目的 探討羧甲司坦口服溶液聯(lián)合鹽酸莫西沙星片治療慢性支氣管炎急性發(fā)作的臨床療效。方法 選取2019年10月—2022年1月在山東省泰山醫(yī)院進(jìn)行治療的112例慢性支氣管炎急性發(fā)作患者為研究對象，根據(jù)用藥差別將所有患者分為對照組和治療組，每組各56例。對照組患者口服鹽酸莫西沙星片，0.4 g/次，1次/d；治療組在此基礎(chǔ)上口服羧甲司坦口服溶液，10 mL/次，3次/d。兩組均連續(xù)治療7 d。觀察兩組的臨床療效，比較兩組臨床癥狀改善時間、相關(guān)評分、血氣分析指標(biāo)、細(xì)胞因子水平。結(jié)果 治療后，治療組總有效率為98.21%%，顯著高于對照組82.14%（P<0.05）。治療后，治療組咳嗽、咳痰、喘息改善時間顯著短于對照組（P<0.05）。治療后，兩組患者圣喬治呼吸問卷（SGRQ）評分、咳嗽視覺模擬評分均較治療前顯著降低，而萊賽斯特生活質(zhì)量問卷（LCQ）評分、EORTC生命質(zhì)量測定量表（QLQ-C30）評分均顯著升高（P<0.05），并以治療組改善更明顯（P<0.05）。治療后，兩組血氧分壓（pO₂）顯著升高，而二氧化碳分壓（pCO₂）均顯著降低（P<0.05），并以治療組改善更明顯（P<0.05）。治療后，兩組C反應(yīng)蛋白（CRP）、白細(xì)胞介素-4（IL-4）、白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）水平均較治療前顯著下降（P<0.05），且治療后，治療組CRP、IL-4、IL-6、TNF-α水平低于對照組（P<0.05）。結(jié)論 羧甲司坦口服溶液聯(lián)合鹽酸莫西沙星片治療慢性支氣管炎急性發(fā)作具有較好的臨床療效，可促進(jìn)患者癥狀改善及生活質(zhì)量的提高，調(diào)節(jié)患者血氣指標(biāo)，降低CRP、IL-4、IL-6、TNF-α水平，值得臨床推廣應(yīng)用。

Objective To investigate the clinical efficacy of Carbocysteine Oral Solution combined with moxifloxacin in treatment of acute attack of chronic bronchitis. Methods A total of 112 patients with acute exacerbation of chronic bronchitis treated in Shandong Provincial Taishan Hospital from October 2019 to January 2022 were selected as the research objects. All patients were divided into the control group and the treatment group according to the difference in medication, with 56 cases in each group. Patients in the control group were po administered with Moxifloxacin Hydrochloride Tablets, 0.4 g/time, once daily. Patients in the treatment group were po administered with Carbocysteine Oral Solution on the basis of the control group, 10 mL/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and improvement time of clinical symptoms, correlation scores, blood gas analysis indexes and cytokine levels were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 98.21%, which was significantly higher than 82.14% of the control group (P < 0.05). After treatment, the improvement time of cough, expectoration and wheezing in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the St. George's Respiratory Questionnaire (SGRQ) score and cough visual analogue score of the two groups were significantly lower than those before treatment, while the Lyceste Quality of Life Questionnaire (LCQ) score and EORTC Quality of Life Scale (QLQ-C30) score were significantly higher in the two groups (P < 0.05), and the improvement was more obvious in the treatment group (P < 0.05). After treatment, the blood partial pressure of oxygen (pO₂) was significantly increased, while the blood partial pressure of carbon dioxide (pCO₂) was significantly decreased in both groups (P < 0.05), and the improvement was more obvious in the treatment group (P < 0.05). After treatment, the levels of C-reactive protein (CRP), interleukin-4 (IL-4), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the two groups were significantly decreased compared with those before treatment (P < 0.05). The levels of CRP, IL-4, IL-6 and TNF-α in the treatment group were lower than those in the control group (P < 0.05). Conclusion Carbocysteine Oral Solution combined with moxifloxacin has good clinical efficacy in treatment of acute attack of chronic bronchitis, and can promote the improvement of symptoms and quality of life of patients, regulate the blood gas index of patients, reduce the levels of CRP, IL-4, IL-6 and TNF-α, which is worthy of clinical application.

R974

泰安市科技計劃項目（2015NS2098）