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目的:观察羧甲司坦辅助治疗稳定期慢性阻塞性肺疾病(COPD)的临床疗效、不良反应及对炎症因子的影响.方法:114例稳定期COPD患者随机分为对照组和观察组各57例,对照组给予常规治疗,观察组在对照组基础上加用羧甲司坦片,12个月为一疗程.比较两组患者肺功能、6min步行距离(6MWT)、1年内急性加重次数,圣乔治呼吸问题调查问卷(SGRQ)评价生活质量,测定诱导痰中炎症因子(IL-1β、IL-6、IL-8、TNF-α)含量,记录药品不良反应.结果:治疗后,两组患者的肺功能、6MWT、1年内急性加重次数均较前明显改善(P＜0.05),且观察组6MWT、急性加重次数明显优于对照组(P＜0.05);两组患者SGRQ量表各项评分均较前下降(P＜0.05),且观察组部分评分优于对照组(P＜0.05);两组患者痰炎症因子水平均较前显著降低(P＜0.05),且观察组明显低于对照组(P＜0.05).两组药品不良反应发生率相近(P＞0.05).结论:羧甲司坦可明显提高稳定期COPD患者的运动能力和生活质量,降低急性加重次数,这可能与其降低气道炎症因子水平有关.","Objective:To observe the clinical effects,adverse reactions and impacts on inflammatory cytokines of carbocisteine on patients with stable COPD.Methods:114 patients were randomly divided into observation group and control group,the control group was treated with conventional therapy,the observation group received carbocisteine additionally.All treated for 12 months.Pulmonary function,6-minute walking distance (6MWT),the frequency of acute exacerbation were compared,the St george's respiratory questionnaire(SGRQ) was used to evaluate the quality of life,the level of inflammatory cytokines (IL-1 β,IL-6,IL-8 and TNF-α) in induced sputum were determined,the adverse reactions were recorded.Results:After treatment,compared with those before treatment,the pulmonary function,6MWT and the frequency of acute exacerbation improved greatly in both groups (P ＜ 0.05);for the observation group,the 6MWT and frequency of acute exacerbation were better than those of control group (P ＜ 0.05).The SGRQ scores decreased greatly in both groups (P ＜ 0.05),and some scores were better in the observation group (P ＜ 0.05).The level of inflammatory cytokines in induced sputum decreased greatly in both groups (P ＜ 0.05),and those in observation group were lower (P ＜ 0.05).The occurrence rate of adverse reactions was similar (P ＞ 0.05).Conclusion:For the patients with stable COPD,carbocisteine could increase their sports ability and quality of life,decrease the frequency of acute exacerbation,reducing airway inflammation might be its mechanisms.