目的 研究熱毒寧注射液聯(lián)合復方異丙托溴銨治療慢性阻塞性肺疾病急性加重期的臨床療效。方法 選取2020年1月—2020年6月在鄭州大學附屬洛陽中心醫(yī)院治療的86例慢性阻塞性肺疾病急性加重期患者為研究對象，隨機分為對照組和治療組，每組各43例。對照組患者給予吸入用復方異丙托溴銨溶液，2.5 mL加入霧化器氧氣驅(qū)動霧化吸入，3次/d；治療組在對照組的基礎上靜脈滴注熱毒寧注射液，20 mL加入0.9%氯化鈉注射液250 mL稀釋，1次/d。兩組均連續(xù)治療10 d。兩組均連續(xù)治療10 d。比較兩組患者的臨床療效、血氣分析及肺功能指標、炎癥及氧化應激指標、前白蛋白（PA）水平變化。結(jié)果 治療后，對照組和治療組的總有效率分別為81.40%、95.35%，治療組的臨床療效顯著高于對照組（P<0.05）。治療后，兩組動脈血氧分壓（pO₂）顯著升高，但動脈血二氧化碳分壓（pCO₂）顯著降低（P<0.05）；且治療后治療組pO₂高于對照組，而pCO₂低于對照組（P<0.05）。治療后，兩組第1秒用力呼氣容積（FEV₁）、FEV₁/用力肺活量（FVC）均顯著升高，同組治療前后差異顯著（P<0.05）；且治療組肺功能指標上升更為明顯（P<0.05）。治療后，對照組與治療組患者超敏C反應蛋白（hs-CRP）、降鈣素原（PCT）水平均顯著降低（P<0.05）；且治療組降低更為明顯，兩組比較差異存在統(tǒng)計學意義（P<0.05）。治療后，兩組患者丙二醛（MDA）、過氧化脂質(zhì)（LPO）水平均顯著降低，而谷胱甘肽-S轉(zhuǎn)移酶（GSH-ST）、血清PA水平顯著升高（P<0.05）；治療后，治療組MDA、LPO水平低于對照組，而GSH-ST、PA水平高于對照組（P<0.05）。結(jié)論 熱毒寧注射液聯(lián)合復方異丙托溴銨可顯著促進慢性阻塞性肺疾病急性加重期患者的恢復，降低機體炎性反應，恢復氧化–抗氧化平衡，提高機體營養(yǎng)狀態(tài)，值得臨床推廣應用。

Objective To investigate the clinical effects of Reduning Injection combined with compound ipratropium bromide in treatment of acute exacerbations of chronic obstructive pulmonary disease. Methods A total of 86 patients with acute exacerbation of chronic obstructive pulmonary disease treated in Luoyang Central Hospital Affiliated to Zhengzhou University from January 2020 to June 2020 were selected as research objects and randomly divided into control group and treatment group, with 43 patients in each group. Patients in the control group were given Compound Ipratropium Bromide Solution for inhalation, and 2.5 mL was added to the atomizer to drive oxygen inhalation for 3 times daily. Patients in the treatment group were iv administered with Reduning Injection on the basis of the control group, and 20 mL added into 0.9% Sodium Chloride Injection 250 mL, once daily. Patients in two groups were treated for 10 d. After treatment, clinical efficacy, blood gas analysis, lung function indicators, inflammatory and oxidative stress indicators, and changes in prealbumin levels were compared between the two groups. Results After treatment, the total effective rate of the control group and the treatment group were 81.40% and 95.35%, respectively, and the clinical efficacy of the treatment group was significantly higher than that of the control group (P<0.05). After treatment, pO₂ was significantly increased in both groups, but pCO₂ was significantly decreased (P<0.05). After treatment, pO₂ of the treatment group was higher than the control group, while pCO₂ was lower than the control group (P<0.05). After treatment, FEV₁ and FEV₁/FVC in both groups were significantly increased, with significant difference before and after treatment in the same group (P<0.05). In addition, the lung function indexes increased significantly in the treatment group (P<0.05). After treatment, the levels of hs-CRP and PCT in the control group and the treatment group were significantly decreased (P<0.05). The reduction was more significant in the treatment group, and the difference between the two groups was statistically significant (P<0.05). After treatment, MDA and LPO levels were significantly decreased in both groups, while GSH-ST and serum PA levels were significantly increased (P<0.05). After treatment, MDA and LPO levels in the treatment group were lower than those in the control group, while GSH-ST and PA levels were higher than those in the control group (P<0.05). Conclusion Reduning Injection combined with compound ipratropium bromide can significantly promote the recovery of patients with acute exacerbation of chronic obstructive pulmonary disease, and reduce the body's inflammatory response, restore the oxidation-antioxidant balance, and also can improve the body's nutritional status, which is worthy of clinical application.

R974