长期小剂量红霉素口服治疗慢性支气管炎的疗效观察

长期小剂量红霉素口服治疗慢性支气管炎的疗效观察作者单位：510800 广州市中西医结合医院

通讯作者：邹敏

目的观察长期小剂量应用红霉素类抗生素治疗慢性支气管炎的临床疗效，总结其临床价值。方法选取本院2008年12月～2010年12月140例慢性支气管炎患者，随机分为观察组和对照组各70例，对照组根据患者临床症状予抗感染及止咳、祛痰，解痉、平喘等对症治疗及增强免疫治疗，观察组在对照组的治疗基础上加用小剂量红霉素250 mg/d，长期口服，两组均临床观察1年，对比两组治疗效果，记录相关数据并进行统计学分析。结果观察组显效56例，占80.00%，有效12例，占17.14%，无效2例，占2.86%，急性发作住院1次，总有效率97.14%；对照组显效37例，占52.86%，有效16例，占22.86%，无效17例，占24.29%，急性发作住院6次，总有效率75.71%，两组疗效比较差异有统计学意义（P＜0.05）。观察组发生不良反应3例，占4.29%，对照组发生不良反应2例，占2.86%，两组不良反应发生率比较差异无统计学意义（P>0.05）。结论长期小剂量应用红霉素口服治疗慢性支气管炎的临床疗效明显优于常规抗感染及对症治疗，且明显减少急性发作住院次数，不良反应较少，值得在临床上推广应用。

标签：长期；小剂量红霉素；慢性支气管炎；临床疗效

Long-term low-dose oral erythromycin treatment efficacy of chronic bronchitis ZOU Min, XIONG Cheng-wen, ZHANG Jun, XIAO Hui-zhen, CHEN Ren-shan. Guangzhou Hospital of Integrated Chinese and Western Medicine, Guangzhou 510800, China

【Abstract】Objective To observe the long-term low-dose application of erythromycin antibiotics’s clinical efficacy for the treatment of chronic bronchitis, summarize its clinical value.Methods 140 cases of chronic bronchitis were randomly divided into two groups and 70 cases of the control group, the control group according to clinical symptoms in patients with resistance to infection and cough, phlegm, the solution spasm, asthma and other symptomatic treatment and enhanced the immune treatment, observation group was treated based on the use of low-dose erythromycin 250 mg/d, long-term oral, clinical observation in both groups a year, compared two groups of treatment effect observed, recorded relevant data for statistical analysis.Results The markedly effective in 56 cases, accounting for 80.00%, effective in 12 cases, accounting for 17.14%, 2 cases, accounting for 2.86%, acute hospital 1, the total effective rate 97.14%; the control group that were 37 cases, accounting for 52.86%, effective in 16 cases, accounting for 22.86%, ineffective in 17 cases, accounting for 24.29%, acute hospital six times, the total effective rate 75.71%, difference between the two groups was significant（P＜0.05）, with statistical

significance. Group of adverse reactions observed in 3 cases, accounting for 4.29% in the control group had adverse reactions in 2 cases, accounting for 2.86%, the incidence of adverse reactions compared two groups, no significant difference （P>0.05）.Conclusion Long-term low-dose oral erythromycin treatment of chronic bronchitis application of clinical efficacy is superior to conventional anti-infective and symptomatic treatment, and significantly reduced the number of acute hospital stay, and fewer adverse reactions, it is reasonable in the clinical application.

【Key words】Long-term low-dose erythromyc; Clinical efficacy; Chronic bronchitis

慢性支气管炎（chronic bronchitis）通常因感染或非感染的因素引起支气管、气管的黏膜及周围组织发生慢性非特异性炎症。主要发生黏液分泌增多及支气管腺体增生等病理性改变。临床表现一般为咳痰、咳嗽及气喘等一系列呼吸道症状。发病早期症状较轻，冬季发作频繁，春季过后稍微缓解，发病到了晚期炎症明显加重，四季皆可发病。病情恶化可并发肺源性心脏病及阻塞性肺气肿等，严重地危害着患者的身心健康并影响正常生活及工作［1］。本文通过观察长期小剂量应用红霉素口服治疗慢性支气管炎的临床疗效，总结其临床价值，现报道如下。

1 资料与方法

1.1 一般资料选取本院2008年12月～2010年12月140例慢性支气管炎患者，主要临床表现为咳嗽、咳痰、气喘、气急，呈间歇性发作，夜间及清晨加重，白天症状减轻。其中男75例，女65例，随机分为观察组和对照组各70例。观察组男36例，女34例，平均年龄（56.4±1

2.1）岁，平均病程（1

3.2±8.5）年。对照组男39例，女31例，平均年龄（52.9±13.7）岁，平均病程（12.7±7.7）年。两组年龄、性别、临床表现及病程等各方面比较差异无统计学意义（P>0.05），具有可比性。

1.2 治疗方法

1.2.1 观察组在常规抗感染及止咳、祛痰，解痉、平喘等对症治疗及增强免疫基础上加用小剂量红霉素口服250 mg/d，观察疗效1年。

1.2.2 对照组在常规抗感染及止咳、祛痰，解痉、平喘等对症治疗及增强免疫，观察疗效1年。

1.3 疗效评价标准根据中华医学会呼吸病学分会编制的慢性支气管炎临床诊断及疗效判断标准制定疗效评价标准［2］，显效：局部主要症状、全身症状及体征基本消失。有效：局部症状、全身症状及体征明显改善。无效：局部症状、全身症状及体征均无明显改善，甚至病情加重。

1.4 统计学方法本组数据采用SPSS 13.0统计学软件进行处理，组间比较采用t检验，以P＜0.05为差异有统计学意义。