目的 探討烏美溴銨維蘭特羅聯(lián)合阿奇霉素治療慢性阻塞性肺疾病穩(wěn)定期的臨床療效。方法 選取2019年3月—2021年3月在漢中市中心醫(yī)院治療的118例慢性阻塞性肺疾病穩(wěn)定期患者，隨機(jī)分為對(duì)照組（59例）和治療組（59例）。對(duì)照組口服阿奇霉素片，第1天服用0.5 g，第2～7天服用0.25 g，1次/d。治療組患者在對(duì)照組的基礎(chǔ)上吸入烏美溴銨維蘭特羅吸入粉霧劑，1掀/次，1次/d。兩組患者連續(xù)治療7 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緩解時(shí)間，肺功能指標(biāo)第1秒用力呼氣容積（FEV1）、用力肺活量（FVC）和FEV1/FVC，血清炎性因子白細(xì)胞介素（IL）-6、IL-8、IL-1β和超敏C反應(yīng)蛋白（hs-CRP）水平及不良反應(yīng)情況。結(jié)果 治療后，治療組患者總有效率明顯高于對(duì)照組（98.31%vs 83.05%，P<0.05）。治療后，治療組臨床癥狀緩解時(shí)間均早于對(duì)照組（P<0.05）。治療后，兩組患者FEV1、FVC、FEV1/FVC明顯升高（P<0.05），且治療組明顯高于對(duì)照組（P<0.05）。治療后，兩組IL-6、IL-8、IL-1β、hs-CRP水平顯著降低（P<0.05），且治療組明顯低于對(duì)照組（P<0.05）。治療期間，治療組患者不良反應(yīng)發(fā)生率為6.78%，顯著低于對(duì)照組的13.56%（P<0.05）。結(jié)論 烏美溴銨維蘭特羅聯(lián)合阿奇霉素治療慢性阻塞性肺疾病穩(wěn)定期效果確切，可有效改善患者臨床癥狀，能降低炎性反應(yīng)及恢復(fù)肺功能狀態(tài)。

Objective To investigate the curative effect of umeclidinium bromide and vilanterol trifenatate combined with azithromycin in treatment of chronic obstructive pulmonary disease. Methods Patients (118 cases) with chronic obstructive pulmonary disease in Hanzhong Central Hospital from March 2019 to March 2021 were randomly divided into control (59 cases) and treatment (59 cases) groups. Patients in the control group were po administered with Azithromycin Tablets, 0.5 g for the first day, 0.25 g for 2 — 7 day, once daily. Patients in the treatment group were inhalation administered with Umeclidinium Bromide and Vilanterol Trifenatate Powder for inhalation, 1 press/time, once daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, the relief time of clinical symptom, the relief time of clinical symptom, the levels of lung function indexes FEV1, FVC, and FEV1/FVC, the levels of serum inflammatory factor IL-6, IL-8, IL-1β, and hs-CRP, adverse drug reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was significantly higher than that of the control group (98.31% vs 83.05%, P<0.05). After treatment, the relief time of clinical symptoms in the treatment group was earlier than that in the control group (P<0.05). After treatment, the indexes of FEV1, FVC, and FEV1/FVC 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-6, IL-8, IL-1β, and hs-CRP in two groups were significantly decreased (P<0.05), and the levels in the treatment group were significantly lower than those in the control group (P<0.05). During the treatment, the incidence of adverse reactions in the treatment group was 6.78%, which was significantly lower than 13.56% in the control group (P<0.05). Conclusion The effect of umeclidinium bromide and vilanterol trifenatate combined with azithromycin in treatment of chronic obstructive pulmonary disease is definite, which can effectively improve the clinical symptoms of the patients, reduce the inflammatory reaction and restore the state of pulmonary function.

R974