| Background:Chronic obstructive pulmonary disease is an common disease and frequently-occurring disease in respiratory disease. It has threaten to the human’s health. The Patients with acute exacerbation caused by infection has expectoration difficult and increase airway obstruction, infection is not easy to control. Thus make expectoration easy is an important part of the treatment in AECOPD. Ambroxol hydrochloride is an commonly used expectorant drug in clinical. Ambroxol hydrochloride has only oral and intravenous application. There are repots about the therapy of ambroxol hydrochloride aerosol inhalation inland. But more of these reports are small sample survey, the credibility is not high. Although there are more reports about the therapy of ambroxol hydrochloride aerosol inhalation. But it is still belong to exceed manual medicine. And, in the domestic setting of pharmacopoeia, guidelines, instructions, atomization inhalation were recommended approach, so need to further search for relevant evidence of evidence-based medicine.Objective:ambroxol hydrochloride is an commonly used expectorant drug in clinical. This research adopts the atomization inhalation ammonia bromine cable, intravenous drip ammonia bromine cable, three atomization inhalation saline water treatment for the patients for adjuvant treatment of acute exacerbation of copd. Through the comparison of related indexes and observation ambroxol hydrochloride intravenous drip and atomization inhalation whether the two kinds of method can achieve the same expectorant effect. At the same time, we analyze the two kinds of methods of drug related adverse reactions and to provide basis for clinical rational drug use.Mehthods:There are 90 cases of patients with AECOPD, All patients were given conventional treatment, Including continuous low flow oxygen (1-2 L/min), intravenous antibiotics, spasmolysis to smooth wheezing, at the same time pay attention to nutrition, and the long-term lie in bed, erythrocytosis, or dehydrated patients with low molecular heparin sodium anticoagulation. On this basis in accordance with the principle of random is divided into three groups:ambroxol hydrochloride atomization group (atomization group):normal saline 2 ml+ambroxol hydrochloride 30 mg (4 ml) oxygen atomization inhalation, oxygen flow rate 6-8 L/min,15-20 minutes each time,2 times a day, atomization inhalation 7 consecutive days for one period of treatment, a total of 30 cases,17 cases of male,13 cases of female, aged 46-80, an average of 60.13± 7.15 years old; ambroxol hydrochloride intravenous drip group (intravenous drip group):normal saline 100 ml±ambroxol hydrochloride 30 mg intravenous drip,2 times a day, continuous 7 days of treatment for a period of treatment, a total of 30 cases,16 cases of male,14 cases of female, aged 45 to 78 years old, average 61.03± 6.90 years old; normal saline inhalation group (control group):normal saline 5 ml oxygen atomization inhalation, oxygen flow rate 6-8 L/min,15 to 20 minutes each time,2 times a day,7 days of continuous atomizing inhalation is one period of treatment, a total of 30 cases,19 cases of male,11 cases of female, aged 48 to 80 years old, average 60.77± 6.67 years old;by comparing the three groups of patients with clinical symptoms and signs scores,arterial blood gas analysis, pulmonary function index (FEV1), blood routine changes and hospitalization days, average hospitalization costs before and after the treatment, evaluation of ambroxol hydrochloric in the role of adjuvant therapy, patients with AECOPD and observe the adverse reaction of three groups of patients.Result:1. comparison of the clinical curative effect Between the three groups:atomization, the static drop group 7 days after treatment the clinical symptoms, (cough, phlegm, sputum viscosity, shortness of breath, my lungs then) score, arterial blood gas analysis and lung function index (FEV1), blood routine was significant to improve the, the P<0.05, has significant statistical difference. The control group before and after treatment,the clinical symptoms (cough, phlegm, sputum viscosity) there was no significant improvement, their P>0.05, no significant statistical differences, the clinical symptoms (shortness of breath, lung’s) score, arterial blood gas analysis and lung function index (FEV1), blood routine was significant improvement, the P<0.05, has significant statistical difference.2. Clinical curative effect comparison between the three groups:three groups before and after treatment the clinical signs and symptoms score difference, arterial blood gas analysis, pulmonary function (FEV1), blood routine difference comparison, improved atomization, the inhalation group and Intravenous drip group is better than the control group, with statistical difference, the P< 0.05, between the atomization group and the Intravenous drip group has no obvious difference, no statistically significant, the P>05.3. The comparison between the three groups of average hospitalization cost:the atomization group, the Intravenous drip group reduce the hospitalization cost than the control group,has significantly statistical differences (P< 0.05), but between the atomization group and the Intravenous drip group,the hospitalization cost has not obvious difference (P> 0.05).4. The comparison between the three groups of Hospitalization days:the atomization group and the Intravenous drip group has shorten hospitalization days than the control group, has statistically significant (P< 0.05), but the hospitalization days between the atomization group and the Intravenous drip has not obvious difference (P> 0.05).5. Atomization group, Intravenous drip group, control group adverse reactions of 9 cases,1 cases,4 cases, it has statistically significant, the P<0.05. The atomization group of highest incidence of adverse reactions, followed by the control group, the Intravenous drip group of incidence of adverse reactions to a minimum, the Intravenous drip group of adverse reaction of gastrointestinal symptoms, the atomization group and control group has the main adverse reactions of the dyspnea, nausea, throat discomfort.Conclusion:1.The two delivery ways of ambroxol hydrochloric atomization and the Intravenous drip are significantly improve the clinical symptoms in patients with AECOPD, and curative effect has no obvious difference between two kinds of drug delivery way.1.1 The atomization group and the Intravenous drip group relieve patients with cough, phlegm, sputum viscosity, shortness of breath, and lung’s clinical symptoms and signs is better than that the control group. The is no statistically significant between the two groups.1.2 The atomization group and the Intravenous drip group patients before and after treatment of arterial blood gas analysis of various index difference were higher than control group, prompt that ambroxol hydrochloric can obviously increase the blood oxygen partial pressure, reduce CO2 partial pressure, effectively improve the lack of oxygen and carbon dioxide retention with AECOPD.1.3 The atomization group and the Intravenous drip group patients before and after treatment difference compared with the control group significantly improve lung function, patients with ambroxol hydrochloric cable can effectively improve lung function.1.4 The atomization group and the Intravenous drip patients before and after treatment significantly higher than the control group, routine blood difference tip it have synergy that ambroxol hydrochloric with antibiotics can effective control of infection.2. The atomization group and the Intravenous drip group compared with control group, can reduce the average hospitalization days, reduce the average hospitalization expenses, but there is no difference between the two group.3. The atomization group, control group compared with the static drops group, adverse reactions, strictly grasp the indications should be paid attention to. |
