A Study Of The Lung-protective Effects By Using Different Doses Of Ambroxol To Treat After Pulmonary Lobectomy

Objective:To observe and study the different lung-protective effects of different dose ambroxol on patients with lung cancer after pulmonary lobectomy.and then investigate the significance and mechanism of ambroxol after the operation.Methods:From September2010through December2011, we choose120patients undergoing lobectomy for non-small cell lung cancer from the department of thoracic surgery in Tianjin Chest Hospital.They were randomized in three groups: high dose group, medium dose group and conventional does group.Each group had40patients. On the base of routine treatment,the patients were treated by continuous intravenous pumping with ambroxol of990mg/d for5days in the high dose group,and with ambroxol of300mg/d for5days in the medium dose group,and with ambroxol of90mg/d for5days in the conventional dose group after operation.C-reactive protein (CRP), tumour necrosis factor-a (TNF-a) absolute neutrophil count (ANC),arterial partial pressure of oxygen(PaO2) and oxygen index(PaO2/FiO2) were measured and compared respectively on day1, day3and day5after operation.Results:(1)There were no significant difference among the three groups in the general clinical data(Gender, age, surgical sites, histological types and so on) and the levels of CRP,TNF-a,ANC,PaO2and PaO2/FiO2before the operation.and there were no transit thoracotomy, intraoperative, complications associated with the treatment and post-operative death occurred during the operation.(2)On day1after operation, there were no significant differences of CRP, TNF-a and ANC levels among the three groups (P>0.05).On day3,the CRP, TNF-a and ANC levels of high dose group were lower significantly than the conventional dose group (P<0.05),but there were no differences when it was compared with the medium dose group,and there were no differences between the medium does group and the conventional dose group(P>0.05).And compared with the day l,the levels of high does group decreased significantly(P<0.05),but the levels of medium does group and the conventional group were no significant changes(P>0.05).On day5after operation, the CRP, TNF-a and ANC levels of high dose group were lower significantly than the medium dose group and the conventional group (P<0.05),and compared with the day1and the day3,the levels of all groups dropped evidently (P<0.05).(3)On day1after operation, there were no significant differences of PaO2and PaO2/FiO2among the three groups (P>0.05).On day3,the PaO2and PaO2/FiO2of high dose group were lower significantly than the conventional dose group (P<0.05),but there were no differences when it was compared with the medium dose group,and there were no differences between the medium does group and the conventional dose group(P>0.05).And compared with the day l,the PaO2and PaO2/FiO2of high does group decreased significantly(P<0.05),but the PaO2and PaO2/FiO2of medium does group and the conventional group were no significant changes(P>0.05).On day5after operation, the PaO2and PaO2/FiO2of high dose group were lower significantly than the medium dose group and the conventional group (P<0.05).and compared with the day1and the day3,the PaO2and PaO2/FiO2of all groups dropped evidently (P<0.05).Conclusion:High dose ambroxol can reduce the inflammatory reaction of lungs more rapidly and can promote the recovery if lung function after lobectomy,and has a evident lung-protective effect.It also has a better effect on the rehabilitation of patients with lung cancer after the operation. It is available during clinical practice.