目的 觀察布地奈德聯(lián)合氨溴索霧化吸入治療慢性阻塞性肺疾病急性加重期（AECOPD）的臨床療效。方法 選取2012年2月—2013年10月上海市浦東新區(qū)康橋社區(qū)衛(wèi)生服務(wù)中心收治的AECOPD患者125例，隨機(jī)分為治療組（59例）和對照組（66例）。所有患者均給予常規(guī)的控制感染、吸氧、解痙、平喘等治療。治療組在常規(guī)治療的基礎(chǔ)上給予霧化吸入布地奈德混懸液2 mg/次和鹽酸氨溴索注射液30 mg/次，10～15 min/次，2次/d。對照組給予霧化吸入布地奈德混懸液2 mg/次和注射用糜蛋白酶4×10³ U/次，10～15 min/次，2次/d。兩組均持續(xù)治療7 d。治療后，對兩組的臨床療效進(jìn)行評價，同時對其肺功能和血氣分析指標(biāo)進(jìn)行檢測。結(jié)果 治療組和對照組的總有效率分別為93.2%、78.8%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療組喘鳴消失時間、咳嗽緩解時間、濕音消失時間和住院時間均顯著短于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者血氣分析（PaCO₂、PaO₂）和肺功能（FEV₁、FEV₁/FVC）指標(biāo)均顯著改善，同組治療前后差異有統(tǒng)計學(xué)意義（P<0.05）；治療后治療組這些觀察指標(biāo)改善程度優(yōu)于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 布地奈德聯(lián)合氨溴索霧化吸入治療AECOPD具有較好的臨床療效，并能顯著改善患者血氣分析和肺功能指標(biāo)，值得臨床推廣。

Objective To investigate the clinical efficacy of budesonide combined with ambroxol aerosol inhalation in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Patients with AECOPD (125 cases) in Kangqiao Community Health Service Center of Pudong New District in Shanghai from February 2012 to October 2013 were randomly divided into treatment (n = 59) and control (n = 66) groups. All patients were given routine treatment such as infection control, oxygen, spasmolysis, and smooth wheezing. The patients in the treatment group were accepted aerosol inhalation with Budesonide Mixed Suspension (2 mg/time) and Ambroxol Hydrochloride Injection (30 mg/time) on the basis of routine therapy, 10 — 15 min/time, twice daily. The patients in the control group accepted aerosol inhalation with Budesonide Mixed Suspension (2 mg/time) and Chymotrypsin for injection (4×10³ U/time), 10 — 15 min/time, twice daily. The patients in the two groups were treated continuously for 7 d. After treatment, the treatment efficacy was evaluated, while lung function and blood gas analysis indexes were tested.Results The total effective rates of the treatment and control groups were 93.2% and 78.8%, respectively, with significant difference between two groups (P < 0.05). The time periods of wheezing disappearing, cough easing, wet sound disappearing, and hospital stay in treatment group were significantly shorter than those in the control group, with significant difference between two groups (P < 0.05). After treatment, blood gas analysis indexes (PaCO₂ and PaO₂) and pulmonary function indexes (FEV₁ and FEV₁/FVC) were significantly improved, with statistically significant difference before and after treatment (P < 0.05). Those detection indexes in the treatment group were improved better than those in the control group, with statistically significant difference (P < 0.05). Conclusion Budesonide combined with ambroxol aerosol inhalation has a good clinical efficacy in treatment of AECOPD, and can significantly improve blood gas analysis and lung function indexes, which is worthy of clinical application.

浦東新區(qū)衛(wèi)生系統(tǒng)優(yōu)秀青年醫(yī)學(xué)人才培養(yǎng)計劃資助項目（PWRq2011-34）