Efficay of thymosin combined with moxifloxacin in treatment of elderly patients with chronic obstructive pulmonary disease complicated with severe pneumonia
Objective To investigate the efficacy of thymosin combined with moxifloxacin in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)complicated with severe pneumonia(SP).Methods A total of 78 elderly patients with COPD complicated with SP admitted to Leshan Hospital of Traditional Chinese Medicine from March 2022 to November 2023 were enrolled in this study and divided into the moxifloxacin group and the combined group,with 39 patients in each group,by random number table method.The patients in the moxifloxacin group received routine treatment and moxifloxacin.Routine treatment involved regular inhalation of long-acting bronchodilators according to the relevant provisions of the COPD guidelines and inhalation of short-acting agonists when necessary.Inhalation of glucocorticoids or administration of theophylline drugs were also considered.Additionally,treatments for secondary pneumonia(SP)included fever reduction,oxygen therapy,asthma relief,expectoration promotion and nutritional support.The patients in the combined group received thymopeptide therapy in addition to the treatment provided to the moxifloxacin group.All the patients in both groups were treated for 14 days.The clinical efficacy,symptom improvement,humoral immunity,inflammatory response and safety during treatment were compared between the two groups after 14 days of treatment.Results After 14 days of treatment,the total effective rate of the combined group was higher than that of the moxifloxacin group(94.87%vs 76.92%,χ2=5.186,P<0.05).The disappearance time of high fever,cough and lung rale in the combined group was(3.22±0.56)d,(6.27±1.21)d and(7.29±1.27)d,which was shorter than that in the moxifloxacin group((4.05±0.61)d,(7.12±1.10)d,(8.87±1.42)d),there was a statistically significant difference between the two groups(t=6.260,3.246,5.179,all P<0.05).Compared with those before the treatment,serum immunoglobulin(Ig)A,IgG and IgM levels were increased in the two groups after 14 days of treatment.They were(2.05±0.61)g·L-1,(12.70±2.91)g·L-1 and(1.75±0.20)g·L-1 in the combined group,which were higher than those of(1.76±0.55)g·L-1,(9.53±2.23)g·L-1 and(1.43±0.21)g·L-1 in the moxifloxacin group(t=2.205,5.400,6.891,all P<0.05).Compared with those before treatment,the levels of whole blood white blood cells(WBC),serum procalcitonin(PCT)and hypersensitive C-reactive protein(hs-CRP)in the two groups were decreased after 14 days of treatment.They were(8.38±1.09)×109·L-1,(0.15±0.04)ng·mL-1 and(2.54±0.89)mg·L-1 in the combined group,which were lower than those of the moxifloxacin group((9.89±1.17)×109·L-1,(0.26±0.07)ng·mL-1,(5.39±0.92)mg·L-1)(t=5.897,8.521,13.904,all P<0.05).The incidence of adverse reactions showed no significant difference between the moxifloxacin group and the combined group(7.69%(3/39)vs 15.38%(6/39),χ2=0.502,P=0.478).Conclusion Thymosin combined with moxifloxacin is effective for the treatment of elderly patients with COPD complicated with SP since it can improve humoral immunity and relieve inflammation.Meanwhile,this regimen is of high safety.
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