Efficacy of N-acetylcysteine Combined with HRZE Regimen in the Treatment of Patients with Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Tuberculosis

Abstract

Abstract: Objective To investigate and analysis the efficacy of N-acetylcysteine combined with HRZE regimen in the treatment of patients with chronic obstructive pulmonary disease complicated with pulmonary tuberculosis. Methods Eighty-eight patients with chronic obstructive pulmonary disease and pulmonary tuberculosis who were diagnosed and treated in Guiyang Public Health Treatment Center from September 2018 to January 2022 were selected as the research subjects, and the patients were divided into N-acetylcysteine group and control group according to random number table. There were 44 cases in each group. The control group were treated with HRZE regimen, and the N-acetylcysteine group were treated with N-acetylcysteine based on the treatment of the control group. Both groups were treated for 3 months. The total effective rate, pulmonary function indicators [forced vital capacity (FVC), 1-second forced expiratory volume (FEV₁)], serum interleukin-6 (IL-6), and incidence of adverse reactions were compared between the two groups. Results The total effective rate in two groups during treatment was not significantly difference(P>0.05). There was no significant difference in FVC and FEV₁ between the two groups before treatment (P>0.05), were higher than those before treatment (P<0.05), and the N-acetylcysteine group was significantly higher than the control group (P<0.05). There was no significant difference in serum IL-6 content between the two groups before treatment (P>0.05). The serum IL-6 content in the two groups after treatment was significantly lower than before treatment (P<0.05). Acetylcysteine group was also significantly lower than the control group (P<0.05). The incidence of adverse reactions in two groups during treatment was not significantly difference(P>0.05). Conclusion N-acetylcysteine combined with HRZE regimen in the treatment of chronic obstructive pulmonary disease complicated with pulmonary tuberculosis can can effectively inhibit the expression of serum inflammatory factors, improve the patient's pulmonary function, and improve the therapeutic effect, increase the occurrence of adverse reactions.

Key words: N-acetylcysteine, HRZE regimen, chronic obstructive pulmonary disease, inflammatory factors, pulmonary function, adverse reactions

CLC Number:

R563.9

LI Xiao-ying, CHEN Xuan. Efficacy of N-acetylcysteine Combined with HRZE Regimen in the Treatment of Patients with Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Tuberculosis[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(18): 15-18.

References

[1] 刘祖洪,谭运宝,郭海健,等.无创呼吸机通气联合乙酰半胱氨酸吸入治疗慢性阻塞性肺疾病伴Ⅱ型呼吸衰竭的效果[J].实用临床医学,2020,21(5):19-22,34.
[2] 李中祎,张治,曹路,等.N-乙酰半胱氨酸联合无创正压通气治疗COPD急性发作的临床分析[J].中华肺部疾病杂志(电子版),2020, 13(2):188-192.
[3] 杨欣荣,陶丁霞,刘红梅.BiPAP联合N-乙酰半胱氨酸对AECOPD合并呼吸衰竭患者氧化应激反应的影响[J].贵州医药,2020,44(8):1209-1210.
[4] 谭远容,徐红英,夏薇.N-乙酰半胱氨酸联合大容量肺叶灌洗术对煤工尘肺合并慢性阻塞性肺疾病患者的疗效观察[J].内科急危重症杂志,2020,26(5):376-379.
[5] Safe I P,Lacerda MVG,Printes V S,et al.Safety and efficacy of N-acetylcysteine in hospitalized patients with HIV-associated tuberculosis: An open-label,randomized,phase II trial (RIPENACTB Study)[J].PLoS One,2020,15(6):e0235381.
[6] 俞昌赫,甘甜,宋红磊.N-乙酰半胱氨酸联合硫酸特布他林片辅助常规治疗老年COPD并呼吸衰竭对功能康复及β2-MG、CHE血清水平的影响[J].中国老年学杂志,2022,42(6):1385-1389.
[7] 李鹏飞,刘利凯,张建华,等.N-乙酰半胱氨酸抗炎作用在慢性阻塞性肺疾病治疗中的研究及进展[J].临床肺科杂志,2022,27(2):285-289.
[8] 颜廷勇,邵星星,胡晓标.不同剂量阿奇霉素联合N-乙酰半胱氨酸在稳定期COPD患者中的临床疗效对比[J].徐州医科大学学报,2022,42(1):13-16.
[9] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组,中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会.慢性阻塞性肺疾病诊治指南(2021年修订版)[J].中华结核和呼吸杂志,2021,44(3):107-205.
[10] 李鹏飞,张建华,李浩闯,等.N-乙酰半胱氨酸对气道NO的影响及其在慢阻肺患者中的应用[J].临床肺科杂志,2022,27(3):472-475,482.
[11] 胡小燕,郑晓,嵇华夏,等.N-乙酰半胱氨酸联合理疗对慢性阻塞性肺疾病患者白细胞介素-6和呼吸功能的影响[J].中国药物与临床,2021,21(5):721-724.
[12] 胡晨阳,翟成凯,翟飞,等.大剂量N-乙酰半胱氨酸辅助治疗慢性阻塞性肺疾病并肺间质纤维化的效果及其对肺功能、炎性因子指标及血管内皮生长因子的影响[J].中国医学工程,2021,29(7):126-128.
[13] 吴旭,季爽,郭燕,等.NAC/RvD1抑制H2O2诱导的COPD患者气道上皮细胞炎症性黏液高分泌的作用及机制研究[J].安徽医科大学学报,2021,56(12):1853-1859.
[14] 石永传,沈芳,周璇,等.乙酰半胱氨酸吸入剂对老年慢阻肺急性加重期患者肺泡巨噬细胞分泌炎症因子的影响[J].老年医学与保健,2021,27(4):805-808.
[15] 刘霞,张洪森,李洪芳,等.四联抗结核化疗联合N-乙酰半胱氨酸对慢性阻塞性肺疾病合并肺结核患者的影响[J].传染病信息,2021,34(6):539-544.
[16] Shinu P, Singh V A, Nair A, et al.Papain-cetylpyridinium chloride and pepsin-cetylpyridinium chloride; two novel, highly sensitive, concentration, digestion and decontamination techniques for culturing mycobacteria from clinically suspected pulmonary tuberculosis cases[J].PLoS One,2020,15(8):e0236700.
[17] 张立南,刘明,邸红.血清高迁移率族蛋白B1在老年慢性阻塞性肺疾病急性加重病人中的表达及N-乙酰半胱氨酸泡腾片干预效果研究[J].实用老年医学,2021,35(4):370-373.
[18] 陶静,孙秋雁,周铭,等.N-乙酰半胱氨酸联合抗结核药治疗慢性阻塞性肺疾病合并肺结核患者的相关指标分析[J].中国医院药学杂志,2021,41(7):728-731,744.
[19] 付延鑫,戴昂,董亮,等.祛痰/抗氧化药物治疗COPD疗效与安全性的网状Meta分析[J].中国药房,2021,32(22):2778-2784.
[20] 许红飞,刘艳春,王春鲜.雾化吸入N-乙酰半胱氨酸和复方异丙托溴铵治疗AECOPD的疗效及对血清LTB4、IL-6、PCT和SOD水平的影响[J].国际呼吸杂志,2021,41(16):1246-1252.