摘要
目的 探讨虫草清肺胶囊联合盐酸莫西沙星对慢性支气管炎急性发作期的应用效果及免疫功能、复发率的影响.方法 回顾性选取2022年5月至2023年5月延安市人民医院收治的80例慢性支气管炎急性发作期患者,按照治疗方法不同分为联合组与对照组,每组各40例.对照组患者采取盐酸莫西沙星治疗,联合组在对照组基础上口服虫草清肺胶囊.两组均连续治疗1周.比较两组患者临床疗效,治疗前、治疗1周后的免疫功能(CD4+、CD3+、CD8+、CD4+/CD8+)、炎症因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞计数(WBC)]水平、肺功能相关指标[第一秒用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC、最大通气量(MVV)]变化,比较两组患者的不良反应发生率,并对患者进行1年随访,记录两组患者的慢性支气管炎急性发作复发率.结果 联合组总有效率为95.00％,高于对照组(70.00％),差异有统计学意义(P＜0.05).治疗1周后,两组CD4+、CD3+、CD4+/CD8+水平均较治疗前升高,CD8+均较治疗前降低,且联合组 CD4+、CD3+、CD4+/CD8+水平分别为(44.59±6.24)％、(62.58±6.12)％、1.82±0.18,均明显高于对照组[(36.12±7.52)％、(53.21±3.21)％、1.35±0.17],CD8+水平为(22.81±1.25)％,明显低于对照组[(26.70±2.18)％],差异均有统计学意义(P＜0.05).治疗1周后,两组CRP、TNF-α、WBC水平均较治疗前降低,且联合组 CRP、TNF-α、WBC 水平分别为(13.25±3.32)μg/mL、(38.50±6.14)ng/L、(11.62±2.16)× 109/L,均明显低于对照组[(16.62±5.24)μg/mL、(43.60±5.86)ng/L、(15.46±3.11)× 109/L],差异均有统计学意义(P＜0.05).治疗1周后,两组FEV1、FVC、FEV1/FVC、MVV均较治疗前升高,且联合组FEV1、FVC、FEV1/FVC、MVV水平分别为(3.25±0.61)L、(3.33±0.68)L、(64.53±8.54)％、(49.27±4.21)L/min,均明显高于对照组[(2.17±0.34)L、(2.68±0.25)L、(55.68±9.25)％、(57.37±6.38)L/min],差异均有统计学意义(P＜0.05).联合组不良反应发生率为10.00％,对照组为7.50％,两组比较差异无统计学意义(P＞0.05).联合组复发率为0,低于对照组(10.00％),差异有统计学意义(P＜0.05).结论 慢性支气管炎急性发作期患者应用虫草清肺胶囊联合盐酸莫西沙星治疗效果显著,可改善免疫功能,减轻炎症,提升肺功能,安全性高,且可降低患者远期急性发作复发次数.
Abstract
Objective To explore the application effect of cordyceps Qingfei capsules combined with moxifloxacin hydrochloride on acute exacerbation of chronic bronchitis,as well as the impact on immune function and recurrence rate.Methods A total of 80 patients with acute ex-acerbation of chronic bronchitis admitted to Yan'an People's Hospital from May 2022 to May 2023 were retrospectively selected and divided into the combined group and the control group according to different treatment methods,with 40 cases in each group.The control group patients were trea-ted with moxifloxacin hydrochloride,while the combined group received oral cordyceps Qingfei capsules in addition to the control group.Both groups were treated continuously for 1 week.The clinical efficacy,immune function(CD4+,CD3+,CD8+,CD4+/CD8+),inflammatory fac-tors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),white blood cell count(WBC)]levels and lung function related inde-xes[forced expiratory volume in first second(FEV1),forced vital capacity(FVC),FEV1/FVC,maximal volvntary ventilation(MVV)]before and after 1 week of treatment were compared between the two groups,and the incidence of adverse reactions was compared between the two groups,and the patients were followed up for 1 year.The recurrence rate of acute attack of chronic bronchitis was recorded in the two groups.Results The total effective rate of the combined group was 95.00％,which was higher than that of the control group(70.00％),and the difference was statistically significant(P＜0.05).After 1 week of treatment,the levels of CD4+,CD3+and CD4+/CD8+in the two groups were higher than those before treatment,and CD8+was lower than that before treatment,the levels of CD4+,CD3+and CD4+/CD8+in the combined group were(44.59±6.24)％,(62.58±6.12)％and 1.82±0.18,respectively,which were significantly higher than those in the control group[(36.12±7.52)％,(53.21±3.21)％and 1.35±0.17],and the level of CD8+was(22.81±1.25)％,which was significantly lower than that in the control group[(26.70±2.18)％],the differences were statistically significant(P＜0.05).After 1 week of treatment,the levels of CRP,TNF-α and WBC in the two groups were lower than those before treatment,and the levels of CRP,TNF-α and WBC in the combined group were(13.25±3.32)µg/mL,(38.50±6.14)ng/L and(11.62±2.16)x 109/L,respectively,which were significantly lower than those in the control group[(16.62±5.24)µg/mL,(43.60±5.86)ng/L,(15.46±3.11)× 109/L],the differences were statistically significant(P＜0.05).After 1 week of treatment,the levels of FEV1,FVC,FEV1/FVC and MVV in the two groups were higher than those before treatment,and the levels of FEV1,FVC,FEV1/FVC and MVV in the combined group were(3.25±0.61)L,(3.33±0.68)L,(64.53±8.54)％and(49.27±4.21)L/min,respectively,which were significantly higher than those in the control group[(2.17±0.34)L,(2.68±0.25)L,(55.68±9.25)％and(57.37±6.38)L/min],the differences were statistically significant(P＜0.05).The incidence of adverse reactions in the combined group was 10.00％,and that in the control group was 7.50％.There was no statistically significant difference between the two groups(P＞0.05).The recurrence rate of the combined group was 0,which was lower than that of the control group(10.00％),and the differ-ence was statistically significant(P＜0.05).Conclusion The application of Cordyceps Qingfei capsules combined with moxifloxacin hydrochlo-ride in the treatment of patients with acute exacerbation of chronic bronchitis has a significant effect,which can improve immune function,reduce inflammation,improve lung function,with high safety,and can reduce the recurrence frequency of long-term acute exacerbation of patients.
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