| Objectives This study aimed to observe the efficacy of low-dose azithromycin combined with bacterial lysate in the treatment of bronchiectasis,and to explore the optimal combination of drugs for the treatment of bronchiectasis.Methods A total of 122 patients with bronchiectasis who were relieved after hospitalization in the Department of Respiratory Medicine,Affiliated Hospital of North China University of Technology,from December 2016 to June 2018,were selected as subjects.They were randomly divided into four groups:control group,azithromycin group,bacterial lysate group,combined group.The control group was given western medicine for routine antiasthmatic and expectorant.The azithromycin group was given 250 mg of azithromycin tablets on a routine basis,once a day.The bacterial lysate group was given 7mg of bacterial lysate on a routine treatment basis,orally once a day for 10 days and discontinued for 20 days.The combined group was given azithromycin tablets 250 mg once daily for routine treatment,and 7 mg of bacterial lysate was administered at the same time,once a day orally,for 10 consecutive days per month,and for 20 days.The treatment time of each group was 6 months.Collect basic information of all subjects,including age,height,weight,duration and smoking status,monitor cough score before and after 6 months of treatment,24-hour cough,SGRQ score,FEV1/FVC,FEV1%pred,ESR,hs-CRP,complement C3,C4 and mmunoglobulins(IgM,IgG,IgA,IgE),monitor the number of acute attacks during the treatment period,the number of days of acute attacks,and adverse reactions.Statistical analysis was performed using SPSS 20.0.P<0.05 was considered statistically significant,and P<0.01 was considered to be significant.Results 1 There were no statistical differences in age,height,weight,duration of disease and smoking among the four groups(P>0.05).2 There were no significant differences in cough symptom scores in the four groups before treatment(P>0.05).After 6 months of treatment,compared with the control group,the cough symptom score amount in the combination group,the Azithromycin group,and the bacterial lysate group were significantly decreased(P<0.05).but,the cough symptom score decreased in the combined group were more significant than those in the Azithromycin group and the bacterial lysate group(P<0.05).At the same time,there was no significant difference between the Azithromycin group and the bacterial lysate group(P>0.05).3 There were no significant differences in 24-hour cough in the four groups before treatment(P>0.05).After 6 months of treatment,compared with the control group,the 24-hour cough amount in the combination group,the Azithromycin group,and the bacterial lysate group were significantly decreased(P<0.05).but,the 24-hour cough decreased in the combined group were more significant than those in the Azithromycin group and the bacterial lysate group(P<0.05).At the same time,there was no significant difference between the Azithromycin group and the bacterial lysate group(P>0.05).4 There were no significant differences in SGRQ scores between the four groups before treatment(P>0.05).Compared with the control group,the SGRQ scores of the combined group,the Azithromycin group and the bacterial lysate group were significantly lower after 6 months of treatment,but the reduction of the SGRQ score of the combined group was more significant than that of the Azithromycin group and the bacterial lysate group(P<0.05).At the same time,there was no significant difference between the Azithromycin group and the bacterial lysate group(P>0.05).5 There were no significant differences in FEV1%pred and FEV1/FVC levels between the four groups before treatment(P>0.05).Compared with the control group,theFEV1%pred and FEV1/FVC levels in the combination group,the azithromycin group and the bacterial lysate group increased significantly after 6 months of treatment(P<0.05),but the increase of FEV1%pred and FEV1/FVC levels in the combined group was more significant than that in the azithromycin group and the bacterial lysate group(P<0.05).At the same time,there was no significant difference between the Azithromycin group and the bacterial lysate group.6 There were no significant differences in ESR and hs-CRP levels between the four groups before treatment(P>0.05).Compared with the control group,the ESR and hs-CRP data levels were lower in the combination group and the azithromycin group(P<0.05),but there was no significant difference between the bacterial lysate group and the control group(P>0.05).Further comparison between the two groups showed that the ESR and hs-CRP levels in the combined group were significantly lower than those in the azithromycin group(P<0.05).7 There were no significant differences in the levels of complement C3 and C4 between the four groups before treatment(P>0.05).Compared with the control group,the combined group and bacterial lysate could increase the levels of complement C3 and C4(P<0.05),but there was no significant difference between the azithromycin group and the control group(P>0.05).Further comparison between the two groups showed that the level of complement C3 and C4 in the combined group was significantly higher than that in the bacterial lysate group(P<0.05).8 There were no significant differences in IgM,IgG,IgA and IgE between the four groups before treatment(P>0.05).Compared with the control group,the immunoglobulin IgM,IgG and IgA in the combination group,the azithromycin group and the bacterial lysate group all increased significantly after 6 months of treatment,and all IgE decreased significantly(P<0.05),but the combined group was in IgM,IgG,The increase of IgA and the decrease of IgE were more significant than those of the azithromycin group and the bacterial lysate group(P<0.05).There was no significant difference between the azithromycin group and the bacterial lysate group(P>0.05).9 Compared with the control group,the number of days of acute attack and the number of days of persistence in the combination group,azithromycin group and bacterial lysate group decreased significantly after 6 months of treatment(P<0.05).However,the decrease in the number of days and duration of acute attack was more significant in the combination group than in the azithromycin group and the bacterial lysate group(P<0.05),but there was no significant difference between the azithromycin group and the bacterial lysate group(P>0.05).10 There was no significant difference in the incidence of adverse reactions during the treatment group(P=0.943).Conclusions Low-dose azithromycin combined with bacterial lysate in the treatment of bronchiectasis can alleviate symptoms of cough and dyspnea,improve lung function,reduce the number of episodes and duration,increase ESR,hs-CRP levels,and regulate the body's immunoglobulin level.Better than low-dose azithromycin or bacterial lysate alone.Figure0;Table12;Reference 127... |
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