气道廓清术联合小剂量地红霉素及清肺汤对稳定期支气管扩张的疗效  

Study on the Efficacy of Airway Clearance,Low-dose Dierythromycin and Lung Clearing Soup on Stable Bronchiectasis

作　　者：殷华序 佟青 张莉 Yin Huaxu;Tong Qing;Zhang Li(The Third Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)

机构地区：[1]锦州医科大学附属第三医院,辽宁锦州121000

出　　处：《锦州医科大学学报》2023年第6期43-47,共5页Journal of Jinzhou Medical University

基　　金：辽宁省自然科学基金资助项目,项目编号:20170540387。

摘　　要：目的探究气道廓清术、小剂量地红霉素联合清肺汤对稳定期支气管扩张患者的临床症状、肺功能及生活质量的疗效。方法将符合纳入标准的113例稳定期支气管扩张的患者按随机数字法分为对照组(气道廓清术联合小剂量地红霉素)和观察组(气道廓清术联合小剂量地红霉素+清肺汤),对照组(n=62例)规律口服小剂量地红霉素和应用气道廓清术;观察组(n=51例)在对照组的基础上给予清肺汤治疗。治疗周期为12 w。评估两组患者治疗前、后的临床症状(咳嗽及咳痰评分)、肺功能[第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、用力肺活量(forced vital capacity,FVC)、呼吸流量峰值(peak expiratory flow rate,PEF)、25%肺活量时的最大呼气流速占预计值百分比(maximal expiratory flow in 25%vital capacity of the predicted value,MEF25%pred)、50%肺活量时的最大呼气流速占预计值百分比(maximal expiratory flow in 50%vital capacity of the predicted value,MEF50%pred)、75%肺活量时的最大呼气流速占预计值百分比(maximal expiratory flow in 75%vital capacity of the predicted value,MEF75%pred)]及生活质量(the MOS item short from health survey,SF-36评分)的改变。结果无论是对照组还是观察组,治疗后患者的咳嗽及咳痰评分、FEV1、FVC、PEF、SF-36评分较治疗前均得到改善(P<0.05),并且观察组各指标的改善情况明显优于对照组(P<0.05),但治疗前、后患者的MEF25%pred、MEF50%pred、MEF75%pred无明显改善,差异无统计学意义(P>0.05)。结论气道廓清术、小剂量地红霉素联合清肺汤不仅能改善稳定期支气管扩张患者的咳嗽、咳痰症状,而且能改善患者的FEV1、FVC、PEF,并能从各方面提高患者的生活质量。Objective To explore the efficacy of airway clearance,low-dose dierythromycin and lung clearing soup on clinical symptoms,lung function and quality of life in patients with stable bronchiectasis.Methods 113 patients with stable bronchiectasis who met the inclusion criteria were divided into control group(airway clearance+low-dose dierythromycin group)and observation group(airway clearance+low-dose dierythromycin+lung clearing soup group).The control group(n=62 cases)was administered orally with low dose of dierythromycin and airway clearance;observation group(n=51 cases)was treated with lung clearing soup on the basis of control group.The treatment period was 12 weeks.Clinical symptoms(cough and sputum scores),lung function[forced expiratory volume in one second,(FEV1),forced vital capacity(FVC),peak expiratory flow rate(PEF),maximal expiratory flow in 25%vital capacity of the predicted value(MEF25%pred),maximal expiratory flow in 50%vital capacity of the predicted value(MEF50%pred),and maximal expiratory flow in 75%vital capacity of the predicted value(MEF75%pred)]and quality of life(the MOS item short from health survey,SF-36 score)were assessed before and after treatment in both groups.Results In both the control group and the observation group,the scores of cough and expectoration,FEV1,FVC,PEF and SF-36 of patients after treatment were improved compared with those before treatment(P<0.05),and the improvement of various indicators in the observation group was significantly better than that in the control group(P<0.05).However,MEF25%pred,MEF50%pred and MEF75%pred of patients before and after treatment had no significant improvement,with no statistical significance(P>0.05).Conclusion Airway clearance,low-dose of dierythromycin combined with lung clearing soup can not only improve the symptoms of cough and expectoration,but also improve the FEV1,FVC and PEF of patients,and improve the quality of life of patients from all aspects.

关 键 词：支气管扩张 气道廓清术 地红霉素 清肺汤 肺功能 

分 类 号：R562.22[医药卫生—呼吸系统]