【摘要】 目的 观察桉柠蒎肠溶软胶囊（桉柠蒎）治疗慢性阻塞性肺疾病急性加重期（AECOPD）患者的临床疗效，并探讨其减轻气道黏液高分泌的作用机制。方法 将2022年1月至2024年6月期间成都医学院第二附属医院呼吸与危重症医学科收治的137例AECOPD住院患者按随机数表法分为对照组69例和观察组68例。对照组患者接受常规治疗，观察组患者在常规治疗基础上加用桉柠蒎治疗，连续治疗12 d。比较两组患者的治疗效果，以及治疗前后的炎性因子水平[超敏C反应蛋白（hs-CRP）、血清淀粉样蛋白A（SAA）、白细胞介素-6（IL-6）]、气道黏液高分泌指标[血清中性粒细胞弹力蛋白酶（NE）、黏蛋白5ac（MUC5ac）含量、日痰量、痰黏度]、肺功能指标[第1秒用力呼气容积（FEV₁）、FEV₁占预计值百分比（FEV₁pre%）、FEV₁/用力肺活量（FVC）比值（FEV₁/FVC）、气道阻力]，通过Spearman相关性分析AECOPD患者的NE与MUC5ac、痰量和痰黏度的相关性，同时比较两组患者治疗期间的不良反应发生率。结果 观察组患者的治疗总有效率为95.59%，明显高于对照组的85.51%，差异有统计学意义（P<0.05）；治疗后观察组患者的hs-CRP、SAA、IL-6、NE、MUC5ac、日痰量、痰黏度分别为4.00（3.00,8.75） mg/L、13.00（5.00,23.75） mg/L、3.17（1.43,5.83） pg/mL、（3.84±1.73）μg/L、0.46（0.36,0.70）μg/L、6.26（5.21,9.31） g、（2.98±1.05）×10^-2Pa·s，明显低于对照组的6.00（4.00,13.00） mg/L、23.00（8.00,37.50） mg/L、3.84（2.64,7.64） pg/mL、（4.96±3.26）μg/L、0.65（0.40,0.84）μg/L、8.69（7.26,11.67） g、（3.95±0.84）×10^-2Pa·s，差异均有统计学意义（P<0.05）；治疗后观察组患者的FEV1Pre%为（57.19±7.16）%，明显高于对照组的（52.72±8.98）%,Z5Hz%pred为（121.01±11.31）%，明显低于对照组的（130.79±9.56）%，差异均有统计学意义（P<0.05）；所有AECOPD患者治疗前后的NE均与MUC5ac、痰量、痰黏度呈显著正相关（r=0.650,P=0.000;r=0.641,P=0.000;r=0.600,P=0.000）。观察组患者治疗期间的不良反应总发生率为13.24%，略高于对照组的8.70%，但差异无统计学意义（P>0.05）。结论 桉柠蒎可显著减轻AECOPD患者的气道黏液高分泌及炎症反应，改善肺功能并提高临床疗效，其作用机制可能与NE介导的通路有关。更多还原

【Abstract】 Objective To observe the clinical efficacy of Eucalyptol, Pinene, and Dipentene Enteric Soft Capsules（Eucalyptol, Pinene, and Dipentene） in treating patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD） and to explore its mechanism in alleviating airway mucus hypersecretion. Methods A total of 137 hospitalized AECOPD patients admitted to the Department of Respiratory and Critical Care Medicine of the Second Affiliated Hospital of Chengdu Medical College between January 2022 and June 2024 were randomized into a control group（69 cases） and an observation group（68 cases）. Patients in the control group received conventional treatment,while those in the observation group received additional Eucalyptol, Pinene, and Dipentene treatment for 12 days. Treatment efficacy, levels of inflammatory factors（high-sensitivity C-reactive protein [hs-CRP], serum amyloid A [SAA], interleukin-6 [IL-6]）, airway mucus hypersecretion indicators（serum neutrophil elastase [NE], mucin 5ac [MUC5ac] levels, daily sputum volume, sputum viscosity）, and lung function parameters（forced expiratory volume in 1 second [FEV₁], FEV₁ as a percentage of predicted value [FEV₁pre%], FEV₁/forced vital capacity ratio [FEV₁/FVC], airway resistance） were compared between the two groups before and after treatment. Spearman correlation analysis was used to assess the relationship between NE and MUC5ac, sputum volume, and sputum viscosity in AECOPD patients. The incidence of adverse reactions during treatment was also compared between the two groups. Results The total effective rate in the observation group was 95.59%, significantly higher than 85.51% in the control group（P<0.05）. After treatment, the observation group showed significantly lower levels of hs-CRP, SAA, IL-6, NE, MUC5ac, daily sputum volume, and sputum viscosity compared to the control group（all P<0.05）: 4.00（3.00, 8.75） mg/L, 13.00（5.00, 23.75） mg/L, 3.17（1.43, 5.83） pg/mL,（3.84±1.73） μg/L, 0.46（0.36, 0.70） μg/L, 6.26（5.21, 9.31） g,（2.98±1.05）×10^-2Pa·s versus 6.00（4.00, 13.00） mg/L, 23.00（8.00, 37.50） mg/L, 3.84（2.64, 7.64） pg/mL,（4.96±3.26） μg/L, 0.65（0.40, 0.84） μg/L, 8.69（7.26, 11.67） g,（3.95±0.84）×10^-2Pa·s, respectively. After treatment, the observation group had significantly higher FEV1pre% and lower Z5Hz%pred compared to the control group（all P<0.05）:（57.19±7.16）%,（121.01±11.31）% versus（52.72±8.98）%,（130.79±9.56）%, respectively. Spearman correlation analysis revealed significant positive correlations between NE and MUC5ac, sputum volume, sputum viscosity in AECOPD patients before and after treatment（r=0.650,P=0.000; r=0.641, P=0.000; r=0.600, P=0.000）. The total incidence of adverse reactions in the observation group was13.24%, slightly higher than 8.70% in the control group（P>0.05）. Conclusion Eucalyptol, Pinene, and Dipentene significantly alleviate airway mucus hypersecretion and inflammatory responses in AECOPD patients, improve lung function, and enhance clinical efficacy. The mechanism may be related to pathways mediated by NE.更多还原