盐酸氨溴索联合川芎嗪改善慢性阻塞性肺疾病的临床疗效观察
［摘要］ 目的 评价盐酸氨溴索（沐舒坦）联合川芎嗪对慢性阻塞性肺疾病（COPD）急性发作的疗效。方法 74例患者随机分组，测定基础肺功能。治疗组38例给予沐舒坦注射液15 mg+川芎嗪雾化溶液40 mg+NS 30 ml雾化吸入20 min，每日2次；对照组36例给予常规治疗。于治疗后第14天评价临床治疗效果并检测肺功能参数。结果 治疗后两组患者的咳嗽、咳痰及喘息症状明显好转，两组间治疗有效率比较差异有显著性（P＜0.05）；COPD患者在治疗前肺功能均有明显下降，两组差异无显著性。治疗后肺功能都有不同程度改善，但对照组与治疗前相比差异无显著性，治疗组与治疗前相比差异有非常显著性（P＜0.01），两组治疗后相比差异有非常显著性（P＜0.01）。结论 盐酸氨溴索（沐舒坦）联合川芎嗪雾化吸入有利于慢性阻塞性肺疾病急性发作患者临床症状的控制及肺功能的改善。
Clinical effect of mucosolvan and ligustrazine on chronic obstructive pulmonary disease。
［Abstract］ Objective To evaluate the clinical effect of mucosolvan and ligustrazine on the acute attack of chronic obstructive pulmonary disease. Methods Seventyfour cases of patients with COPD were divided into treatment and control groups in random.Conventional therapy were used in two groups,mucosolvan 30 mg and ligustrazine 40 mg were used only in treatment group.Clinical appraisal and pulmonary function were determined after two weeks.Results There were remarkable improvement on the clinical symptoms in two groups.There were remarkable difference of the effective rates between treatment and control groups after two weeks in the clinical symptoms（P＜0.05）.There were no remarkable difference of pulmonary function in two groups before treatment.There were difference improvement of the pulmonary function after treatment in two groups.But there were no remarkable difference compared with pretherapy in control groups.The were remarkable difference compared with pretherapy intreatment groups.And there were remarkable difference of the pulmonary function after treatment in two groups（P＜0.05）. Conclusion It is beneficial to control clinical symptoms and improve pulmonary function that the inhalation of mucosolvan combinated with ligustrazine in the acute attack of COPD.
［Key words］ chronic obstructive pulmonary disease;mucosolvan;ligustrazine;pulmonary function。
慢性阻塞性肺疾病（chronic obstrucitive pulmonary disease,COPD）是呼吸系统常见病，以不完全可逆的气道阻塞为特征，起病隐匿，反复发作，逐渐加重，严重损害心肺功能，最终使患者致残甚至致死，严重威胁人们的健康。慢性阻塞性肺疾病是全世界引起慢性疾病和死亡的主要原因，目前尚无有效的办法遏制病变的发展和恶化。笔者对74例慢性阻塞性肺疾病急性发作期患者采用盐酸氨溴索（沐舒坦）联合川芎嗪雾化吸入治疗，取得了良好的效果，现报告如下。
1 资料与方法。
1.1 患者及分组 所有患者均系我院呼吸科2004年5月～2006年5月住院的COPD急性加重期患者，诊断标准参照中华医学会呼吸病分会COPD诊断规范（草案）［1］，共计74例，随机分为观察组38例，对照组36例。两组年龄、病情比较差异无显著性。
1.2 治疗方法 两组患者住院以后均按常规予抗生素、吸氧、祛痰、解痉、平喘等处理；观察组患者在此基础上辅以川芎嗪40 mg，盐酸氨溴索（沐舒坦）15 mg加生理盐水30 ml，超声雾化吸入20 min左右，每天2次，直至病情缓解；对照组用等容生理盐水雾化吸入5天。超声雾化器采用上海鱼跃牌YUYUE402A超声雾化器，直至病情缓解。
1.3 观察指标 用药前后患者咳嗽、咳痰、肺部音及肺活量（VC）、用力肺活量（FVC）、FEV1%及FEV1/FVC%、最大呼气中段流量（MMEF）、50%肺活量最大呼气流量（V50）、25%肺活量最大呼气流量（V25）。
1.4 疗效标准标准 参考中华人民共和国卫生部药政局制定的《药物临床研究指导原则》中有关镇咳、祛痰、平喘药物的疗效判断标准，将临床疗效按显效、好转、无效三级进行评定。
1.5 统计学方法 数据以均数±标准差（x±s）表示。两组间各指标比较用F检验和q检验。用药前后各指标比较用配对t检验。