The application value of combination of ambroxol and fluid-micronized ipratropium bromide in treating senile refractory pneumonia / 中华老年医学杂志

ABSTRACT

Objective To investigate the application value of combination of ambroxol and fluidmicronized ipratropium bromide in full dose and frequency in treating senile refractory pneumonia.Methods From January 2010 to November 2013,84 cases of elderly patients with refractory pneumonia were divided into 3 groups.On the basis of anti-inflammatory and symptomatic treatment,the control group (n=28) received routine sputum suction and normal saline irrigation;the routine dose group (n=28) received the intravenous ambroxol 15 mg twice daily and the inhalation of 2.5 ml of nebulized ipratropium bromide once daily plus treatment in control group while full dose group (n=28) received intravenous ambroxol hydrochloride 30 mg three times a day and the inhalation of 2.5 ml of nebulized ipratropium bromide four times a day.The severity of pulmonary infection was described by clinical pulmonary infection score (CPIS) and C reactive protein (CRP),and therapeutic efficiency was evaluated by clinical symptom remission time,average hospitalization days and effective rate.Results At the 5 day and 10 days after treatment,the CPIS in full dose group was (4.82 ± 1.21) scores and (4.39± 1.03),respectively,C-reactive protein (CRP) was (58.11 ± 11.12) mg/L and (57.57±12.69) mg/L respectively,and these CPIS and CRP values at the 5 day and 10 days were significantly lower than those in the control group (6.10 ± 1.10) scores and (5.36 ± 0.95) scores,(74.50± 12.79)mg/L and (68.46± 13.77) mg/L (all P＜0.05).The above Values were lower as compared with those [(5.43±0.84) and (5.21 ±0.83),(65.11 ±834) mg/L and (59.11± 13.77) mg/L (P＜ 0.05)] in routine dose group.The CPIS and CRP concentration in full dose group and routine dose group were lower at the 10 days than at the 5 days (P＜0.05).Besides,clinical symptom remission time (4.43 ± 1.75) days,average hospitalization duration(26.32 ± 4.92) days in full dose group,clinical symptom remission time (5.68 ± 2.29) day,average hospitalization (32.21 ± 5.63) days in conventional dose group were significantly lower than in the control group (7.79±2.74) and (36.71 ± 11.78) days (P ＜ 0.05).Clinical manifestation,time of remission,and average hospitalization days of the full dose group were also reduced as compared with the conventional dose group (P＜0.05).The efficiency rates in the three groups of control,conventional dose and full dose were 42.9％ (12/28),71.4％ (20/28),92.9％ (26/28),among which the efficiency of full dose group was significantly higher than those of the control group and the conventional dose group,(x2 =16.047,6.788,P＜0.01).The conventional dose group showed a higher efficiency than the control group (x2 =4.667,P ＜ 0.01).Conclusions Combination of ambroxol and fluid-micronized ipratropium bromidet in full dose and frequency for treating senile refractory pneumonia is a useful managemen in the elderly patients.