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Objective: To investigate the value of ultrasound guided intra-amniotic instillation of pulmonary surfactant (PS) combined with prenatal ambroxol hydrochloride (AH) for prevention of lung injury in preterm rabbits. Methods Totally 20 pregnant New Zealand rabbits were randomly divided into 4 groups (each n=5), i.e. ultrasound guided intra-amniotic instillation of PS before cesarean section (PS group), prenatal AH (AH group), ultrasound guided intra-amniotic instillation of PS combined with prenatal AH (PS+AH group) and control group. On the 27th day of pregnancy, rabbit fetuses were removed through cesarean section 1 hour after injection. The survival time of the preterm rabbits, the concentration of interleukin-6 (IL-6) and dipalmitoyl phosphatidylcholine (DPPC) in bronchoalveolar lavage fluid, the expression level of pulmonary surfactant-associated proteins-A (SP-A) in lung tissue were detected. And the lung tissue sections were taken to observe the degree of lung injury. Results: Compared with control group, the survival time of the preterm rabbits of PS group, AH group and PS+AH group prolonged, the concentration of IL-6 decreased, the concentration of DPPC and SP-A increased, and the pathological score of lung injury decreased (all P<0.05). There were significant differences between PS+AH group and PS, AH group in those indexes except for survival time (all P<0.05). Conclusion: Ultrasound guided intra-amniotic instillation of PS combined with prenatal AH plays a role in the prevention of lung injury in preterm rabbits.
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Objective@#To observe the efficacy of ambroxol hydrochloride in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD).@*Methods@#From January 2015 to December 2017, 84 patients with COPD exacerbation in Zhuji Central Hospital were selected and randomly divided into two groups according to the digital table, with 42 cases in each group.The control group was treated with routine therapy, the observation group was treated with ambroxol hydrochloride on the basis of routine treatment.The course of treatment in both two groups was 14 days.The clinical efficacy, clinical symptom disappearance time, pulmonary function index, inflammation index and adverse reaction were compared between the two groups.@*Results@#The total effective rate in the observation group was 95.24%(40/42), which was higher than that in the control group(78.57%, 33/42), and the difference was statistically significant(χ2=5.126, P<0.05). The disappearance time of cough, wheezing, sputum and dampness in the observation group was (4.01±0.68)d, (3.22±0.60)d, (3.62±1.25)d, (4.16±0.72)d, respectively, which were shorter than those in the control group [(5.32±1.17)d, (4.66±1.12)d, (4.50±1.83)d, (5.10±1.06)d](t=6.274, 7.345, 2.573, 4.754, all P<0.05). After treatment, the forced expiratory volume, oxygen partial pressure, carbon dioxide partial pressure, C-reactive protein, neutrophil count and total white blood cell count in the observation group were (0.99±0.32)L, (71.36±7.61)mmHg, (42.28±4.39)mmHg, (8.71±2.46)mg/L, (6.40±3.19)×109/L, (6.11±3.28)×109/L, respectively, which in the control group were (0.80±0.20)L, (65.28±7.29)mmHg, (48.40±6.00)mmHg, (13.60±4.50)mg/L, (11.45±5.27)×109/L, (7.81±3.82)×109/L, respectively, and the differences between the two groups were statistically significant(t=3.263, 3.739, 5.335, 6.179, 5.313, 2.188, all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).@*Conclusion@#Ambroxol hydrochloride can shorten the time of disappearance of clinical symptoms, improve the clinical efficacy and improve the pulmonary function and inflammation related indicators in the exacerbation period of COPD.
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Objective To observe the efficacy of ambroxol hydrochloride in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods From January 2015 to December 2017,84 patients with COPD exacerbation in Zhuji Central Hospital were selected and randomly divided into two groups according to the digital table,with 42 cases in each group.The control group was treated with routine therapy,the observation group was treated with ambroxol hydrochloride on the basis of routine treatment.The course of treatment in both two groups was 14 days.The clinical efficacy,clinical symptom disappearance time,pulmonary function index,inflammation index and adverse reaction were compared between the two groups.Results The total effective rate in the observation group was 95.24％ (40/42),which was higher than that in the control group (78.57％,33/42),and the difference was statistically significant(x2 =5.126,P ＜ 0.05).The disappearance time of cough,wheezing,sputum and dampness in the observation group was (4.01 ± 0.68) d,(3.22 ± 0.60) d,(3.62 ± 1.25) d,(4.16 ± 0.72) d,respectively,which were shorter than those in the control group [(5.32 ± 1.17)d,(4.66 ± 1.12)d,(4.50 ± 1.83)d,(5.10 ± 1.06)d] (t =6.274,7.345,2.573,4.754,all P ＜ 0.05).After treatment,the forced expiratory volume,oxygen partial pressure,carbon dioxide partial pressure,C-reactive protein,neutrophil count and total white blood cell count in the observation group were (0.99 ± 0.32) L,(71.36 ± 7.61) mmHg,(42.28 ± 4.39) mmHg,(8.71 ± 2.46) mg/L,(6.40 ± 3.19) × 109/L,(6.11 ± 3.28) × 109/L,respectively,which in the control group were (0.80 ± 0.20) L,(65.28 ±7.29)mmHg,(48.40 ±6.00)mmHg,(13.60 ±4.50)mg/L,(11.45 ±5.27) × 109/L,(7.81 ±3.82) × 109/L,respectively,and the differences between the two groups were statistically significant (t =3.263,3.739,5.335,6.179,5.313,2.188,all P ＜ 0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05).Conclusion Ambroxol hydrochloride can shorten the time of disappearance of clinical symptoms,improve the clinical efficacy and improve the pulmonary function and inflammation related indicators in the exacerbation period of COPD.
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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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This article reviewed the pharmacokinetic and pharmacodynamic characteristics of ambroxol and the interactions be-tween ambroxol and antibacterial agents. The use order of ambroxol and antiseptic drugs was analyzed and discussed. Ambroxol was a-ble to increase antibiotics concentration in bronchoalveolar lavage fluid (BALF) samples. Besides, ambroxol could destroy the struc-ture of bacterial biofilm(BF) in a dose-dependent manner,and high dose of ambroxol hydrochloride showed good safety. When ambr-oxol and antibacterial agents were in combination use,ambroxol should be administrated before antibacterial agents in order to enhance antibacterial efficacy,since ambroxol could increase the concentration of antibacterial agents in lung and help the antibacterial agents enter the bacterial BF. It was suggested that the label of ambroxol be further improved and revised as follows:①the administration se-quence of ambroxol and antibacterial agents should be stated;②the recommended doses of ambroxol for different indications should al-so be listed in the label;③ the clinical safety and efficacy of high dose of ambroxol should be stated.
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Objective To evaluate the effect of ambroxol on p38 mitogen-activated protein kinase pathway in mice with sepsis-induced lung injury.Methods Sixty male C57BL/6 mice were equally and randomly divided into 3 groups (n=20 each) using a random number table:sham operation group (group S),sepsis-induced lung injury group (group CLP),and sepsis-induced lung injury + ambroxol group (group AMB).Sespsis was produced by cecal ligation and puncture(CLP).Ambroxol 50 mg/kg preconditioning was injected intraperitoneally for 3 days in group AMB,while the equal volume of normal saline instead was given in S and VILI groups.The arterial blood gas was detected 24 h after CLP.Then the mice were sacrificed and broncho-alveolar lavage fluid (BALF) was collected for determination of the concentrations of total protein,interleukin-1β (IL-1β),tumor necrosis factor-α (TNF-α),IL-6 and intercellular adhesion molecule-1 (ICAM-1).The lung tissues were taken for determination of wet to dry lung weight ratio (W/D ratio),expression of p-p38 MAPK,IL-1β mRNA,TNF-α mRNA,IL-6 mRNA and ICAM-1 mRNA,and for examination of the pathological changes which were scored.Results Compared with group S,partial pressure of oxygen in arterial blood(PaO2) was decreased (P＜0.05),and W/D ratio,lung injury score,concentrations of total protein,IL-1β,TNF-α,IL-6 and ICAM-1 in BALF,and expression of p-p38 MAPK,IL-1β,TNF-α,IL-6 and ICAM-1 mRNA were significantly increased in CLP group (P＜0.05).Compared with group CLP,PaO2 was increased (P＜0.05),W/D ratio,lung injury score,concentrations of total protein,IL-1β,TNF-α,IL-6 and ICAM-1 in BALF,and expression of p-p38 MAPK,IL-1β,TNF-α,IL-6 and ICAM-1 mRNA were decreased in group AMB (P＜0.05).Conclusion Ambroxol can attenuate sepsis-induced lung injury probably through inhibiting p38 mitogen-activated protein kinase pathway in mice.
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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 effect of inhalation of budesonide combined with ambroxol hydrochloride in the treatment of chronic obstructive pulmonary disease ( COPD ) in acute exacerbation stage . Methods 60 patients with acute exacerbation of COPD treated in the Department of respiratory medicine of Zhenhai People's Hospital from January 2013 to December 2015 were selected as the research subjects in Ningbo , and they were randomly divided into control group and observation group according to the digital table ,with 30 cases in each group.The control group received routine treatment, the observation group was given budesonide and ambroxol hydrochloride inhalation on the basis of conventional therapy .After 1 week of treatment ,the clinical efficacy indicators of pulmonary function,arterial blood gas analysis index,time of symptoms were compared between the two groups . Results The total effective rate of the observation group was 100.0％,which was higher than 83.3％of the control group (χ2 =5.455,P<0.05).After treatment,the forced expiratory volume in one second (FEV1),the ratio of FEV1 and forced vital capacity (FVC) (FEV1/FVC),arterial partial pressure of carbon dioxide (PaCO2),arterial oxygen pressure (PaO2) in the observation group were (2.09 ±0.69)L,(58.94 ±15.67)％,(35.08 ±3.79)mmHg, (85.92 ±4.97)mmHg,respectively,which in the control group were (1.43 ±0.57)L,(43.12 ±11.03)％,(48.47 ± 4.24)mmHg,(79.54 ±4.56)mmHg,respectively,the differences between the two groups were statistically significant (t=4.039,4.522,12.896,5.181,all P<0.05).The remission time of shortness of breath ,cough,expectoration in the observation group were (2.04 ±0.86)d,(4.49 ±1.25)d,(4.56 ±1.34)d,respectively,which were shorter than those in the control group [(3.36 ±1.08)d,(6.53 ±1.82)d,(6.78 ±1.91)d],the differences between the twogroups were statistically significant (t=5.237,5.061,5.212,all P<0.05).Conclusion Inhalation of budesonide combined with ambroxol hydrochloride in the treatment of acute exacerbation of COPD can effectively improve the treatment effect , and the pulmonary ventilation function and arterial blood gas status , and shorten the time of remission,and is benefit to disease control .
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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 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 off-label drug use of Ambroxol hydrochloride injection,and to provide reference for further evidence-based evaluation on rationality and standardized management of off-label drug use. METHODS:All medical orders for inpatients receiving Ambroxol hydrochloride injection were selected from 10 hospitals of Guangdong province during Apr. 2014 to Mar. 2015. Situation of drug use in different categories of departments was summarized,the incidence of off-label administation route and off-label dosage were analyzed;according to drug package inserts,prescription daily dose(PDD)and drug utilization in-dex(DUI)were calculated for each category of department,and the degree of off-label dosage was evaluated. RESULTS:A total of 761 821 person·day who used Ambroxol hydrochloride injection was included. Off-label drug use occurred in each category of departments,and the incidence of off-label drug use was 62.10%. The incidence of off-label administration route was 40.51%, mainly atomization inhalation;the incidence of it was the high-est in gynecology and obstetrics department(92.70%).The in-cidence of off-label dosage was 36.30%,and the incidence of it was the highest in cardiothoracic surgery department (85.36%). Departments whose PDDs were higher than the drug package inserts were cardiothoracic surgery department,ICU,surgical department,cardiovascular medicine department,emer-gency department,department of internal medicine and pediatrics department.CONCLUSIONS:Off-label drug use of Ambroxol hy-drochloride injection is common,and the effectiveness,safety and necessity remain controversial,which need to be proved by multi-center randomized controlled prospective trial.
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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 off-label drug use of Ambroxol hydrochloride injection,and to provide reference for further evidence-based evaluation on rationality and standardized management of off-label drug use. METHODS:All medical orders for inpatients receiving Ambroxol hydrochloride injection were selected from 10 hospitals of Guangdong province during Apr. 2014 to Mar. 2015. Situation of drug use in different categories of departments was summarized,the incidence of off-label administation route and off-label dosage were analyzed;according to drug package inserts,prescription daily dose(PDD)and drug utilization in-dex(DUI)were calculated for each category of department,and the degree of off-label dosage was evaluated. RESULTS:A total of 761 821 person·day who used Ambroxol hydrochloride injection was included. Off-label drug use occurred in each category of departments,and the incidence of off-label drug use was 62.10%. The incidence of off-label administration route was 40.51%, mainly atomization inhalation;the incidence of it was the high-est in gynecology and obstetrics department(92.70%).The in-cidence of off-label dosage was 36.30%,and the incidence of it was the highest in cardiothoracic surgery department (85.36%). Departments whose PDDs were higher than the drug package inserts were cardiothoracic surgery department,ICU,surgical department,cardiovascular medicine department,emer-gency department,department of internal medicine and pediatrics department.CONCLUSIONS:Off-label drug use of Ambroxol hy-drochloride injection is common,and the effectiveness,safety and necessity remain controversial,which need to be proved by multi-center randomized controlled prospective trial.
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Objective To investigate the therapeutic effect of ambroxol hydrochloride on severe pneumonia, and the influence on the inflammatory cytokines of TNF-alpha and hs-CRP etc.MethodsThe clinical data of 70 patients with severe pneumonia patients treated in our hospital from December 2014 to August 2016 were retrospectively analyzed.The patients were divided into control group(n=30) and observation group(n=40) according to the treatment methods, the control group was given routine treatment, the observation group was given ambroxol hydrochloride on the basis of conventional treatment.The therapeutic effect of the two groups was observed, the differences of serum levels of inflammatory cytokines, pulmonary function, cough and expectoration symptom scores of the two groups were compared before and after treatment.ResultsThe effective rate of the observation group was 97.50%, which was significantly higher than that of the control group(80.00%);There was no significant difference in serum inflammatory cytokine levels between the two groups before treatment, after treatment,the levels of IL-6, IL-8, hs-CRP and TNF-alpha the observation group were lower than those in the control group;There was no significant difference in the indexes of lung function between the two groups before treatment.After treatment, the levels of FVC, FEV1 and FEV1/FVC in the observation group were higher than those in the control group;There was no significant difference in symptom score between the two groups before treatment.After treatment, cough, sputum volume, cough ease and wheezing scores in the observation group were lower than in the control group.ConclusionAmbroxol hydrochloride has a good therapeutic effect on severe pneumonia,which can significantly reduce the levels of inflammatory cytokines such as TNF-α and hs-CRP, and improve the related symptoms, and has good application value.
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Objective To explore and analyze the effect of ambroxol hydrochloride combined with budesonide inhalation in the treatment of neonatal pneumonia and intervention treatment. Methods May 2014 to March 2017, Taizhou Hospital for treatment of pneumonia in infants, a total of 100 cases of the research object, according to the different treatment methods of the infant patients into the control group and the study group, 50 cases in each group. The study group were treated with ambroxol combined with budesonide inhalation treatment methods, patients in control group were treated with budesonide inhalation treatment methods, two patients were given nursing intervention on in the process of treatment, observation and comparison of two groups of children were observed two different quality methods the therapeutic effect. Results The children of patients with treatment effect was stronger than the control group, the difference is statistically significant(P<0.05). The study of the recovery time and hospitalization time were significantly less than the control group, with statistically significant difference (P<0.05). The degree of satisfaction with nursing is significantly better than the control group(P<0.05). Conclusion The treatment method of neonatal pneumonia ambroxol combined with budesonide inhalation, and implement the corresponding nursing intervention, can effectively improve the clinical symptoms of patients, improve lung function in patients, improve the therapeutic effect, shorten the patient's symptoms disappeared time and hospitalization time, children can not only improve the standard of living of the patients, but also enhance the degree of recognition of the hospital and nursing care of patients thus, play a role in the promotion.