Clinical study of Danshen ketone Ⅱ A sodium sulfonate combined with budesonide-formoterol and tiotropium bromide for acute exacerbation of chronic obstructive pulmonary disease
Objective To observe the clinical efficacy of Danshen ketoneⅡA sodium sulfonate combined with budesonide-formoterol and tiotropium bromide in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 112 AECOPD patients admitted to the First People's Hospital of Wuhu from September 2021 to September 2023 were selected as the research objects.According to the severity of the disease,the patients were divided into the control group and the study group,with 56 cases in each group.The control group received aerosol inhalation of budesonide-formoterol and tiotropium bromide,while the study group was treated with budesonide-formoterol and tiotropium bromide combined with Danshen ketoneⅡA sodium sulfonate.After 10 days of treatment,the lung function,blood gas indexes,hematological indexes,and adverse reactions were compared between the two groups.Results Compared to pre-treatment levels,the forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC,arterial partial pressure of oxygen(PaO2),superoxide dismutase(SOD)and glutathione(GSH)were significantly increased in the two groups after treatment[control group:FEV1(L)was 59.76±11.43 vs.53.71±5.62,FVC(L)was 63.54±6.19 vs.55.28±7.51,FEV1/FVC was(59.48±8.15)%vs.(53.96±8.43)%,PaO2(mmHg,1 mmHg≈0.133 kPa)was 76.93±4.58 vs.68.95±4.96,SOD(kU/L)was 83.19±6.58 vs.70.41±5.57,GSH(mg/L)was 242.89±21.78 vs.218.31±46.52;study group:FEV1(L)was 65.83±10.35 vs.52.49±5.41,FVC(L)was 69.41±10.73 vs.53.31±8.36,FEV1/FVC was(67.62±7.35)%vs.(52.71±7.33)%,PaO2(mmHg)was 83.21±5.34 vs.70.32±5.31,SOD(kU/L)was 90.32±7.14 vs.71.63±5.94,GSH(mg/L)was 264.33±26.14 vs.213.67±41.36,all P<0.05],while the arterial partial pressure of carbon dioxide(PaCO2),interleukins(IL-1β,IL-6),tumor necrosis factor-α(TNF-α)exhibited significant decreases[control group:PaCO2(mmHg)was 53.56±5.14 vs.59.16±5.59,IL-1β(ng/L)was 6.43±1.71 vs.8.53±3.89,IL-6(ng/L)was 18.64±2.13 vs.25.31±4.19,TNF-α(ng/L)was 81.72±10.79 vs.102.58±14.31;study group:PaCO2(mmHg)was 47.13±5.42 vs.61.37±6.08,IL-1β(ng/L)was 5.16±1.37 vs.9.01±4.13,IL-6(ng/L)was 10.52±2.43 vs.25.84±4.27,TNF-α(ng/L)was 61.35±12.81 vs.104.35±16.51,all P<0.05],and the improvements in the study group were more obvious.The differences of FEV1,FVC,FEV1/FVC,PaO2,PaCO2,IL-1β,IL-6,TNF-α,SOD and GSH before and after treatment in the study group were significantly higher than those in the control group[ΔFEV1(L):13.85±4.52 vs.6.13±2.31,ΔFVC(L):15.83±2.74 vs.8.32±2.46,ΔFEV1/FVC:(14.65±1.95)%vs.(5.47±1.39)%,ΔPaO2(mmHg):13.14±2.81 vs.8.12±2.37,ΔPaCO2(mmHg):13.68±2.75 vs.4.84±2.53,ΔIL-1β(ng/L):4.33±1.06 vs.2.02±0.56,ΔIL-6(ng/L):15.31±2.07 vs.7.53±2.45,ΔTNF-α(ng/L):37.92±8.3 vs.22.51±8.73,ΔSOD(kU/L):18.52±3.36 vs.14.13±3.27,ΔGSH(mg/L):41.59±8.61 vs.28.75±7.34,all P<0.05].There was no significant difference in the incidence of adverse reactions between the study group and the control group[28.57%(16/56)vs.21.43%(16/56),P>0.05].Conclusion The combination of Danshen ketoneⅡA sodium sulfonate combined with budesonide-formoterol and tiotropium bromide inhalation therapy in AECOPD helps to suppress airway inflammation,improve lung function and blood gas parameters,and demonstrates a favorable safety profile.
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