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N 乙酰半胱氨酸联合布地奈德 / 福莫特罗治疗慢性阻塞性肺病合并支气管扩张的疗效观察

Efficacy of N-Acetyl-L-cysteine and Budesonide/ Formoterol Combination for the Treatment of Chinese Patients with Bronchiectasis and Chronic Obstructive Pulmonary Disease Overlab

临床医学前沿 / 2020,2(2)：27-36 / 2020-05-07 2109 3674

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• 作者： 曾德文*      李冬梅      何顺平      吴伟英      袁会清      刘志锋      黄江     
• 单位：

  韶关市第一人民医院，韶关

• 关键词： 布地奈德 / 福莫特罗；慢性阻塞性肺病；支气管扩张；N- 乙酰半胱氨酸
• Chronic obstructive pulmonary disease; Bronchiectasis; over; Budesonide/ formoterol; N-Acetyl-L-cysteine
• 摘要： 目的：本研究评估N-乙酰半胱氨酸联合布地奈德/福莫特罗在治疗慢性阻塞性肺病合并支气管扩张的临床疗效和安全性。方法：在 2018 年 6月至 2019 年 6月期间，纳入了 118 名符合条件的中国慢性阻塞性肺病合并支气管扩张患者，治疗时间为12周。其中，干预组 60 名患者接受N-乙酰半胱氨酸联合布地奈德/福莫特罗治疗，而对照组 58 名患者单独接受布地奈德/福莫特罗治疗。疗效观察指标包括运动时呼吸困难的严重程度（DOE）、肺功能、生活质量评价和不良反应。运动时呼吸困难的严重程度使用6分钟步行试验（6MWT）进行测量，肺功能为 1 秒内用力呼气量，George呼吸问卷测量生活质量并记录治疗过程中的所有不良反应。结果：经过12周的治疗后，两组临床有效率达90%以上，两组没有显著差异，但联合用药的干预组在临床显效率显著较高（p <0.01）。与治疗前基准相比，两组患者的症状和生活质量有明显改善。其中，联合用药的干预组在 DOE（p <0.01）、肺功能（p <0.01）和生活质量（p <0.01）方面表现出更好的治疗效果。此外，两组的不良反应均在可接受范围，没有出现患者死亡。结论：N-乙酰半胱氨酸联合布地奈德/福莫特罗可能为慢性阻塞性肺病合并支气管扩张患者提供安全且更为有效的治疗。
• Objective: The efficacy and safety of N-Acetyl-L-cysteine and budesonide/ formoterol (B/F) combination in the management of bronchiectasis and chronic obstructive pulmonary disease (COPD) overlab (BCO) in Chinese patients were investigated in this study. Methods: Between June2018 and June2019,118 patients with BCO were included and divided into an intervention group and a control group, who were treated for12 weeks. Sixty patients in the intervention group underwent N-Acetyl-L-cysteine and B/F combination, while58 patients in the control group received budesonide/formoterol alone. Therapeutic effect indexes included severity of dyspnea on exertion (DOE), lung function measured by the forced expiratory volume in1 second (FEV1), quality of life measured by the St. George’s Respiratory Questionnaire (SGRQ), and adverse events during treatment. All outcomes were measured at the end of12-week treatment. Results: The clinical effective rate of the two groups was more than90% without significant difference, while the intervention group showed a significantly higher apparent efficiency rate (p<0.01).The intervention group showed greater efficacy in DOE (p<0.01), lung function (p<0.01), and quality of life (p<0.01), compared with control group at the end of12-week treatment. In addition, adverse events in both groups were similar and tolerable. Conclusion: The results suggest that N-Acetyl-L-cysteine and B/F combination or B/F was effective, while the N-Acetyl-L-cysteine and B/F combination shows more effective for patients with BCO.
• DOI： https://doi.org/10.35534/fcm.0202006
• 引用： 曾德文，李冬梅，何顺平，等．N 乙酰半胱氨酸联合布地奈德 / 福莫特罗治疗慢性阻塞性肺病合并支气管扩张的疗效观察［J］．临床医学前沿，2020，2（2）：27-36．
  https://doi.org/10.35534/fcm.0202006