Objective To investigate the effects of ambroxol on pulmonary function and inflammatory mediators in adult severe pneumonia.Methods Seventy-two cases of patients with severe pneumonia were selected,which were treated in hospital from March 2014 to March 2017,and they were divided into the observation group(36 cases)and control group (36 cases).The patients of control group were treated with conventional treatment.Based on control group,the patients of observation group were treated with ambroxol hydrochloride (15 mg,50 ml 5％ glucose injection,intravenous infusion,2 times / d).The patients of 2 groups were all treated for 2 weeks.Compare the clinical symptoms improvement time,safety and changes of lung function index,hs CRP,TNF-α,IL-6,IL-8,PCT levels of two groups.Results After the appropriate treatment,the total effective rate of the observation group was 94.4％,which was significantly higher than 77.8％ of the control group (x2 =4.181;P =0.041);The times of fever,cough,shortness of breath and lung wet rales improvement in the observation group were significantly lower than those in the control group(t =.4.122,2.911,2.720,1.884;P =0.000,P =0.002,P =0.004,P =0.032);The FVC,FEV1,FEV1 ％,MMF,PEF levels in the observation group were significantly higher than those in the control group(t =2.556,6.843,3.758,5.653,8.051;P =0.006,P =0.000,P =0.000,P =0.000,P =0.000);The hs CRP,TNF-α,IL-6,IL-8,PCT levels in the observation group were significantly lower than those in the control group(t =4.422,t =4.231,t =4.830,t =35.182,t =15.570;P =0.000,P =0.000,P =0.000,P =0.000,P =0.000);There were no significant changes in blood,urine,liver and kidney function of 2 groups during treatment,and also no significant adverse reactions occurred.Conclusion Ambroxol in treatment of adult severe pneumonia can obtain the exact effect,significantly improve clinical symptoms and lung function,reduce inflammatory response,and also has high safety,which makes it worthy of clinical promotion.%目的 观察氨溴索辅助治疗成人重症肺炎疗效及其对肺功能指标、炎性因子的影响.方法 选择2014年3月-2017年3月陕西省宝鸡市人民医院呼吸内科收治的重症肺炎患者72例作为研究对象,随机数字表法分为观察组36例和对照组36例.对照组给予常规治疗,观察组在对照组基础上联合应用盐酸氨溴索15 mg(溶入5％葡萄糖注射液50 ml)静脉滴注,每日2次.2组患者均连续治疗2周.比较2组患者临床疗效、症状改善时间,治疗前后肺功能指标(FVC、FEV1、FEV1％、MMF、PEF)、炎性因子(hs-CRP、TNF-α、IL-6、IL-8、PCT)水平变化,并评价2组不良反应发生情况.结果 观察组总有效率94.4％显著高于对照组77.8％(x2 =4.181,P=0.041);观察组在发热、咳嗽、气促、肺部湿啰音等临床症状改善时间明显低于对照组(t =4.122、2.911、2.720、1.884,P＜0.05或0.01);观察组治疗后血清FVC、FEV1、FEV1％、MMF、PEF显著高于对照组(t=2.556、6.843、3.758、5.653、8.051,P均＜0.01);观察组治疗后血清hs-CRP、TNF-α、IL-6、IL-8、PCT亦显著低于对照组(=4.422、4.231、4.830、35.182、15.570,P均=0.000);2组患者治疗期间发生血、尿常规,肝肾功能均无明显变化.结论 氨溴索应用于成人重症肺炎疗效确切,可有效改善临床症状,提高肺功能,减轻炎性反应,使用安全性高,值得临床推广.
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