厄多司坦对稳定期轻中度慢性阻塞性肺疾病患者气道炎性反应的影响
Effect of erdosteine on the airway inflammatory reaction in mild and moderate chronic obstructive pulmonary disease patients during the stable phase
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摘要: 目的：探讨厄多司坦对稳定期轻中度慢性阻塞性肺疾病（COPD）患者气道炎性反应的影响。方法：选择稳定期轻中度COPD患者72例，随机分成观察组和对照组，各36例。2组均根据COPD指南选用沙丁胺醇气雾剂并允许使用茶碱制剂，观察组在对照组基础上应用厄多司坦，每天2次，每次300 mg。2组均治疗6个月。比较2组患者用药3个月及6个月后的临床症状、肺通气功能、急性加重次数和呼吸困难问卷评分，监测患者血清C反应蛋白及痰液中白细胞介素-8、肿瘤坏死因子-α和髓过氧化物酶水平。结果：治疗3、6个月后，2组呼吸困难问卷评分、肺通气功能及血清C反应蛋白水平差异均无统计学意义（P>0.05）；但治疗6个月后观察组黏痰消失率增加，急性加重次数少于对照组（P<0.05），观察组痰液中白细胞介素-8和肿瘤坏死因子-α水平均明显低于对照组（P<0.01）。结论：厄多司坦可作为有效的黏痰溶解剂，同时可抑制气道炎性反应，对稳定期轻中度COPD安全有效。Abstract: Objective:To investigate the effects of erdosteine on the airway inflammatory reaction in mild and moderate chronic obstructive pulmonary disease(COPD) patients during the stable phase.Methods:Seventy-two mild and moderate COPD patients during the stable phase were randomly divided into the observation group and control group(36 cases each group).Two groups were treated with salbutamol aerosol combined with theophylline according to the COPD guideline,the observation group were additionally treated with 300 mg of erdosteine twice a day,and two groups were treated for 6 months.The clinical symptoms,pulmonary ventilation function,number of acute exacerbation,dyspnea questionnaire score,serum C reactive protein level,and sputum interleukin-8,tumor necrosis factor-α and myeloper-oxidase levels between two groups were analyzed and compared after 3 and 6 months of treatment.Results:The differences of the dyspnea questionnaire score,pulmonary ventilation function and serum C reactive protein level between two groups were not statistically significant after 3 and 6 months of treatment(P>0.05).After 6 months of treatment,the phlegm disappearance rate in observation group increased,the number of acute exacerbation in observation group was less than that in control group(P<0.05),and the levels of sputum interleukin-8 and tumor necrosis factor-α in observation group were significantly lower than those in control group(P<0.01).Conclusions:The erdosteine is an effective phlegm dissolving agent,which can inhibit the airway inflammation reaction,and is safe and effective in mild and moderate COPD patients during the stable phase.
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