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目的观察抗生素联合糖皮质激素治疗老年慢性支气管炎急性发作的临床疗效。方法选取广州市黄埔区黄埔街社区卫生服务中心2010年1月～2012年1月收治的经确诊的慢性支气管炎急性发作的老年患者108例,用随机分组的方法分为两组,每组54例。对照组给予舒巴坦钠2 g溶于5%葡萄糖注射液100 ml中,静脉滴注,2次/d,7 d为1个疗程;对于病情严重的患者联合应用β-受体激动剂口服;对于伴有喘息的患者给予多巴胺10 ml,溶于5%葡萄糖注射液250 ml中,静脉滴注,1次/d。观察组在对照组的治疗基础上加用糖皮质激素,将5～10 mg地塞米松溶于5%葡萄糖注射液500 ml中,静脉滴注,1次/d,7 d为1个疗程。比较两组患者治疗后的临床疗效、症状消失时间及不良反应发生率。结果观察组有效率为88.89%,对照组为70.37%,观察组患者病情控制效果明显优于对照组,差异有统计学意义(χ2=5.71,P<0.05);观察组的咳嗽、喘息消失时间和用药实施时间明显短于对照组,差异有统计学意义(t=8.438,P<0.05;t=5.611,P<0.05;t=6.974,P<0.05);治疗期间药物不良反应发生率观察组明显低于对照组,差异有统计学意义(χ2=4.70,P<0.05)。结论抗生素联合糖皮质激素治疗老年慢性支气管炎急性发作临床效果显著,且安全性较好。
Objective To observe the clinical efficacy of antibiotics combined with glucocorticoid in the treatment of acute exacerbation of senile chronic bronchitis. Methods A total of 108 elderly patients with acute exacerbation of chronic bronchitis who were admitted from January 2010 to January 2012 in Huangpu Street Community Health Service Center of Guangzhou City were randomly divided into two groups example. Control group was given sulbactam sodium 2 g dissolved in 5% glucose injection 100 ml, intravenous infusion, 2 times / d, 7 d for a course of treatment; for patients with severe disease combined with β-agonist oral ; For patients with wheezing, dopamine 10 ml, dissolved in 5% glucose injection 250 ml, intravenous infusion, 1 / d. The observation group was treated with glucocorticoid on the basis of the control group. 5 ~ 10 mg of dexamethasone was dissolved in 500 ml of 5% dextrose injection, once a day for 7 days for 1 course of treatment. After treatment, the clinical efficacy, the disappearance of symptoms and the incidence of adverse reactions were compared between the two groups. Results The effective rate was 88.89% in the observation group and 70.37% in the control group. The disease control effect in the observation group was significantly better than that in the control group (χ2 = 5.71, P <0.05). The cough, wheezing disappearance time (T = 8.438, P <0.05; t = 5.611, P <0.05; t = 6.974, P <0.05). The incidence of adverse drug reactions during the treatment group was significantly lower than that of the control group Significantly lower than the control group, the difference was statistically significant (χ2 = 4.70, P <0.05). Conclusion The combination of antibiotics and glucocorticoids in the treatment of acute exacerbation of senile chronic bronchitis has obvious clinical effect and good safety.