目的 探討龍香平喘膠囊聯(lián)合噻托溴銨噴霧劑治療老年支氣管哮喘的臨床療效。方法 選取2017年10月—2019年10月在平煤神馬醫(yī)療集團總醫(yī)院治療的80例老年支氣管哮喘患者，隨機分為對照組（40例）和治療組（40例）。對照組患者吸入噻托溴銨噴霧劑，2撳/次，1次/d。治療組在對照組的基礎上口服龍香平喘膠囊，3粒/次，3次/d。兩組患者治療10 d。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀消失時間，肺功能指標第1秒用力呼氣量（FEV1）、用力肺活量（FVC）、FEV1/FVC和最大呼氣流速峰值（PEFR），血清白細胞介素4（IL-4）、IL-18、腫瘤壞死因子α（TNF-α）、C反應蛋白（CRP）和干擾素γ（INF-γ）水平及不良反應情況。結果 治療后，治療組臨床總有效率明顯高于對照組（P<0.05）。治療后，治療組患者臨床癥狀消失時間均顯著早于對照組（P<0.05）。治療后，兩組患者FEV1、FVC、FEV1/FVC、PEFR指標均顯著升高（P<0.05），且治療組明顯高于對照組（P<0.05）；治療后，兩組患者IL-4、IL-18、TNF-α、CRP水平顯著降低，而INF-γ水平顯著升高（P<0.05），且治療組患者血清炎性因子水平明顯好于對照組（P<0.05）。治療后，治療組患者藥物不良反應總發(fā)生率明顯低于對照組（P<0.05）。結論 龍香平喘膠囊聯(lián)合噻托溴銨噴霧劑治療老年支氣管哮喘臨床效果顯著，可有效減輕患者癥狀，改善肺功能狀態(tài)及降低炎性因子反應。

Objective To investigate the efficacy of Longxiang Pingchuan Capsules combined with tiotropium bromide in treatment of senile bronchial asthma.Methods Patients (80 cases) with bronchial asthma in General Hospital of Pingmei Shenma Medical Group from October 2017 to October 2019 were randomly divided into control (40 cases) and treatment (40 cases) groups. Patients in the control group were inhalation administered with Tiotropium Bromide Spray, 2 press/time, once daily. Patients in the treatment group were po administered with Longxiang Pingchuan Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacy was evaluated, and the disappearance time of clinical symptoms, the lung function indexes of FEV1, FVC, FEV1/FVC and PEFR, the levels of serum IL-4, IL-18, TNF-α, CRP, and INF-γ, and adverse reaction in two groups before and after treatment were compared.Results After treatment, the total clinical effective rate of the treatment group was significantly higher than that of the control group (P<0.05). After treatment, the disappearance time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, the indexes of FEV1, FVC, FEV1/FVC and PEFR in two groups were significantly increased (P<0.05), and which in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the levels of IL-4, IL-18, TNF-α and CRP in the two groups were significantly decreased, while the level of INF-γ was significantly higher (P<0.05). After treatment, the levels of serum inflammatory factors in the treatment group were significantly better than that in the control group (P<0.05). After treatment, the total incidence of adverse drug reactions in the treatment group was significantly lower than that in the control group (P<0.05).Conclusion Longxiang Pingchuan Capsules combined with tiotropium bromide is effective in treatment of senile bronchial asthma, can effectively relieve symptoms, improve lung function and reduce inflammatory response.

R974