To observe the clinical effect and safety of N-acetylcysteine combined with budesonide and terbutaline in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and respiratory failure (RF).

According to queuing method, patients with AECOPD and RF were divided into treatment group and control group. On basis of basic treatment, control group was given aerosol inhalation of budesonide suspension (1 mg/once, bid) and terbutaline solution (5 mg/once, bid), while treatment group was given aerosol inhalation of N-acetylcysteine solution (0.3 g/once, bid) on basis of control group. All patients were treated for 2 weeks. The clinical effect, pulmonary function indexes [forced vital capacity (FVC), peak expiratory flow (PEF)], dyspnea degree [modified version of British medical research council dyspnea scale (mMRC)], oxidative stress response indexes [superoxide dismutase (SOD)] and inflammatory response indexes [hypersensitive C-reactive protein (hs-CRP)] were compared between the two groups after treatment, and safety was evaluated.

There were 56 cases in control group and 64 cases in treatment group. After treatment, the total effective rate of the treatment group and the control group were 93.75% (60 cases /64 cases) and 82.14% (46 cases /56 cases), respectively, and the difference was statistically significant (P<0.05). After treatment, FVC in treatment group and control group were (2.41±0.59) and (2.08±0.54) L; PEF were (4.97±1.18) and (4.08±1.12) L·s^-1; mMRC scores were (1.86±0.39) and (2.67±0.56) points; SOD levels were (97.54±8.03) and (79.02±7.27) U·L^-1; hs-CRP levels were (5.09±1.42) and (8.63±2.13) mg·L^-1. Compared with control group, the above indexes in treatment group were statistically significant (all P<0.001). The adverse drug reactions in treatment group were mainly on vomiting, rash, palpitation and nausea, while in control group were mainly on fatigue, gastrointestinal reactions and rash. There was no significant difference in total incidence of adverse drug reactions between treatment group and control group [10.94% (7 cases/64 cases) vs 8.93% (5 cases/56 cases), P>0.05].

Curative effect of N-acetylcysteine combined with budesonide and terbutaline is significant in patients with AECOPD and RF, which can promote the recovery of pulmonary function, relieve dyspnea, oxidative stress and inflammatory response.