Objective To explore the curative effect difference between fudosteine and N-acetylcysteine in treatment of chronic obstructive pulmonary disease complicated with pulmonary fibrosis. Methods From January 2013 to June 2013, 80 COPD patients complicated with IPF were randomly divided into the group A and the group B, 40 cases in each group. Both groups were given oxygen therapy, nutritional support, well exercise ( including breath-ing exercise, shrinkage lip breathing, abdominal breathing, etc. ) , such as conventional treatment. The group A was additionally given fudosteine ( oral, 0. 4 g/time, 3 times/d) , and the group B was given N-acetylcysteine tablets o-rally, 0. 6 g/time, 3 times/d. Both groups were treated for six months, and their clinical curative effect was com-pared. Results In the group A, there were 7 markedly improved cases ( 17. 50%) and 29 effective cases (72. 50%), and 5 cases (12. 50%) and 29 cases (57. 50%) respectively in the group B. The total effective rate of the group A (90. 00%) was significantly higher than that of the group B (70. 00%) (P<0. 05). Their lung func-tion indexes improved obviously after treatment in the two groups. The value of FEV1% pred, FVC% pred and FEV1/FVC were 80. 21 ± 9. 45, 86. 21 ± 6. 44 and 85. 43 ± 4. 17 in the group A, which were significantly higher than that of the group B (68. 98 ± 3. 4, 79. 46 ± 6. 81 and 80. 23 ± 6. 14) (P<0. 05). Pulmonary fibrosis and inflamma-tion indexes decreased obviously. The value of LN and HA after treatment in the group A were 87. 69 ± 20. 35μg/mL and 91. 43 ± 16. 52μg/mL, which were significantly lower than those of the group B ( 118. 45 ± 25. 73μg/mL and 114. 68 ± 24. 36μg/mL) (P<0. 05). In the two groups after treatment, CRP score and quality of life score were sig-nificantly lower, and they were 66. 41 ± 5. 12 points, 45. 65 ± 6. 23 points, 42. 69 ± 16. 1points, and 51. 02 ± 4. 85points in the group A, which were significantly lower than those of the group B (70. 05 ± 6. 24points, 57. 43 ± 8. 02 points, 55. 94 ± 5. 78 points, and 5. 78 ± 5. 43) (P<0. 05). Conclusion Both fudosteine and N-acetylcys-teine can slow down disease progression in treatment of COPD patients complicated with IPF, but fudosteine has better curative effect, and it can effectively resist pulmonary fibrosis and improve lung function and quality of life, which is worthy of wide popularization and application.%目的 探讨福多司坦和乙酰半胱氨酸治疗慢性阻塞性肺疾病(慢阻肺)并发肺纤维化(IPF)的疗效差异.方法 选择2013年1月至2015年6月我院收治的慢阻肺并发IPF患者80例,按照随机法分为A组与B组,每组各40例.两组患者确诊后均予以氧疗、营养支持、呼吸肌锻炼(包括呼吸操、缩唇呼吸、腹式呼吸等)等常规治疗.A组予以福多司坦颗粒口服,0.4g/次,3次/d;B组予以乙酰半胱氨酸泡腾片口服,0.6g/次,3次/d;两组均连续服用6个月,对比两组的临床疗效.结果 A组显效、有效分别为7例(17.50%)和29例(72.50%),B组分别为5例(12.50%)和29例(57.50%),A组总有效率(90.00%)显著高于B组(70.00%)(P<0.05).治疗后两组肺功能指标均明显提高,A组治疗后FEV1%pred、FVC%pred及FEV1/FVC分别为80.21±9.45、86.21±6.44、85.43±4.17,均显著高于B组(68.98±3.4、79.46±6.81、80.23±6.14)(P<0.05);治疗后两组肺纤维化及炎症指标均明显下降,A组治疗后LN、HA分别为87.69±20.35μg/mL、91.43±16.52μg/mL,均显著低于B组(118.45±25.73μg/mL、114.68±24.36μg/mL)(P<0.05);治疗后两组CRP评分及生活质量评分均明显降低,A组治疗后CRP评分及生活质量评分(活动能力、呼吸症状、疾病影响)分别为66.41±5.12分和45.65±6.23分、42.69±16.1分、51.02±4.85分,均显著低于B组(70.05±6.24分和57.43±8.02分、55.94±5.78分、66.72±5.43分)(P<0.05).结论 福多司坦与乙酰半胱氨酸治疗慢阻肺伴IPF均可延缓病情进展,但福多司坦疗效更好,能够有效抗肺纤维化,改善肺功能并改善患者的生活质量,值得推广应用.
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