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目的观察阿奇霉素联合布地奈德干粉吸入剂治疗支气管哮喘的临床效果,探讨其作用机制。方法选择支气管哮喘患者86例作为观察对象,随机分为观察组43例和对照组43例。两组均给予解痉、平喘、止咳、化痰等对症治疗;对照组再给予雾化吸入布地奈德,200 g/次,2次/d;观察组在对照组的基础上口服阿奇霉素,250 mg/次,1次/d;两组均治疗4周。治疗前后检测第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占预计值百分比(FEV1/pred%)、呼气峰值流速(PEF)、呼气峰值流速占预计值百分比(PEF/pred%),血清高敏C-反应蛋白(hs-CRP)、Ig E,评价临床疗效,观察不良反应。采用SPSS 17.0统计软件。计数资料以率表示,比较采用χ2检验;计量资料以(xˉ±s)表示,比较采用t检验。P<0.05为差异有统计学意义。结果观察组总有效率为93.03%,对照组为72.09%,两组比较差异有统计学意义(χ2=7.873、P<0.05)。两组治疗后FEV1、FEV1/pred%、PEF、PEF/pred%均较治疗前升高,血清hs-CRP、Ig E水平均较治疗前降低,观察组效果均优于对照组(P均<0.05)。观察组出现恶心、呕吐2例(4.65%),对照组1例(2.33%),两组不良反应发生率差异无统计学意义(χ2=0.345、P>0.05)。结论阿奇霉素联合布地奈德干粉吸入剂可有效治疗支气管哮喘,改善肺功能、抑制炎症及过敏反应可能是其作用机制。
Objective To observe the clinical effect of azithromycin combined with budesonide dry powder inhalation in the treatment of bronchial asthma and to explore its mechanism. Methods Eighty-six patients with bronchial asthma were selected as observational subjects and randomly divided into observation group (43 cases) and control group (43 cases). Both groups were given antispasmodic, antiasthmatic, cough, phlegm and other symptomatic treatment; control group were given inhalation of budesonide, 200 g / times, 2 times / d; the observation group in the control group based on oral azithromycin, 250 mg / time, 1 time / d; both groups were treated for 4 weeks. FEV1, FEV1 / pred%, peak expiratory flow (PEF), and peak expiratory flow rate (PEF) were measured before and after treatment. / pred%), serum high-sensitivity C-reactive protein (hs-CRP), Ig E, evaluation of clinical efficacy, adverse reactions observed. Using SPSS 17.0 statistical software. Counting data in terms of rate, compared with χ2 test; measurement data to (x ˉ ± s) said, compared with t test. P <0.05 for the difference was statistically significant. Results The total effective rate was 93.03% in the observation group and 72.09% in the control group. There was significant difference between the two groups (χ2 = 7.873, P <0.05). The levels of FEV1, FEV1 / pred%, PEF, PEF / pred% in both groups were significantly higher than those before treatment, and the levels of serum hs-CRP and IgE were lower than those before treatment in both groups (P < 0.05). The observation group had nausea and vomiting in 2 cases (4.65%) and in the control group in 1 case (2.33%). There was no significant difference in the incidence of adverse reactions between the two groups (χ2 = 0.345, P> 0.05). Conclusion Azithromycin combined with budesonide dry powder inhaler can be effective in the treatment of bronchial asthma, improve lung function, inhibit inflammation and allergic reactions may be its mechanism of action.