙美特罗替卡松治疗慢性阻塞性肺疾病急性加重期患者的疗效及安全性评价邵星星乐兆喜刘荣朱蓉【摘要】目的探讨热毒
2、宁注射液联合沙美特罗替卡松治疗慢性阻塞性肺疾病急性加重期(Acute Exacerba-tion of Chronic Obstructive Pulmonary Disease，AECOPD)的疗效及安全性评价。方法选取 2019 年 6 月2020 年6 月期间淮安市第一人民医院收治的 AECOPD 患者 90 例，按照随机数字表法分为观察组和对照组，每组各 45 例。对照组在常规内科处理基础上联合沙美特罗替卡松吸入治疗，观察组在对照组基础上给予注射热毒宁。治疗10 d后，观察比较两组患者临床疗效、不良反应发生率，治疗前后中医证候积分、慢性阻塞性肺疾病(Chronic Obstructiv
3、ePulmonary Disease，COPD)评分(CAT)、呼吸困难指数(mMC)评分、圣乔治呼吸调查问卷(SGQ)评分、肺功能指标 第 1 秒用力呼气容积(Forced expiratory volume in one second，FEV1)、用力肺活量(Forced vital capacity，FVC)、呼气峰值流量(Peak expiratory flow，PEF)、白细胞数量及中性粒细胞百分比。结果治疗后两组患者发热、咳嗽、咯痰、气促、肺干湿啰音积分均较治疗前明显降低，差异有统计学意义(P 0 05);且观察组发热、咳嗽、咯痰、气促、肺干湿啰音积分均较对照组明显降低，差异有统计
4、学意义(P 0 05)。治疗后两组患者 CAT、mMC、SGQ 评分均较治疗前明显降低，差异有统计学意义(P 0 05);且观察组 CAT、mMC、SGQ 评分均较对照组明显降低，差异有统计学意义(P 0 05)。治疗后两组患者 FEV1、FVC、PEF 指标均较治疗前明显升高，差异有统计学意义(P 0 05);且观察组 FEV1、FVC、PEF 指标均较对照组明显升高，差异有统计学意义(P 0 05)。治疗后两组患者白细胞计数和中性粒细胞百分比均较治疗前明显降低，差异有统计学意义(P 0 05);且观察组白细胞计数和中性粒细胞百分比均较对照组明显降低，差异有统计学意义(P 0 05)。治疗后
5、观察组总有效率 93 3%(42/45)明显高于对照组 75 6%(34/45)，差异有统计学意义(P 0 05)。两组患者不良反应发生率比较，差异无统计学意义(P 0 05)。结论热毒宁注射液联合沙美特罗替卡松能够提高 COPD 急性加重期患者肺功能，改善患者临床症状，抑制病情发展，疗效显著，安全性高。【关键词】慢性阻塞性肺疾病急性加重期;热毒宁注射液;沙美特罗替卡松;肺功能;炎性反应【中图分类号】563【文献标识码】AEfficacy and Safety of eduning Injection Combined with Salmeterol Fluticasone inthe Tre
6、atment of Patients with Acute Exacerbation of Chronic Obstructive Pulmona-ry DiseaseSHAO Xing xing，LE Zhao xi，LIU ong，ZHU ong(Huaian Cancer Hospital，espiratory Department of Huaian Hospital，Jiangsu Huaian 223200)【Abstract】ObjectiveTo evaluate the efficacy and safety of eduning injection combined wit
7、h salmeterol flutica-sone in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)MethodsNinety pa-tients with AECOPD admitted to Huaian First Peoples Hospital from June 2019 to June 2020 were included and dividedinto an observation group and a control group by random
8、number table，with 45 patients in each group The control groupwas treated with salmeterol fluticasone inhalation based on routine medical treatment，and the observation group was addi-tionally treated with eduning injection based on the control group After 10 days of treatment，the clinical efficacy an
9、d theincidence rate of adverse reactions，traditional Chinese medicine(TCM)syndrome score，COPD score(CAT)，modifiedMedical esearch Council(mMC)Dyspnea Scale score，St Georges espiratory Questionnaire(SGQ)score，lung func-39世界中西医结合杂志 2023 年第 18 卷第 1 期World Journal of Integrated Traditional and Western Me
10、dicine2023，Vol.18，No.1tion indexesforced expiratory volume in one second(FEV1)，forced vital capacity(FVC)，and peak expiratory flow(PEF)，white blood cell count，and percentage of neutrophils before and after treatment of the two groups were observedand compared esultsAfter treatment，the scores of feve
11、r，cough，expectoration，shortness of breath，and lung dry and wetrale in the two groups were significantly lower than those before treatment(P 0 05)，and these scores in the observationgroup were significantly lower than those in the control group(P 0 05)After treatment，the scores of CAT，mMC，andSGQ in t
12、he two groups were significantly lower than those before treatment(P 0 05)，and the scores in the observationgroup were significantly lower than those in the control group(P 0 05)After treatment，the FEV1，FVC，and PEF in thetwo groups were significantly higher than those before treatment(P 0 05)，and th
13、ese indexes in the observation groupwere significantly higher than those in the control group(P 0 05)After treatment，the white blood cell count and neutro-phil percentage of the two groups were significantly lower than those before treatment(P 0 05)，and the observationgroup was significantly lower t
14、han the control group(P 0 05)After treatment，the total effective rate in the observationgroup was 93 3%(42/45)，which was significantly higher than that in the control group 75 6%(34/45)，P 0 05 There was no significant difference in the incidence rate of adverse reactions between the two groups(P 0 0
15、5)Conclu-sioneduning injection combined with salmeterol fluticasone can improve the pulmonary function of patients with AECO-PD，improve their clinical symptoms，and inhibit the development of the disease，with significant efficacy and high safety【Keywords】Acute Exacerbation of Chronic Obstructive Pulm
16、onary Disease;eduning Injection;Salmeterol Fluti-casone;Lung Function;Inflammatory eaction慢性阻塞性肺疾病(Chronic Obstructive Pulmo-nary Disease，COPD)是一种常见的呼吸系统疾病，其发病主要与吸入有害颗粒或有害气体引起炎症反应有关，临床表现为持续性的气流受限，可进一步发展为肺心病、呼吸衰竭等慢性疾病。慢性阻塞性肺疾病急性加重期(Acute Exacerbation of ChronicObstructive Pulmonary Disease，AECOPD)是 COPD 的急性发病过程，其会明显加重患者咳嗽、气短、喘息、胸闷、呼吸困难等症状，使病情持续恶化，是导致 COPD 患者临床死亡的重要原因1，2。目前，AECOPD治疗的目标主要为缓解临床症状、提高肺功能及积极预防并发症，治疗手段主要依靠支气管扩张剂、低流量吸氧、抗生素和糖皮质激素药物。而全身糖皮质激素的长期应用，会使患者逐渐出现代谢紊乱、肌肉骨骼系统、免疫抑制等一系列不良反应。随着抗生素的长期大量
