[1]柴海强,刘　敏,李　妮,等.阿奇霉素联合山莨菪碱和布地奈德治疗社区获得性肺炎疗效观察[J].新乡医学院学报,2020,37(12):1177-1181.[doi:10.7683/xxyxyxb.2020.12.017]
　CHAI Haiqiang,LIU Min,LI Ni,et al.Effect of azithromycin combined with anisodamine and budesonide in the treatment of community acquired pneumonia[J].Journal of Xinxiang Medical University,2020,37(12):1177-1181.[doi:10.7683/xxyxyxb.2020.12.017]
点击复制

阿奇霉素联合山莨菪碱和布地奈德治疗社区获得性肺炎疗效观察
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年12
页码:
1177-1181
栏目:
临床研究
出版日期:
2020-12-05

文章信息/Info

Title:
Effect of azithromycin combined with anisodamine and budesonide in the treatment of community acquired pneumonia
作者:
柴海强; 刘　敏; 李　妮; 何世伟; 武俊慧
（西安国际医学中心医院胸科医院呼吸科二病区，陕西　西安　710100）
Author(s):
CHAI Haiqiang; LIU Min; LI Ni; HE Shiwei; WU Junhui
(Department of Respiratory Diseases,Chest Hospital,Xi′an International Medical Center Hospital,Xi′an 710100,Shaanxi Province,China)
关键词:
社区获得性肺炎; 阿奇霉素; 山莨菪碱; 布地奈德; T淋巴细胞亚群; 白细胞三烯B4; 白细胞介素-6; 可溶性白细胞介素-2受体
Keywords:
community acquired pneumonia; azithromycin; anisodamine; budesonide; T lymphocyte subsets; leukotriene B4; interleukin-6; soluble interleukin-2 receptor
分类号:
R563.1
DOI:
10.7683/xxyxyxb.2020.12.017
文献标志码:
A
摘要:
目的　探讨阿奇霉素联合山莨菪碱和布地奈德治疗社区获得性肺炎（CAP）的临床效果。方法　选择2018年2月至2019年10月西安国际医学中心医院胸科医院收治的116例CAP患者为研究对象，根据治疗方案分为A组（n=38）、B组（n=38）、C组（n=40）。A组患者给予阿奇霉素、山莨菪碱治疗，B组患者给予阿奇霉素、布地奈德治疗，C组患者给予阿奇霉素、山莨菪碱、布地奈德治疗，3组患者疗程均为7 d。观察3组患者胸闷、气促、咳痰、咳嗽、发热等临床症状消失时间，并观察治疗期间患者不良反应。治疗前及治疗7 d后，使用肺功能检测仪检查患者第1秒用力呼气量（FEV1）、用力肺活量（FVC）和肺一氧化碳弥散量（DLCO），采用酶联免疫吸附法检测血清白细胞三烯B4（LTB4）、可溶性白细胞介素-2受体（sIL-2R）、表面活性蛋白A（SP-A）、半胱氨酰白细胞三烯（CysLTs）及白细胞介素-6（IL-6）水平，使用流式细胞仪检测T淋巴细胞亚群CD3+、CD4+、CD4+/CD8+水平。结果　A组与B组患者胸闷、气促、咳痰、咳嗽及发热的消失时间比较差异无统计学意义（P>0.05），C组患者胸闷、气促、咳痰、咳嗽、发热的消失时间显著短于A组和B组（P<0.05）。治疗前3组患者FEV1、FVC、DLCO比较差异无统计学意义（P>0.05），3组患者治疗后FEV1、FVC、DLCO显著高于治疗前（P<0.05）；治疗后，A组与B组患者FEV1、FVC、DLCO比较差异无统计学意义（P>0.05），C组患者FEV1、FVC、DLCO显著高于A组和B组（P<0.05）。治疗前3组患者血清LTB4、sIL-2R、SP-A、CysLTs、IL-6水平比较差异无统计学意义（P>0.05），3组患者治疗后血清LTB4、sIL-2R、SP-A、CysLTs、IL-6水平显著低于治疗前（P<0.05）；治疗后，C组患者血清LTB4、sIL-2R、SP-A、CysLTs、IL-6水平显著低于A组和B组（P<0.05），A组与B组患者血清LTB4、sIL-2R、SP-A、CysLTs、IL-6水平比较差异无统计学意义（P>0.05）。治疗前3组患者CD3+、CD4+、CD4+/CD8+水平比较差异无统计学意义（P>0.05），3组患者治疗后CD3+、CD4+、CD4+/CD8+水平显著高于治疗前（P<0.05）；治疗后，C组患者CD3+、CD4+、CD4+/CD8+水平显著高于A组和B组（P<0.05），A组与B组患者CD3+、CD4+、CD4+/CD8+水平比较差异无统计学意义（P>0.05）。A组、B组和C组患者不良反应发生率分别为13.16%（5/38）、13.16%（5/38）、17.50%（7/40），3组患者不良反应发生率比较差异无统计学意义（χ2=0.962，P>0.05）。结论　阿奇霉素联合山莨菪碱和布地奈德可快速缓解CAP患者临床症状，抑制炎症反应，改善肺功能和免疫功能。
Abstract:
Objective　To investigate the clinical effect of azithromycin combined with anisodamine and budesonide in the treatment of community acquired pneumonia (CAP).Methods　A total of 116 patients with CAP admitted to the Chest Hospital of Xi′an International Medical Center Hospital from February 2018 to October 2019 were selected as the research subjects,and the patients were divided into group A (n=38),group B (n=38) and group C (n=40) according to the treatment plan.The patients in the group A were treated with azithromycin and anisodamine,and the patients in the group B were treated with azithromycin and budesonide,while the patients in the group C were treated with azithromycin,anisodamine and budesonide.The course of treatment in the three groups was 7 days.The disappearance time of clinical symptoms such as chest distress,tachypnea,expectoration,cough,fever and so on of the patients in the three groups were observed,and the adverse reactions during the treatment were observed.Before treatment and after 7 days of treatment,the first second forced expiratory volume (FEV1),forced vital capacity (FVC) and diffusing capacity of the lung for carbon monoxide (DLCO) were measured by pulmonary function analyzer;the levels of serum leukotrienes B4 (LTB4),soluble interleukin-2 receptor(sIL-2R),surfactant protein A (SP-A),cysteinyl leukotrienes (CysLTs) and interleukin-6 (IL-6) were detected by enzyme linked immunosorbent assay;the levels of CD3+,CD4+,CD4+/CD8+ were detected by flow cytometry.Results　There was no significant difference in the disappearance time of chest distress,tachypnea,expectoration,cough and fever between the group A and group B (P>0.05).The disappearance time of chest distress,tachypnea,expectoration,cough and fever in the group C was significantly shorter than that in the group A and group B (P<0.05).There was no significant difference in the FEV1,FVC and DLCO among the three groups before treatment (P>0.05).The FEV1,FVC and DLCO after treatment were significantly higher than those before treatment in the three groups (P<0.05).After treatment,there was no significant difference in the FEV1,FVC and DLCO between the group A and group B (P>0.05);while the FEV1,FVC and DLCO in the group C were significantly higher than those in the group A and group B (P<0.05).There was no significant difference in serum LTB4,sIL-2R,SP-A,CysLTs and IL-6 levels among the three groups before treatment (P>0.05).The levels of serum LTB4,sIL-2R,SP-A,CysLTs and IL-6 after treatment were significantly lower than those before treatment in the three groups (P<0.05).After treatment,the levels of serum LTB4,sIL-2R,SP-A,CysLTs and IL-6 in the group C were significantly lower than those in the group A and group B (P<0.05);but there was no significant difference in the levels of serum LTB4,sIL-2R,SP-A,CysLTs and IL-6 between the group A and group B (P>0.05).There was no significant difference in the levels of CD3+,CD4+,CD4+/CD8+ among the three groups before treatment (P>0.05).The levels of CD3+,CD4+,CD4+/CD8+ after treatment were significantly higher than those before treatment in the three groups (P<0.05).After treatment,the levels of CD3+,CD4+,CD4+/CD8+ in the group C were significantly higher than those in the group A and group B (P<0.05);but there was no significant difference in the levels of CD3+,CD4+,CD4+/CD8+ between the group A and group B (P>0.05).The incidence of adverse reactions in the group A,group B and group C was 13.16% (5/38),13.16% (5/38) and 17.50% (7/40),respectively.There was no significant difference in the incidence of adverse reactions among the three groups (χ2=0.962,P>0.05).Conclusion　Azithromycin combined with anisodamine and budesonide can quickly relieve the clinical symptoms,inhibit inflammatory reaction,and improve lung function and immune function of patients with CAP.

参考文献/References:

［1］　叶树鸣.痰热清注射液联合抗生素治疗社区获得性肺炎96例临床观察［J］.中国医师杂志，2018，20（12）：1872-1873.
［2］　柯礼业.千金苇茎汤加减联合左氧氟沙星治疗社区获得性肺炎疗效分析［J］.中医临床研究，2019，11（20）：19-20.
［3］　ARPINELLI F,CARAMORI G,MAGNONI M S.Risk of pneumonia during long term regular treatment of stable COPD with inhaled glucocorticoids:a systematic review［J］.Recenti Prog Med,2017,108(4):175-182.
［4］　中华医学会呼吸病学分会.中国成人社区获得性肺炎诊断和治疗指南（2016年版）［J］.中华结核和呼吸杂志，2016，39（4）：253-279.
［5］　李霖玲，周树平，陈强，等.头孢泊肟酯与头孢克肟对儿童社区获得性肺炎常见病原菌体外抗菌活性的比较［J］.中华实用儿科临床杂志，2020，35（21）：1633-1637.
［6］　徐娟，殷勇，赵丽霞，等.上海儿童社区获得性肺炎致病菌分布及耐药性分析［J］.中华实用儿科临床杂志，2018，33（16）：1246-1250.
［7］　程元妹，熊惠萍，熊峰.小剂量山莨菪碱辅助治疗小儿支气管肺炎的疗效［J］.实用临床医学，2012，13（1）：86-87.
［8］　赵汝勤.阿奇霉素联合山莨菪碱治疗小儿支原体肺炎的临床疗效及对免疫功能的影响［J］.实用中西医结合临床，2016，16（8）：5-6，11.
［9］　郝凤秀，王洪琰，程军，等.布地奈德联合盐酸氨溴索对幼儿支原体感染性肺炎治疗疗效及复发的影响［J］.贵州医药，2018，42（6）：711-713.
［10］　张少雨，吕良，刘秀兰，等.血清白三烯B4和降钙素原在儿童肺炎病原诊断和危重度判定中的意义［J］.中华急诊医学杂志，2019，28（1）：96-100.
［11］　郭清，韩登高.肺痈宁方辅助治疗对肺炎支原体肺炎患儿早期血清中sIL-2R、IL-6与外周血单个核细胞SOCS3表达的影响［J］.中药材，2016，39（7）：1664-1666.

相似文献/References:

[1]王俊芳 秦周顺 崔风杰,中 斌.阿奇霉素治疗急性扁桃体炎60例[J].新乡医学院学报,2002,19(02):126.
[2]张淑利.桉柠蒎肠溶软胶囊联合哌拉西林舒巴坦治疗社区获得性肺炎疗效观察[J].新乡医学院学报,2019,36(8):759.[doi:10.7683/xxyxyxb.2019.08.014]
　ZHANG Shu-li.Effect of limonene and pinene enteric soft capsules combined with piperacillin and sulbactam in the treatment of community acquired pneumonia[J].Journal of Xinxiang Medical University,2019,36(12):759.[doi:10.7683/xxyxyxb.2019.08.014]
[3]秦小菀,高伟霞.阿奇霉素联合甲泼尼龙治疗儿童难治性支气管哮喘疗效观察[J].新乡医学院学报,2019,36(11):1070.[doi:10.7683/xxyxyxb.2019.11.015]
　QIN Xiao-wan,GAO Wei-xia.Effect of azithromycin combined with methylprednisolone in the treatment of refractory bronchial asthma in children[J].Journal of Xinxiang Medical University,2019,36(12):1070.[doi:10.7683/xxyxyxb.2019.11.015]
[4]张桂欣.甲泼尼龙联合阿奇霉素序贯疗法治疗儿童难治性肺炎支原体肺炎疗效观察[J].新乡医学院学报,2020,37(10):964.[doi:10.7683/xxyxyxb.2020.10.014]
　ZHANG Guixin.Effect of methylprednisolone combined with azithromycin sequential therapy in the treatment of refractory mycoplasma pneumoniae pneumonia in children[J].Journal of Xinxiang Medical University,2020,37(12):964.[doi:10.7683/xxyxyxb.2020.10.014]
[5]王大英,陈海琼,曾广萍.阿奇霉素和盐酸丙卡特罗联合治疗对肺炎支原体肺炎患儿免疫功能的影响[J].新乡医学院学报,2021,38(1):073.[doi:10.7683/xxyxyxb.2021.01.016]
　WANG Daying,CHEN Haiqiong,ZENG Guangping.Effect of azithromycin combined with procaterol hydrochloride on the immune function in children with Mycoplasma pneumoniae pneumonia[J].Journal of Xinxiang Medical University,2021,38(12):073.[doi:10.7683/xxyxyxb.2021.01.016]
[6]韩金芬,王会娟,唐晓燕,等.人免疫球蛋白联合阿奇霉素治疗小儿肺炎支原体肺炎合并中枢神经系统损伤疗效观察[J].新乡医学院学报,2022,39(1):034.[doi:10.7683/xxyxyxb.2022.01.008]
　HAN Jinfen,WANG Huijuan,TANG Xiaoyan,et al.Efficacy of human immunoglobulin combined with azithromycin in the treatment of mycoplasma pneumoniae pneumonia complicated with central nervous system involvement in children[J].Journal of Xinxiang Medical University,2022,39(12):034.[doi:10.7683/xxyxyxb.2022.01.008]
[7]韩金芬,柳晓艳,王会娟.阿奇霉素联合小儿肺热咳喘口服液治疗儿童支原体肺炎疗效观察[J].新乡医学院学报,2016,33(6):483.[doi:10.7683/xxyxyxb.2016.06.010]
　HAN Jin-fen,LIU Xiao-yan,WANG Hui-juan.Effect of azithromycin combined with infantile feirekechuan oral solution for mycoplasma pneumonia in children[J].Journal of Xinxiang Medical University,2016,33(12):483.[doi:10.7683/xxyxyxb.2016.06.010]
[8]韩金芬,王文秀,王川云,等.布地奈德联合阿奇霉素治疗儿童肺炎支原体肺炎疗效观察[J].新乡医学院学报,2016,33(8):684.[doi:10.7683/xxyxyxb.2016.08.009]
　HAN Jin-fen,WANG Wen-xiu,WANG Chuan-yun,et al.Curative effect analysis of budesonide combined with azithromycin on mycoplasma pneumoniae pneumonia in children[J].Journal of Xinxiang Medical University,2016,33(12):684.[doi:10.7683/xxyxyxb.2016.08.009]
[9]李天超,展效文,徐亚利,等.阿奇霉素联合甲泼尼龙治疗儿童重症肺炎支原体肺炎疗效观察[J].新乡医学院学报,2023,40(6):543.[doi:10.7683/xxyxyxb.2023.06.008]
　LI Tianchao,ZHAN Xiaowen,XU Yali,et al.Effect of azithromycin combined with methylprednisolone in the treatment of severe Mycoplasma pneumoniae pneumonia in children[J].Journal of Xinxiang Medical University,2023,40(12):543.[doi:10.7683/xxyxyxb.2023.06.008]

更新日期/Last Update: 2020-12-05