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Objective To investigate the effect of Xingnaojing injection combined with ambroxol hydrochloride on precalcitonin (PCT),C-reactive protein (CRP) and white blood cell count (WBC) in the elderly patients with severe pneumonia,and to observe the clinical effect.Methods From December 2013 to March 2015,94 cases of severe pneumonia in Zhejiang Quhua Hospital were selected and divided into treatment group and control group according to the random digital table method,with 47 cases in each group.The control group was treated with ambroxol hydrochloride,while the treatment group was treated with Xingnaojing injection on the basis of the control group.The main symptom scores,blood gas analysis indicators,PCT,CRP and WBC changes and therapeutic effects were compared between the two groups before and after treatment.Results After treatment,the fever score and cough score in the treatment group [(1.03 ± 0.25) points,(1.12 ± 0.29) points] were significanly lower than those in the control group [(2.17 ± 0.42) points,(2.34 ± 0.71) points] (t =15.989,10.905,all P ＜ 0.05).After treatment,the PaO2 of the treatment group [(89.47 ± 8.41) mmHg] was higher than that of the control group [(76.39 ± 5.63) mmHg],while PaCO2 [(48.37 ± 7.19) mmHg] was lower than that in the control group [(63.27 ± 3.48) mmHg],the differences were statistically significant (t =8.860,12.780,all P ＜ 0.05).After treatment,the serum levels of PCT,CRP and WBC in the treatment group were (5.41 ± 0.97) ng/L,(48.98 ± 8.97) mg/L,(7.82 ± 1.23) × 109/L,respectively,which were significanly lower than those in the control group [(7.98 ± 1.47) ng/L,(76.45 ± 12.54) mg/L and (12.56 ± 1.89) × 109/L] (t =10.004,12.214,14.410,all P ＜ 0.05).The total effective rate in the treatment group(91.49％) was higher than that in the control group (72.34％),and there was statistically significant difference (x2 =5.817,P ＜ 0.05).Conclusion Xingnaojing injection combined with ambroxol can reduce the changes of serum PCT,CRP and WBC in the elderly patients with severe pneumonia,and the curative effect is significant.It is worthy of clinical study.
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Objective To observe clinical effect of the hydrochloric acid ammonium bromide auxiliary treatment of acute exacerbation of chronic bronchitis.Methods From February 2014 to January 2016,60 patients with chronic bronchitis in the Second People's Hospital of Yuyao were selected as observation objects.They were randomly divided into control group(30 cases)and observation group(30 cases)by using digital table method.The control group was treated with amoxicillin on the basis of conventional treatment, the observation group was treated with hydrochloric acid ammonia bromine based on the control group.The symptoms integral, clinical curative effect,blood gas analysis and lung function index were observed between the two groups.Results After treatment, cough,sputum, asthma of the observation group were(0.87 ± 0.32)points,(0.85 ± 0.34)points,(0.86 ± 0.34)points,respectively ,which were lower than those of the control group[(1.78 ± 0.48)points,(1.80 ± 0.47)points,(1.82 ± 0.46)points], the differences between the two groups had statisticallly significant(t =8.40,8.97,9.19, all P ＜0.05);The forced expiratory volume in one second(FEV1), forced expiratory volume in one second(FEV1/FVC)and forced vital capacity ratio in the observation group were(2 344.51 ± 373.44)mL,(69.34 ± 7.56)％,respectively,which in the control group were(2 001.63 ± 368.61)mL,(53.98 ± 6.78)％, respectively, the differences were statistically significant between the two groups(t =3.58,8.28, all P ＜ 0.05);The arterial oxygen partial pressure(PaO2)and artery CO2 partial pressure(PaCO2)in the observation group were(73.58 ± 6.33)mmHg,(43.51 ± 6.24)mmHg, respectively, which in the control group were(66.87 ± 7.25)mmHg,(51.05 ±6.36)mmHg, respectively, differences betwee.n the two groups were statistically significant(t =3.82,4.64, all P ＜0.05);The total effective rate in the observation group was 96.67％ ,which was higher than 66.67％ of the control group(x2 =10.42, P ＜ 0.01).Condusion Hydrochloric acid ammonia bromine adjuvant therapy for patients with acute exacerbation of chronic bronchitis can improve arterial blood gas analysis and pulmonary function indexes,alleviate clinical symptoms and improve clinical efficacy.
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Objective To investigate the effects of ambroxol hydrochloride injection combined with pulmonary surfactant(PS) on the improvement of arterial blood gas index and the time of mechanical ventilation in neonates with respiratory distress syndrome (NRDS).Methods 82 children with NRDS were selected,and they were randomly divided into two groups according to the digital table ,41 cases in each group.The control group received 100mg/kg PS inhalation,and the study group received intravenous injection of 7.5mg/kg ambroxol hydrochloride +100mg/kg PS inhalation.The changes of arterial blood gas index [PaO2 ,arterial carbon dioxide pressure ( PaCO2 ),pH value], mechanical ventilation time,oxygen supply time and hospitalization time were statistically compared between the two groups.Results The PaO2 [(89.38 ±4.72)mmHg]and pH value (7.40 ±0.02) of the study group were higher than those of the control group [(66.42 ±5.58) mmHg,(7.32 ±0.04)] at 12h after treatment,while PaCO2 [(29.04 ±4.63)mmHg]was lower than that in the control group [(35.38 ±5.67)mmHg],and the differences were statistically significant(t =20.115,11.454,5.545,all P =0.000).The hospitalization time,oxygen supply time and mechanical ventilation time of the study group were lower than those of the control group [(11.10 ±3.47) d vs. (18.61 ±8.72)d,(7.49 ±5.31) d vs.(14.32 ±11.61) d,(56.21 ±11.78)h vs.(78.22 ±18.31)h],and the differences were statistically significant (t =5.123,3.425,6.473,all P =0.000).Conclusion Ambroxol hydrochlo-ride injection combined with PS can improve the arterial blood gas index in children with NRDS and shorten the time of mechanical ventilation,hospitalization and oxygen supply .
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Objective To establish a method for the dissolution determination of ambroxol hydrochloride orally disinegreting tablets. Methods The UV spectrophotometry was used. The detecting wavelength was at 244 nm. The liquid of dissolution was hydrochloride(0.1 mol·L -1). Rotational speed was 50 r·min-1. Results The linearity range was 3.16-28.44 μg·mL-1.The regression equation was Y＝0.024 2X+0.018 3(r＝0.999 3).The RSD of repeatable test was 0.28%.The average recovery of methodology was 100.4% and RSD was 0.77%. Conclusion The method is simple and reliable, and can be used for the dissolution determination of ambroxol hydrochloride orally disinegreting tablets.
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Objective To discuss the efficacy of ambroxol hydrochloride inhalation in treatment of infantile pneumonia.Methods Totally 80 pneumonia infants were selected and randomly divided into two groups.The control group (39 cases) were given anti-infection,cough-relieved,and other treatment.The observation group (41 cases) were given ambroxol hydrochloride inhalation on the basis of control group treatment.The efficacy of ambroxol hydrochloride inhalation in treatment of infantile pneumonia was evaluated by efficacy,clinical symptoms disappearing time,red blood cell hematocrit,blood viscosity,and adverse reaction during treatment.Results After treatment,the effective rate of observation group was higher than that of control group (P ＜ 0.05).There were 38 infants in observation group and 28 infants in control group with cough and dyspnea alleviated and phlegm reduced.After atomizing inhalation of ambroxol hydrochloride,the cough,pulmonary rales disappearing time and hospitalization time were significantly shortened (P ＜ 0.05).After treatment,the red blood cell hematocrit and blood viscosity of observation group was lower than that of control group (P ＜ 0.05).During treatment,there was no statistical significance on adverse reaction between two groups.Conclusion Ambroxol hydrochloride inhalation has a good curative effect on infantile pneumonia.It could improve the symptoms of pneumonia and reduce blood viscosity with good safety,which is worthy of clinical use.
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Objective To systematically assess the clinical effect and safety of Poractant Alfa Injection and ambroxol hydro-chloride in treating neonatal respiratory distress syndrome (NRDS) .Methods The home and abroad randomized controlled trials ( RCTs ) on the comparison of clinical effect and safety of Poractant Alfa Injection and ambroxol hydrochloride in treating NRDS were retrieved by computer .The literature quality was evaluated by the modified JADAD scale .Rev Man5 .3 .1 software was used for conducting the meta analysis .Results Twenty-four RCT were included .The meta analysis results showed that compared with ambroxol hydrochloride ,Poractant Alfa Injection for treating NRDS could more significantly increase the PH value (MD= -0 .02 , 95% CI:-0 .03- -0 .01 ,P<0 .01) ,increased the PaO2 value(MD= -2 .92 ,95% CI:-4 .59 - -1 .26 ,P<0 .01) ,decreased the PaCO2 value (MD=0 .95 ,95% CI:0 .12-1 .77 ,P=0 .02) ,reduced the FiO2 value(MD=0 .03 ,95% CI:0 .01-0 .05 ,P<0 .01) ,en-hanced the Pa O2/FiO2 ratio (MD= -7 .62 ,95% CI:-10 .87 - -4 .37 ,P<0 .01) ,reduced the short term complications (RR=1 .67 ,95% CI:1 .31-2 .12 ,P<0 .01) and long-term complications (RR=2 .85 ,95% CI:1 .14-7 .07 ,P=0 .02) ,shortened the hos-pitalization days (RR=3 .03 ,95% CI:0 .94 -5 .11 ,P<0 .01) as well as decreased the mortality rate (RR=1 .96 ,95% CI:1 .15-3 .34 ,P=0 .01) .However ,there were no statistical differences in the durations of continuous positive airway pressure (CPAP) me-chanical ventilation ,oxygen inhalation time ,time of clinical symptom outcome ,incidence rate of NRDS and total effective rate of treatment between the two groups .Conclusion Currently published evidences show that Poractant Alfa Injection is superior to am-broxol hydrochloride in treating NRDS ,however ,due to limited number of included RCD and medium quality ,the conclusion needs large scale and multicenter RCT verification .
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OBJECTIVE: To select excipients and optimize preparation for the ambroxol hydrochloride/levosalbutamol sulfate dry powder inhalation. METHODS: Drug and different excipients in the same ratio were prepared by spray drying to obtain a certain particle size as drug particles or carriers for dry powder inhalation, respectively. Study and compare the parameters of powders of the dry powder inhaler, such as the angle of repose, moisture content, and emptying rate, etc, to screen the excipient of the vectors. Afterward, Box-Behnken design method was adopted to optimize of preparation parameters. RESULTS: When lactose-high branched cyclodextrin compounds were used as composite carriers, their powder properties meet the requirements of dry powder inhaler, such as the repose angle was 39.69 degrees, the bulk density was 0.37 g·mL-1, the tap density was 0.66 g·mL-1, the evacuation rate of drug-carrier powders in capsules was 93.12%, and the water content was 0.10% and the simulated lung deposition rate was 14.63%. The preparation parameters, such as sample concentration, inlet air temperature, nozzle diameter parameters, theirs values were 50 mg·mL-1, 110℃, 1 mm, respectively, were opmized by Box-Behnken design method, which could obtain the carrier particle size of 30.33 μm. CONCLUSION: Lactose-high branched cyclodextrin complexes can be used as carrier for levosalbutamol sulfate-ambroxol hydrochloride compound dry powder inhaler, which could meet the requirements of dry powder inhaler by spray-drying preparation method.
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Objective To study the clinical efficacy of ulinastatin combined with ambroxol hydrochloride in the treatment of acute respiratory distress syndrome (ARDS) complicated with ventilator-associated pneumonia (VAP).Methods One hundred and ten cases of ARDS complicated with VAP were randomly divided into the study group (55 cases) and the control group (55 cases) according to the different treatment method.The two groups accepted symptomatic anti-infective treatment,and the control group was treated with 300mg of ambroxol twice daily,the study group were intravenously infused 200 000U ulinastatin on the basis of the control group,two groups of patients were treated for 1 week.The ventilation indicators,pathogen clearance rate,off-time rate,mechanical ventilation time,respiratory rate,APACHE score,lung injury score and adverse reactions during the treatment were compared between the two groups.Results After treatment,PaO2,PaO2/FiO2,CL,RAW and PIP in the study group were (97.83 ± 12.01)mmHg,(364.25 ±35.77)mmHg,(88.93 ±9.44)mL/cmH2O,(31.45 ±4.87)cmHH2O · L-1 · s-1,(21.43 ± 5.75)cmH2O,respectively,which in the control groupwere (83.25 ± 10.13)mmHg,(238.55 ± 34.29) mmHg,(62.77 ± 8.54) mL/cmH2 O,(37.97 ± 6.54) cmH2 O · L-1 · s-1,(29.12 ± 5.43) cnH2 O,respectively.The P.aO2,PaO2/FiO2,CL in the study group were significantly higher than those in the control group,the RAW,PIP in the study group were significantly lower than those in the control group,the differences were statistically significant (t =6.88,18.81,5.93,7.21,15.42,all P ＜ 0.05).The clearance rate of both Gram-positive lacteria (90.00％)and Gram-negative bacteria (92.00％) in the study group were significantly higher than those in the control group (66.67％ and 70.21％) (x2 =4.81,8.84;P =0.03,0.00).The mean mechanical ventilation time in the study group [(7.15 ± 2.43) days] was significantly shorter than that in the control group [(12.85 ± 3.12) days] (t =10.69,P ＜ 0.05).The respiratory rate,APACHE score and lung injury scores of the two groups were significantly lower than those before treatment (P ＜ 0.05).The respiratory rate,APACHE scores and lung injury scores of the study group [(18.94 ± 6.99) times/min,(12.53 ± 3.14) points,(1.31 ± 0.15) points] were significantly lower than those of the control group [(25.87 ± 6.12) times/min,(16.53 ± 4.42) points,(1.65 ± 0.32) points],the differences were statistically significant (t =5.53,5.47,7.14;P =0.00,0.00,0.00).The off-line success rate and mortality between the two groups had no statistically significant differences (all P ＞ 0.05).Conclusion Ulinastatin combined with ambroxol hydrochloride can significantly improve the respiratory function of ARDS patients complicated with VAP,significantly shorten the duration of mechanical ventilation,improve respiratory function,reduce lung injury and improve pathogens clearance rate,but with no significant impact on mortality.
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Objective To investigate the clinical effect of ambroxol hydrochloride combined with cough syrupintegrated traditional Chinese and Western Medicine on infantile cough.Methods Selected 200 cases of patients with cough who were treated in our hospital from January 2012 to December 2015,divided into two groups randomly,100 cases in observation group,100 cases in control group.The observation group was treated with ambroxol hydrochloride combined with cough syrup,the control group were treated with ambroxol hydrochloride.To observe the clinical symptoms and clinical manifestations of the patients after treatment,recorded the time of cough and the disappearance of cough,and to determine the effect of treatment.The lung function indexes of the two groups were detected:peak expiratory flow,forced vital capacity,forced expiratory volume in one second,maximal expiratory flow rate of 50％ vital capacity and maximal expiratory flow rate of 25％ vital capacity.All the patients were followed up for 6 months by telephone or clinic,the recurrence rate of the two groups was observed,and the number of children with asthma were recorded.Results The time of cough and the disappearance time of cough in observation group were significantly shorter than that of the control group (P ＜ 0.05);the total effective rate of observation group was 93.00％ (93/100),significantly higher than that of the control group 74.00％ (74/100) (P ＜ 0.05).After treatment,expiratory flow peak,forced vital capacity,one second forced expiratory volume,vital capacity 50％ of maximum expiratory flow and 25％ of vital capacity maximal expiratory flow of two groups were significantly increased (P ＜ 0.05) and the observation group increased more significantly than the control group (P ＜0.05).After 6 months of follow-up,the control group had 22 cases of recurrence,the recurrence rate was 22.00％;the observation group had 6 cases of recurrence,the recurrence rate was 6.00％,the recurrence rate of the observation group was significantly lower than that of the control group (P ＜ 0.05);the control group had 14 cases of children with asthma,the change rate was 14％;the observation group had 2 cases of children with asthma,the change rate was 2％,the change rate of the observation group was significantly lower than that of the control group (P ＜ 0.05).Conclusion Ambroxol hydrochloride combined with cough syrup has better curative effect on infantile cough,can effectively improve children's lung function,reduce the rate of recurrence and change of asthma,which has high clinical application value.
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Objective To investigate the effect of ambroxol atomization inhalation combined with erythromycin on neonatal pneumonia patients and its influence on high sensitivity C reactive protein( hs-CRP) ,myocardial enzyme level. Methods 100 cases of neonatal pneumonia were selected and they were randomly divided into observation group and control group according to the digital table,50 cases in each group. The control group was treated with erythromycin 30mg/kg, 1 time/d. The observation group was given ambroxol ultrasonic nebulizer inhalation, 15 minutes per time,3 times daily,on the basis of the treatment of the control group. The patients were treated for 4 consecutive weeks. The clinical symptoms disappeared time, hs -CRP level, CK -MB level and clinical efficacy were detected and compared. Results Compared with before treatment, the hs - CRP and CK - MB levels were decreased after treatment. Compared with the control group,the hs - CRP[(7. 25 ± 2. 11) mg/L vs. (12. 21 ± 3. 76)mg/L] and CK-MB[(21. 31 ± 4. 42) U/L vs. (27. 12 ± 3. 17) U/L] levels in the observation group were lower(t=8. 134,7. 553,all P<0. 05),the clinical symptoms disappeared in a relatively shorter time(t= 6. 520, 11. 824,19. 473,all P <0. 05),the clinical curative effect was better. Conclusion Ambroxol aerosol inhalation combined with erythromycin can reduce hs-CRP,CK-MB levels in neonatal pneumonia patients,and the clinical symptoms of the patients disappeared in a relatively short time, the clinical curative effect is better, has guiding significance in clinic.
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Objective To investigate the clinical effect of ambroxol hydrochloride combined with cough syrupintegrated traditional Chinese and Western Medicine on infantile cough.Methods Selected 200 cases of patients with cough who were treated in our hospital from January 2012 to December 2015,divided into two groups randomly,100 cases in observation group,100 cases in control group.The observation group was treated with ambroxol hydrochloride combined with cough syrup,the control group were treated with ambroxol hydrochloride.To observe the clinical symptoms and clinical manifestations of the patients after treatment,recorded the time of cough and the disappearance of cough,and to determine the effect of treatment.The lung function indexes of the two groups were detected:peak expiratory flow,forced vital capacity,forced expiratory volume in one second,maximal expiratory flow rate of 50％ vital capacity and maximal expiratory flow rate of 25％ vital capacity.All the patients were followed up for 6 months by telephone or clinic,the recurrence rate of the two groups was observed,and the number of children with asthma were recorded.Results The time of cough and the disappearance time of cough in observation group were significantly shorter than that of the control group (P ＜ 0.05);the total effective rate of observation group was 93.00％ (93/100),significantly higher than that of the control group 74.00％ (74/100) (P ＜ 0.05).After treatment,expiratory flow peak,forced vital capacity,one second forced expiratory volume,vital capacity 50％ of maximum expiratory flow and 25％ of vital capacity maximal expiratory flow of two groups were significantly increased (P ＜ 0.05) and the observation group increased more significantly than the control group (P ＜0.05).After 6 months of follow-up,the control group had 22 cases of recurrence,the recurrence rate was 22.00％;the observation group had 6 cases of recurrence,the recurrence rate was 6.00％,the recurrence rate of the observation group was significantly lower than that of the control group (P ＜ 0.05);the control group had 14 cases of children with asthma,the change rate was 14％;the observation group had 2 cases of children with asthma,the change rate was 2％,the change rate of the observation group was significantly lower than that of the control group (P ＜ 0.05).Conclusion Ambroxol hydrochloride combined with cough syrup has better curative effect on infantile cough,can effectively improve children's lung function,reduce the rate of recurrence and change of asthma,which has high clinical application value.
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Objective To investigate the therapeutic effect of ambroxol hydrochloride combined with Xuebijing injection for treatment of elderly patients with severe pneumonia. Methods A total of 60 patients with severe pneumonia admitted to the Third Affiliated Hospital of Soochow University from January 2015 to December 2016 were enrolled, and they were divided into an observation group and a control group by random number table method, 30 cases in each group. Both groups were given routine treatment of antibiotics, nutritional support, oxygen aspiration, spasmolysis and phlegm reduction therapies. etc. On the basic conventional treatment, the patients of the control group were treated with 300 mg ambroxol hydrochloride added into 100 mL normal saline for intravenous (IV) drip, twice a day; on the basis of treatment of control group, the patients in the observation group additionally were treated with 50 mL Xuebijing injection added into 100 mL normal saline for IV drip, twice a day. After treatment for 14 days, the curative effect was observed. Before and after treatment, the changes of immune function, inflammatory factors, respiratory mechanics, blood gas indexes and clinical efficacy were observed in the two groups. Results Compared with those before treatment, levels of the CD3+, CD4+ and CD4+/CD8+, arterial oxygen satuation (SaO2), arterial partial pressure of oxygen (PaO2) and oxygenation index (PaO2/FiO2) in the two groups after treatment were significantly increased, while CD8+, interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), airway platform pressure (Pplat), peak inspiratory pressure (PIP), mean airway pressure (mPaw) and airway resistance (Raw) and arterial partial pressure of carbon dioxide (PaCO2) were decreased significantly after treatment in the two groups (all P < 0.05), the levels of immune indexes CD3+, CD4+, CD4+/CD8+, SaO2, PaO2 and PaO2/FiO2 after treatment in the observation group were significantly higher than those in the control group [CD3+: 0.69±0.05 vs. 0.60±0.04, CD4+: 0.40±0.04 vs. 0.35±0.03, CD4+/CD8+: 1.84±1.10 vs. 1.41±0.79, SaO2: 0.96±0.04 vs. 0.91±0.05, PaO2 (mmHg, 1 mmHg =0.133 kPa): 97.71±10.03 vs. 74.68±8.14, PaO2/FiO2 (mmHg): 361.87±20.01 vs. 258.95±17.54, all P < 0.05], meanwhile the CD8+, IL-6, CRP, TNF-α, Pplat, PIP, mPaw, Raw and PaCO2 were significantly lower than those of the control group [CD8+: 0.23±0.03 vs. 0.30±0.05, IL-6 (pg/L): 97.48±8.14 vs. 144.51±12.67, CRP (mg/L): 31.26±4.85 vs. 68.97±7.02, TNF-α (mg/L): 16.07±1.80 vs. 21.85±2.64, Pplat (cmH2O, 1 cmH2O = 0.098 kPa): 12.23±1.57 vs. 15.97±1.91, PIP (cmH2O): 23.26±3.07 vs. 28.09±3.10, mPaw (cmH2O): 8.54±0.54 vs. 9.39±1.30, Raw (cmH2O·L-1·s-1): 6.74±1.12 vs. 9.29±1.55, PaCO2 (mmHg): 36.44±4.13 vs. 47.07±5.35, all P < 0.05]. After treatment, the effective rate of the observation group was significantly higher than that of the control group [90.00% (27/30) vs. 63.33% (19/30), P < 0.05]. Conclusions Using ambroxol hydrochloride combined with Xuebijing injection for treatment of elderly patients with severe pneumonia can promote their immune function, reduce the inflammatory factors, improve respiratory mechanics and blood gas index levels, thus the combined therapy can elevate the clinical therapeutic effect for treatment of senile severe pneumonia.
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Objective To observe the clinical therapeutic efficacy of N-acetylcysteine (NAC) on chronic bronchitis. Methods The data were retrieved by computer from data bases, including the data bases in Cochrane library, American National Library Pubmed, Holland Medical Digest EMBase, Web of Science, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Wanfang and the Chinese Journal of Science and Technology (VIP), starting from the dates of various database establishments to April 2017 for collecting the randomized controlled trials (RCTs) of using NAC combined with conventional drugs like ambroxol hydrochloride, montelukast or placebo (treatment group) and simply using the conventional drug alone as above conventional drugs (control group) for treatment of chronic bronchitis, and the therapeutic effects were compared between the two groups. The main indicators were total effective rate, lung function indexes [forced vital capacity (FVC), percentage of forced expiratory volume in one second (FEV1) / the predictive value (FEV1%)]; the secondary indicator was St. George Hospital Respiratory Questionnaire evaluation score (the SGRQ evaluation score). Document quality evaluation and data acquisition were carried out independently by two researchers. Meta-analysis was performed by using RevMan 5.3 software. A funnel graph was drawn to evaluate the article publication bias. Results There were 7 Chinese and 3 English RCTs, including 1521 patients in the study. The results of Meta analyses showed: NAC could elevate the overall therapeutic efficiency of patients with chronic bronchitis [relative risk (RR) = 1.17, 95% confidence interval (95%CI) was 1.10-1.25, P < 0.00001], FVC [mean difference (MD) = 0.22, 95%CI was 0.02-0.42, P = 0.03), FEV1% (MD = 4.10, 95%CI was 1.02-7.18, P = 0.005) and lower the SGRQ score (MD = -6.32, 95%CI was -10.48 to -2.17, P = 0.003), showing that the therapeutic effects on these aspects in using NAC treatment group were more prominent than those in the control group. The subgroup analyses showed that NAC combined with ambroxol hydrochloride could elevate overall therapeutic efficiency (RR = 1.20, 95%CI was 1.11-1.29, P <0.00001), FVC (RR = 1.18, 95%CI was 0.99-1.41, P = 0.04) and FEV1% (MD = 4.10, 95%CI was 1.02-7.18, P = 0.005), showing that the therapeutic effects on these aspects in using NAC combined with ambroxol hydrochloride group were more prominent than those in the control group; the total rate of therapeutic effect of NAC combined with montelukast was superior to that of the control group (RR = 1.12, 95%CI =1.03-1.22, P = 0.006); NAC combined with placebo in elevating FVC aspect was better than the control group (MD =-0.01, 95%CI = -0.02 to -0.01, P < 0.00001); funnel plots showed that no publication bias was found in the literatures in the study. Conclusion It is shown that NAC for treatment of chronic bronchitis can improve the overall therapeutic efficiency, lower the SGRQ evaluation score and elevate the lung function in FVC and FEV1% aspects, but no effect on FEV1/FVC.
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Objective To investigate the effect of ambroxol atomization inhalation combined with erythromycin on neonatal pneumonia patients and its influence on high sensitivity C reactive protein( hs-CRP) ,myocardial enzyme level. Methods 100 cases of neonatal pneumonia were selected and they were randomly divided into observation group and control group according to the digital table,50 cases in each group. The control group was treated with erythromycin 30mg/kg, 1 time/d. The observation group was given ambroxol ultrasonic nebulizer inhalation, 15 minutes per time,3 times daily,on the basis of the treatment of the control group. The patients were treated for 4 consecutive weeks. The clinical symptoms disappeared time, hs -CRP level, CK -MB level and clinical efficacy were detected and compared. Results Compared with before treatment, the hs - CRP and CK - MB levels were decreased after treatment. Compared with the control group,the hs - CRP[(7. 25 ± 2. 11) mg/L vs. (12. 21 ± 3. 76)mg/L] and CK-MB[(21. 31 ± 4. 42) U/L vs. (27. 12 ± 3. 17) U/L] levels in the observation group were lower(t=8. 134,7. 553,all P<0. 05),the clinical symptoms disappeared in a relatively shorter time(t= 6. 520, 11. 824,19. 473,all P <0. 05),the clinical curative effect was better. Conclusion Ambroxol aerosol inhalation combined with erythromycin can reduce hs-CRP,CK-MB levels in neonatal pneumonia patients,and the clinical symptoms of the patients disappeared in a relatively short time, the clinical curative effect is better, has guiding significance in clinic.
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Objective To investigate the therapeutic effect of ambroxol hydrochloride combined with Xuebijing injection for treatment of elderly patients with severe pneumonia. Methods A total of 60 patients with severe pneumonia admitted to the Third Affiliated Hospital of Soochow University from January 2015 to December 2016 were enrolled, and they were divided into an observation group and a control group by random number table method, 30 cases in each group. Both groups were given routine treatment of antibiotics, nutritional support, oxygen aspiration, spasmolysis and phlegm reduction therapies. etc. On the basic conventional treatment, the patients of the control group were treated with 300 mg ambroxol hydrochloride added into 100 mL normal saline for intravenous (IV) drip, twice a day; on the basis of treatment of control group, the patients in the observation group additionally were treated with 50 mL Xuebijing injection added into 100 mL normal saline for IV drip, twice a day. After treatment for 14 days, the curative effect was observed. Before and after treatment, the changes of immune function, inflammatory factors, respiratory mechanics, blood gas indexes and clinical efficacy were observed in the two groups. Results Compared with those before treatment, levels of the CD3+, CD4+ and CD4+/CD8+, arterial oxygen satuation (SaO2), arterial partial pressure of oxygen (PaO2) and oxygenation index (PaO2/FiO2) in the two groups after treatment were significantly increased, while CD8+, interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), airway platform pressure (Pplat), peak inspiratory pressure (PIP), mean airway pressure (mPaw) and airway resistance (Raw) and arterial partial pressure of carbon dioxide (PaCO2) were decreased significantly after treatment in the two groups (all P < 0.05), the levels of immune indexes CD3+, CD4+, CD4+/CD8+, SaO2, PaO2 and PaO2/FiO2 after treatment in the observation group were significantly higher than those in the control group [CD3+: 0.69±0.05 vs. 0.60±0.04, CD4+: 0.40±0.04 vs. 0.35±0.03, CD4+/CD8+: 1.84±1.10 vs. 1.41±0.79, SaO2: 0.96±0.04 vs. 0.91±0.05, PaO2 (mmHg, 1 mmHg =0.133 kPa): 97.71±10.03 vs. 74.68±8.14, PaO2/FiO2 (mmHg): 361.87±20.01 vs. 258.95±17.54, all P < 0.05], meanwhile the CD8+, IL-6, CRP, TNF-α, Pplat, PIP, mPaw, Raw and PaCO2 were significantly lower than those of the control group [CD8+: 0.23±0.03 vs. 0.30±0.05, IL-6 (pg/L): 97.48±8.14 vs. 144.51±12.67, CRP (mg/L): 31.26±4.85 vs. 68.97±7.02, TNF-α (mg/L): 16.07±1.80 vs. 21.85±2.64, Pplat (cmH2O, 1 cmH2O = 0.098 kPa): 12.23±1.57 vs. 15.97±1.91, PIP (cmH2O): 23.26±3.07 vs. 28.09±3.10, mPaw (cmH2O): 8.54±0.54 vs. 9.39±1.30, Raw (cmH2O·L-1·s-1): 6.74±1.12 vs. 9.29±1.55, PaCO2 (mmHg): 36.44±4.13 vs. 47.07±5.35, all P < 0.05]. After treatment, the effective rate of the observation group was significantly higher than that of the control group [90.00% (27/30) vs. 63.33% (19/30), P < 0.05]. Conclusions Using ambroxol hydrochloride combined with Xuebijing injection for treatment of elderly patients with severe pneumonia can promote their immune function, reduce the inflammatory factors, improve respiratory mechanics and blood gas index levels, thus the combined therapy can elevate the clinical therapeutic effect for treatment of senile severe pneumonia.
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Objective To observe the clinical therapeutic efficacy of N-acetylcysteine (NAC) on chronic bronchitis. Methods The data were retrieved by computer from data bases, including the data bases in Cochrane library, American National Library Pubmed, Holland Medical Digest EMBase, Web of Science, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Wanfang and the Chinese Journal of Science and Technology (VIP), starting from the dates of various database establishments to April 2017 for collecting the randomized controlled trials (RCTs) of using NAC combined with conventional drugs like ambroxol hydrochloride, montelukast or placebo (treatment group) and simply using the conventional drug alone as above conventional drugs (control group) for treatment of chronic bronchitis, and the therapeutic effects were compared between the two groups. The main indicators were total effective rate, lung function indexes [forced vital capacity (FVC), percentage of forced expiratory volume in one second (FEV1) / the predictive value (FEV1%)]; the secondary indicator was St. George Hospital Respiratory Questionnaire evaluation score (the SGRQ evaluation score). Document quality evaluation and data acquisition were carried out independently by two researchers. Meta-analysis was performed by using RevMan 5.3 software. A funnel graph was drawn to evaluate the article publication bias. Results There were 7 Chinese and 3 English RCTs, including 1521 patients in the study. The results of Meta analyses showed: NAC could elevate the overall therapeutic efficiency of patients with chronic bronchitis [relative risk (RR) = 1.17, 95% confidence interval (95%CI) was 1.10-1.25, P < 0.00001], FVC [mean difference (MD) = 0.22, 95%CI was 0.02-0.42, P = 0.03), FEV1% (MD = 4.10, 95%CI was 1.02-7.18, P = 0.005) and lower the SGRQ score (MD = -6.32, 95%CI was -10.48 to -2.17, P = 0.003), showing that the therapeutic effects on these aspects in using NAC treatment group were more prominent than those in the control group. The subgroup analyses showed that NAC combined with ambroxol hydrochloride could elevate overall therapeutic efficiency (RR = 1.20, 95%CI was 1.11-1.29, P <0.00001), FVC (RR = 1.18, 95%CI was 0.99-1.41, P = 0.04) and FEV1% (MD = 4.10, 95%CI was 1.02-7.18, P = 0.005), showing that the therapeutic effects on these aspects in using NAC combined with ambroxol hydrochloride group were more prominent than those in the control group; the total rate of therapeutic effect of NAC combined with montelukast was superior to that of the control group (RR = 1.12, 95%CI =1.03-1.22, P = 0.006); NAC combined with placebo in elevating FVC aspect was better than the control group (MD =-0.01, 95%CI = -0.02 to -0.01, P < 0.00001); funnel plots showed that no publication bias was found in the literatures in the study. Conclusion It is shown that NAC for treatment of chronic bronchitis can improve the overall therapeutic efficiency, lower the SGRQ evaluation score and elevate the lung function in FVC and FEV1% aspects, but no effect on FEV1/FVC.
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Objective To investigate the effect of combined inhalation of ambroxol hydrochloride, intermittent tapping and sputum drainage and psychological intervention on postoperative lung cancer. Methods 68 cases of lung cancer patients treated in our hospital from January 2015 to March 2017 were selected, the control group received oxygen aerosol inhalation of ambroxol hydrochloride and intermittent beating back sputum at the early stage of the operation. The study group was treated with psychological intervention on the basis of the treatment of the control group. The postoperative pulmonary complications in two groups of patients with lung cancer were recorded. The data were input into SPSS statistical software and analyzed. Results The incidence rate of atelectasis and pulmonary infection in the study group (5.88％, 8.82％) were higher than those in the control group (The incidence of atelectasis was 32.35％, and the incidence of pulmonary infection was 38.24％) was significantly reduced, the difference was statistically significant (P<0.05). Conclusion On the basis of providing oxygen aerosol inhalation of ambroxol hydrochloride and intermittent beating back sputum for early postoperative lung cancer patients, the clinical prognosis can be significantly improved if psychological intervention is used.
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Objective To compare and analysis of the clinical effect of Sanziyangqin decoction and ambroxol hydrochloride in the treatment of bronchiolitis.Methods 125 cases of bronchiolitis patients with complete data collected were retrospectively analyzed, randomly divided into control group ( 62 cases ) and observation group ( 63 cases ) , were treated with conventional ambroxol hydrochloride and Sanziyangqin decoction. The improvement of clinical symptoms, hospitalization time and treatment effect of the two groups were observed.Results The observation group of cough, wheezing, shortness of breath, throat phlegm and rales disappeared time and hospitalization time were significantly shorter than the control group, the difference was statistically significant (P<0.05).After treatment, the observation group of the total effective rate was 95.24%, significantly higher than the control group 72.58%, the difference was statistically significant (P<0.05).After Three months of treatment, the quality of life (GQOLI-74) was used to evaluate the scores of the patients in the two groups.The scores of the observation group were significantly higher than those of the control group, the difference was statistically significant (P<0.05).Before and after treatment in the two groups respectively were detected in blood and liver and kidney function, urine routine and other indicators, the detection and comparison were not abnormal, and the two groups before and after treatment were not found any adverse reaction.Conclusion The treatment of bronchiolitis in patients with Sanziyangqin decoction has the exact effect, compared with conventional ambroxol hydrochloride treatment can better improve the patient's clinical symptoms and signs, shorten the hospitalization time, improve the treatment efficiency and quality of life of patients, and there is no adverse reactions, is a safe and effective treatment method.
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Objective To explore and analyze the effect of ambroxol hydrochloride combined with budesonide in treatment of children bronchial pneumonia on C-reactive protein level and WBC levels.Methods 100 cases of patients with bronchial pneumonia treated in our hospital from May 2015 to December 2016, were randomly divided into observation group and control group, 50 cases in each group.The control group were given routine treatment, while the observation group were given ambroxol hydrochloride combined with budesonide treatment on the basis of the control group,the course of treatment was 14 days.C-reactive protein and WBC levels were measured before treatment and 14 days after treatment, the Resultswere observed and statistical.ResultsThere were significant differences in the content of CRP between groups and multiple time points(F=11.50, P=0.003;F=4.78, P=0.03;F=5.45, P=0.02).The content of CRP 14 days after treatment in the observation group were significantly lower than the control group(t=14.12,P<0.05), the difference was statistically significant.There were significant differences in the WBC counts between groups and multiple time points(F=11.52, P=0.003;F=4.73, P=0.03;F=5.44, P=0.02),the difference was statistically significant.The count of WBC 14 days after treatment in the observation group after treatment were significantly lower than the control group(t=8.12, P<0.05), the difference was statistically significant.The number of cured, effective and ineffective cases in the control group was 20, 13 and 15, respectively.The observation group was 30, 15, and 5 cases, respectively.By rank sum test, the difference of the effective rate between the 2 groups was statistically significant(u=2.33, P<0.05).And the total effective rate in observation group was 90.0%, which was significantly higher than the control group(70.0%)(x2=6.25, P<0.05), the difference was statistically significant.Conclusion Ambroxol hydrochloride combined with budesonide in the treatment of bronchial pneumonia in children is effective and can effectively reduce the CRP and WBC count, so it is worth popularizing widely in clinic.
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Objective To observe the clinical Resultsof ambroxol combined with glucocorticoids in the treatment of otitis media with effusion.Methods 81 cases fron June 2015 to 2016 October, were randomly, double-blind principle divided into observation group(42cases)and control group(39cases).The control group glucocorticoid therapy observation group were treated with ambroxol combined with glucocorticoid treatment, pure tone was observed before and after treatment were compared listen valve measured air conduction hearing level, hearing recovery and clinical efficacy.ResultsThe observation group were pure tone hearing valve after treatment was measured air conduction hearing level was significantly higher (P<0.05);drum pipe tobacco functioning proportion of patients in the observation group after treatment was 85.71%, significantly higher than 48.72% (P<0.05);The observation group total effective rate was 92.86%, significantly higher than 74.36% (P<0.05).Conclusion Ambroxol combined with glucocorticoids be effective in treating secretory otitis media, otitis media with effusion improve the clinical efficacy, and easy to operate, and is worthy of clinical application.