布地格福联合白葡奈氏菌片维持治疗中重度慢性阻塞性肺疾病稳定期患者的临床观察

李强; 赵凤德; 王瑞瑞; 张婷; 王明明

doi:10.6039/j.issn.1001-0408.2024.19.12

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布地格福联合白葡奈氏菌片维持治疗中重度慢性阻塞性肺疾病稳定期患者的临床观察

药物与临床 | 更新时间：2024-10-11

- 布地格福联合白葡奈氏菌片维持治疗中重度慢性阻塞性肺疾病稳定期患者的临床观察
- Clinical observation of Budigafol combined with Staphylococcus and Neisseria tablets in the maintenance treatment of patients with stable moderate to severe chronic obstructive pulmonary disease
- 中国药房 2024年35卷第19期页码：2391-2396
- 作者机构：
  
  阜阳市第二人民医院呼吸与危重症医学科感染病区，安徽阜阳　236015
- 作者简介：
  
  副主任医师。研究方向：慢性阻塞性肺病诊疗。 E-mail：13956685295@163.com
  主任医师。研究方向：肺癌、慢性阻塞性肺病。 E-mail：13966580920@163.com
- 基金信息：
  
  安徽省临床医学研究转化项目(1924223118)
- DOI：10.6039/j.issn.1001-0408.2024.19.12
  中图分类号： R974;R969.4
- 纸质出版日期：2024-10-15，
  
  收稿日期：2024-02-05，
  
  修回日期：2024-09-08，
- 稿件说明：
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李强,赵凤德,王瑞瑞等.布地格福联合白葡奈氏菌片维持治疗中重度慢性阻塞性肺疾病稳定期患者的临床观察 ^Δ[J].中国药房,2024,35(19):2391-2396.

LI Qiang,ZHAO Fengde,WANG Ruirui,et al.Clinical observation of Budigafol combined with Staphylococcus and Neisseria tablets in the maintenance treatment of patients with stable moderate to severe chronic obstructive pulmonary disease[J].ZHONGGUO YAOFANG,2024,35(19):2391-2396.
李强,赵凤德,王瑞瑞等.布地格福联合白葡奈氏菌片维持治疗中重度慢性阻塞性肺疾病稳定期患者的临床观察 ^Δ[J].中国药房,2024,35(19):2391-2396. DOI： 10.6039/j.issn.1001-0408.2024.19.12.

LI Qiang,ZHAO Fengde,WANG Ruirui,et al.Clinical observation of Budigafol combined with Staphylococcus and Neisseria tablets in the maintenance treatment of patients with stable moderate to severe chronic obstructive pulmonary disease[J].ZHONGGUO YAOFANG,2024,35(19):2391-2396. DOI： 10.6039/j.issn.1001-0408.2024.19.12.

摘要

目的

考察布地格福联合白葡奈氏菌片维持治疗中重度慢性阻塞性肺疾病（COPD）稳定期患者的临床效果。

方法

将2021年10月1日至2023年1月31日于我院呼吸与危重症医学科感染病区就诊的122例中重度COPD稳定期患者，按照随机数字表法分为对照组（

＝61）和观察组（

＝61）。对照组患者单用布地格福吸入气雾剂（每次2揿，每日2次），观察组患者在对照组用药的基础上加用白葡奈氏菌片（每次1.2 mg，每日3次），两组疗程均为3个月。比较两组患者治疗前后的生活质量、运动耐量、肺功能、炎症指标、免疫功能，以及COPD急性发作次数和不良反应发生情况。

结果

对照组和观察组分别脱落12、9例患者。治疗后，两组患者的6分钟步行距离均较治疗前显著延长（

＜0.05），COPD评估测试问卷评分、St George’s呼吸问卷评分、残气量与肺总量的比值、呼出气一氧化氮浓度、血清C反应蛋白及白细胞介素6水平均较治疗前显著降低（

＜0.05），第1秒用力呼气容积（FEV1）、FEV1与用力肺活量的比值、肺一氧化碳弥散量实测值占预计值的百分比以及FEV

实测值占预计值的百分比均较治疗前显著升高（

＜0.05），且观察组上述指标的改善程度均显著优于对照组（

＜0.05）。与治疗前比较，治疗后对照组患者的免疫功能指标及观察组患者的血清免疫球蛋白A（IgA）、IgM水平差异均无统计学意义（

＞0.05）；观察组患者的CD3

、CD4

、B淋巴细胞、自然杀伤细胞的百分比和CD4

/CD8

以及IgG水平均显著升高（

＜0.05），CD8

细胞百分比显著降低（

＜0.05），且观察组的改善程度均显著优于对照组（

＜0.05）。两组患者在随访期间的COPD急性发作次数和治疗期间的不良反应发生率比较，差异均无统计学意义（

＞0.05）。

结论

布地格福联合白葡奈氏菌片能有效改善中重度COPD稳定期患者的免疫功能，降低其炎症水平，提升其运动耐量和生活质量，且用药安全性较好。

Abstract

OBJECTIVE

To investigate the clinical effect of Budigafol combined with

Staphylococcus

and

neisseria

tablets in maintenance treatment of patients with stable moderate to severe chronic obstructive pulmonary disease （COPD）.

METHODS

A total of 122 patients with stable moderate to severe COPD who were admitted to the infections diseases ward of the department of respiratory and critical care medicine in our hospital from October 1， 2021 to January 31， 2023 were divided into control group （

＝61） and observation group （

＝61） according to the random number table method. Patients in the control group were treated with Budigafol inhalation aerosol alone （2 presses each time， twice a day）， and patients in the observation group were treated with

Staphylococcus

and

neisseria

tablets （1.2 mg each time， 3 times a day） on the basis of the control group. The treatment course of both groups was 3 months. The quality of life， exercise tolerance， lung function， inflammatory indexes， immune function， as well as the number of acute attacks of COPD and the occurrence of adverse reactions were compared between the two groups before and after treatment.

RESULTS

Control group and observation group shed 12 and 9 patients， respectively. After treatment， the 6 minute walking distance of the two groups of patients was significantly prolonged compared with that before treatment （

＜0.05）. The COPD assessment test questionnaire score， St George’s respiratory qu

estionnaire score， the ratio of residual volume to total lung capacity， the fractional exhaled nitric oxide， the serum levels of C-reactive protein and interleukin-6 were significantly decreased compared with those before treatment （

＜0.05）. The forced expiratory volume in one second （FEV

）， the ratio of FEV

to forced vital capacity， the percentage of the measured value of carbon monoxide diffusion capacity to the predicted value， and the percentage of the measured value of FEV

to the predicted value were significantly increased compared with those before treatment （

＜0.05）. The improvement of the above indicators in the observation group was significantly better than that in the control group （

＜0.05）. Compared with before treatment， there was no statistical significance in the immune function indexes of the control group or the serum levels of immunoglobulin A （IgA） and IgM in the observation group after treatment （

＞0.05）. The percentages of CD3

， CD4

， B lymphocytes and natural killer cells， the levels of CD4

/CD8

and IgG were significantly increased in the observation group （

＜0.05）， the percentage of CD8

cells was significantly decreased （

＜0.05）， and the improvement degree of the observation group was significantly better than that of the control group （

＜0.05）. There was no significant difference in the number of acute exacerbations of COPD during the follow-up period and the incidence of adverse events during treatment between the two groups （

＞0.05）.

CONCLUSIONS

Budigafol combined with

Staphylococcus

and

neisseria

tablets can effectively improve the immune function of patients with stable moderate to severe COPD， further reduce the level of inflammation， and improve their exercise tolerance and their quality of life

with good safety.

关键词

布地格福白葡奈氏菌片慢性阻塞性肺疾病生活质量6分钟步行距离肺功能炎症免疫功能

Keywords

Staphylococcus and neisseria tabletschronic obstructive pulmonary diseasequality of life6 minute walking distancelung functioninflammatoryimmune function

references

KAHNERT K，JÖRRES R A，BEHR J，et al. The diagnosis and treatment of COPD and its comorbidities[J]. Dtsch Arztebl Int，2023，120（25）：434-444.

DUFFY S P，CRINER G J. Chronic obstructive pulmonary disease：evaluation and management[J]. Med Clin North Am，2019，103（3）：453-461.

GUO P，LI R，PIAO T H，et al. Pathological mechanism and targeted drugs of COPD[J]. Int J Chron Obstruct Pulmon Dis，2022，17：1565-1575.

姜洪娟，张国英. 白葡奈氏菌片对咳嗽变异性哮喘气道阻力及气道反应性的影响[J]. 中国卫生标准管理，2023，14（4）：118-122.

JIANG H J，ZHANG G Y. Influence of Staphylococcus and Neisseria tablet for airway resistance and airway responsiveness of patients with cough variant asthma[J]. China Health Stand Manag，2023，14（4）：118-122.

陈亚红. 2021年GOLD慢性阻塞性肺疾病诊断、治疗及预防全球策略解读[EB/OL]. （2020-12-18）[2024-07-06]. https：//mp.weixin.qq.com/s?_biz=MzUyMzE3NDA4OQ==&mid=2247485464&idx=1&sn=7740b2ac08aa66df21529-815f10758d0&chksm=f9c1e1beceb668a8a8f864f56f449-beb5c0174ea0c26c3cb4c332260edb6fe9b7b32d07b1ffa&s-cene=27https://mp.weixin.qq.com/s?_biz=MzUyMzE3NDA4OQ==&mid=2247485464&idx=1&sn=7740b2ac08aa66df21529-815f10758d0&chksm=f9c1e1beceb668a8a8f864f56f449-beb5c0174ea0c26c3cb4c332260edb6fe9b7b32d07b1ffa&s-cene=27.

CHEN Y H. Interpretation of global strategy for the diagnosis，management，and prevention of GOLD chronic obstructive pulmonary disease 2021 report[EB/OL]. （2020-12-18）[2024-07-06]. https：//mp.weixin.qq.com/s?_biz=MzUyMzE3NDA4OQ==&mid=2247485464&idx=1&sn= 7740b2ac08aa66df21529815f10758d0&chksm=f9c1e1-beceb668a8a8f864f56f449beb5c0174ea0c26c3cb4c3322-60edb6fe9b7b32d07b1ffa&scene=27https://mp.weixin.qq.com/s?_biz=MzUyMzE3NDA4OQ==&mid=2247485464&idx=1&sn=7740b2ac08aa66df21529815f10758d0&chksm=f9c1e1-beceb668a8a8f864f56f449beb5c0174ea0c26c3cb4c3322-60edb6fe9b7b32d07b1ffa&scene=27.

HANSEN W A H，SCHLÜNSSEN V，JØRS E，et al. Precision and accuracy of FEV1 measurements from the vitalograph COPD-6 mini-spirometer in a healthy Ugandan population[J]. PLoS One，2021，16（6）：e0253319.

阎聪侠，李宝平，沈福海，等. 心肺运动试验与6分钟步行试验在尘肺病患者中的相关性研究[J]. 医学理论与实践，2024，37（5）：829-831.

YAN C X，LI B P，SHEN F H，et al. Correlation between cardiopulmonary exercise test and 6-minute walking test in pneumoconiosis patients[J]. J Med Theory Pract，2024，37（5）：829-831.

高博，郭军，李娜，等. 慢性阻塞性肺疾病评估测试问卷对不同年龄稳定期慢性阻塞性肺疾病患者的病情评估[J]. 北京医学，2022，44（6）：485-489.

GAO B，GUO J，LI N，et al. Evaluation of chronic obstructive pulmonary disease assessment test questionnaire in stable chronic obstructive pulmonary disease patients of different ages[J]. Beijing Med J，2022，44（6）：485-489.

孟现玲，何玉廷，毛若琳，等. 圣乔治呼吸问卷、CAT及mMRC评分在慢性阻塞性肺病中的应用[J]. 复旦学报（医学版），2022，49（6）：862-868，876.

MENG X L，HE Y T，MAO R L，et al. Application of St George’s respiratory questionnaire，CAT and mMRC in chronic obstructive pulmonary disease[J]. Fudan Univ J Med Sci，2022，49（6）：862-868，876.

孙印，何士杰，景卫革，等. 慢性阻塞性肺疾病免疫发病机制研究进展[J]. 医学综述，2019，25（13）：2574-2578.

SUN Y，HE S J，JING W G，et al. Advances in research on immune pathogenesis of chronic obstructive pulmonary disease[J]. Med Recapitul，2019，25（13）：2574-2578.

党辉，陈军，杨菲菲，等. ACBT联合HRR对稳定期COPD肺功能及运动能力的影响[J]. 中华肺部疾病杂志（电子版），2023，16（5）：667-669[2024-01-04]. https：//zhfbjbzz.cma-cmc.com.cn/CN/10.3877/cma.j.issn.1674-6902.2023.05.014https://zhfbjbzz.cma-cmc.com.cn/CN/10.3877/cma.j.issn.1674-6902.2023.05.014. DOI：10.3877/cma.j.issn.1674-6902.2023.05.014http://dx.doi.org/10.3877/cma.j.issn.1674-6902.2023.05.014.

DANG H，CHEN J，YANG F F，et al. Effect of active respiratory circulation technique combined with HRR rehabilitation exercise on pulmonary function and exercise capacity in patients with stable COPD[J]. Chin J Lung Dis Electron Ed，2023，16（5）：667-669[2024-01-04]. https：//zhfbjbzz.cma-cmc.com.cn/CN/10.3877/cma.j.issn.1674-6902.2023.05.014https://zhfbjbzz.cma-cmc.com.cn/CN/10.3877/cma.j.issn.1674-6902.2023.05.014. DOI：10.3877/cma.j.issn.1674-6902.2023.05.014http://dx.doi.org/10.3877/cma.j.issn.1674-6902.2023.05.014.

中华医学会呼吸病学分会慢性阻塞性肺疾病学组，中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会. 慢性阻塞性肺疾病诊治指南：2021年修订版[J]. 中华结核和呼吸杂志，2021，44（3）：170-205.

Chronic Obstructive Pulmonary Disease Group of the Chinese Thoracic Society，Chronic Obstructive Pulmonary Disease Working Committee of the Chest Physicians Branch of the Chinese Medical Doctor Association. Guidelines for the diagnosis and management of chronic obstructive pulmonary disease：revised version 2021[J]. Chin J Tuberc Respir Dis，2021，44（3）：170-205.

娄红超，谢汉华，卢乃棉. 泛福舒对老年COPD患者的肺功能和细胞免疫力的分析[J]. 中华肺部疾病杂志（电子版），2021，14（3）：315-317[2024-01-04]. https：//zhfbjbzz.cma-cmc.com.cn/CN/10.3877/cma.j.issn.1674-6902.2021.03.012https://zhfbjbzz.cma-cmc.com.cn/CN/10.3877/cma.j.issn.1674-6902.2021.03.012. DOI：10.3877/cma.j.issn.1674-6902.2021.03.012http://dx.doi.org/10.3877/cma.j.issn.1674-6902.2021.03.012.

LOU H C，XIE H H，LU N M. Analysis of pulmonary function and the cellular immunity in elderly patients with COPD[J]. Chin J Lung Dis Electron Ed，2021，14（3）：315-317[2024-01-04]. https：//zhfbjbzz.cma-cmc.com.cn/CN/10.3877/cma.j.issn.1674-6902.2021.03.012https://zhfbjbzz.cma-cmc.com.cn/CN/10.3877/cma.j.issn.1674-6902.2021.03.012. DOI：10.3877/cma.j.issn.1674-6902.2021.03.012http://dx.doi.org/10.3877/cma.j.issn.1674-6902.2021.03.012.

韩淑贞，董磊，李登峰. 白葡奈氏菌片联合布地奈德雾化吸入治疗小儿急性肺炎的临床疗效[J]. 新疆医科大学学报，2024，47（3）：355-359.

HAN S Z，DONG L，LI D F. Clinical effect of Staphylococcus and Neisseria tablets combined with budesonide aerosol inhalation in treatment of acute pneumonia （AP） in children[J]. J Xinjiang Med Univ，2024，47（3）：355-359.

范存永，宋志明，张涵. 白葡奈氏菌片与新活素联合治疗慢性肺源性心脏病急性发作的疗效及安全性[J]. 海南医学，2023，34（17）：2454-2459.

FAN C Y，SONG Z M，ZHANG H. Efficacy and safety of the combination of Staphylococcus and Neisseria tablets and natriuretic peptide in the treatment of acute exacerbation of chronic pulmonary heart disease[J]. Hainan Med J，2023，34（17）：2454-2459.

KEERATICHANANONT W，KAENMUANG P，GEATER S L，et al. Correlation of fractional exhaled nitric oxide （FeNO） and clinical outcomes in patients with chronic obstructive pulmonary disease：a prospective cohort study[J]. Respir Med，2024，229：107682.

ELLINGSEN J，JANSON C，BRÖMS K，et al. CRP，fibrinogen，white blood cells，and blood cell indices as prognostic biomarkers of future COPD exacerbation frequency：the TIE cohort study[J]. J Clin Med，2024，13（13）：3855.

JUNG A L，HAN M，GRISS K，et al. Novel protein biomarkers for pneumonia and acute exacerbations in COPD：a pilot study[J]. Front Med （Lausanne），2023，10：1180746.

RAN B，QIN J Y，WU Y Q，et al. Causal role of immune cells in chronic obstructive pulmonary disease：Mendelian randomization study[J]. Expert Rev Clin Immunol，2024，20（4）：413-421.

KHERADMAND F，ZHANG Y，CORRY D B. Contribution of adaptive immunity to human COPD and experimental models of emphysema[J]. Physiol Rev，2023，103（2）：1059-1093.

UNNINAYAR D，SHEA B，CAMERON D W，et al. Le- vels of immunoglobulin isotypes in serum and respiratory samples of patients with chronic obstructive pulmonary disease：protocol for a systematic review and meta-analysis[J]. BMJ Open，2023，13（2）：e064307.

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