目的 探討肺力咳合劑聯(lián)合莫西沙星治療慢性阻塞性肺疾病急性加重期（AECOPD）的臨床效果。方法 選取2017年3月—2019年12月天津市第五中心醫(yī)院收治的116例AECOPD患者，隨機分成對照組（58例）和治療組（58例）。對照組靜脈滴注鹽酸莫西沙星注射液，0.4 g/次，1次/d。治療組在對照組基礎(chǔ)上口服肺力咳合劑，20 mL/次，3次/d。兩組患者均治療14 d。觀察兩組患者臨床療效，比較治療前后兩組患者主要癥狀體征緩解時間、自我評估測試（CAT）問卷、改良版英國醫(yī)學(xué)研究委員會呼吸問卷（mMRC）評分、肺功能參數(shù)、呼出氣一氧化氮（FeNO）濃度，及血清脂蛋白相關(guān)磷脂酶A2（Lp-PLA2）、白細胞介素-1β（IL-1β）、白三烯B4（LTB4）和超敏C反應(yīng)蛋白（hs-CRP）水平。結(jié)果 治療后，治療組總有效率為94.8%，顯著高于對照組的82.8%（P<0.05）。治療后，治療組主要癥狀體征的緩解時間均顯著短于對照組（P<0.05）。治療后，兩組患者CAT問卷和mMRC評分較同組治療前均顯著降低，而第1秒用力呼氣容積（FEV1）占預(yù)計值%、FEV1與用力肺活量（FVC）比值（FEV1/FVC）較治療前則均顯著升高（P<0.05）；治療后，治療組CAT問卷、mMRC評分、FEV1占預(yù)計值%和FEV1/FVC均顯著好于對照組（P<0.05）。治療后，兩組FeNO濃度及血清Lp-PLA2、IL-1β、LTB4和hs-CRP水平均顯著低于治療前（P<0.05）；且治療組FeNO濃度及血清Lp-PLA2、IL-1β、LTB4和hs-CRP水平比對照組降低更顯著（P<0.05）。結(jié)論 肺力咳合劑聯(lián)合莫西沙星能安全、快速地緩解AECOPD患者加重的呼吸道癥狀，保護肺功能，減輕氣道炎癥和系統(tǒng)性炎癥，利于穩(wěn)定患者病情。

Objective To explore the clinical effect of Feilike Mixture combined with moxifloxacin in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods Patients (116 cases) with acute exacerbation of chronic obstructive pulmonary disease in Tianjin Fifth Central Hospital from March 2017 to December 2019 were randomly divided into control (58 cases) and treatment (58 cases) groups. Patients in the control group were iv administered with Moxifloxacin Hydrochloride Injection, 0.4 g/time, once daily. Patients in the treatment group were po administered with Feilike Mixture on the basis of the control group, 20 mL/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the remission time of main symptoms and signs, CAT questionnaire, mMRC score, lung function parameters, FeNO concentration and the levels of serum Lp-PLA2, IL-1β, LTB4, hs-CRP in two groups before and after treatment were compared.Results After treatment, the total effective rate in the treatment group was 94.8%, which was significantly higher than 82.8% of the control group (P<0.05). After treatment, the remission time of main symptoms and signs in the treatment group was significantly shorter than that in the control group (P<0.05). After treatment, the CAT questionnaire and mMRC score in two groups were significantly lower than those before treatment, while the percentage of FEV1 and FEV1/FVC were significantly higher than those before treatment (P<0.05). After treatment, the CAT questionnaire, mMRC score, FEV1% and FEV1/FVC in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the concentration of FeNO and the levels of serum Lp-PLA2, IL-1β, LTB4 and hs-CRP in two groups were significantly lower than those before treatment (P<0.05), and the concentration of FeNO and the levels of serum Lp-PLA2, IL-1β, LTB4 and hs-CRP in the treatment group were significantly lower than those in the control group (P<0.05).Conclusion Feilike Mixture combined with moxifloxacin can safely and quickly relieve the acute exacerbation of AECOPD patients, protect lung function, reduce airway inflammation and systemic inflammation, and help to stabilize the condition of patients.

R974

海南省自然科學(xué)基金青年基金資助項目（819QN368）