慢性阻塞性肺疾病合并哮喘患者噻托溴铵粉吸入剂联合布地奈德福莫特罗吸入粉雾剂疗效观察

Effect of tiotropium bromide powder combined with budesonide formoterol powder inhalation on inflammatory factors and lung function in patients with chronic obstructive pulmonary disease complicated with asthma

目的探讨噻托溴铵粉吸入剂联合布地奈德福莫特罗吸入粉雾剂方案治疗慢性阻塞性肺疾病(COPD)伴哮喘患者的临床效果及价值。方法选取2019年2月至2020年2月徐州矿务集团总医院收治100例COPD伴哮喘患者作为研究对象,采用随机数字表法分为观察组和对照组,每组50例。对照组治疗方案为常规治疗+布地奈德福莫特罗吸入粉雾剂治疗,观察组在对照组治疗基础上加用噻托溴铵粉吸入剂,两组治疗时间均为3个月。比较两组患者炎症反应、肺功能、血气指标等改善情况。结果观察组治疗后白细胞介素-5(IL-5)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、超敏C-反应蛋白(hs-CRP)水平均低于对照组,差异有统计学意义(P<0.05);观察组治疗后呼气高峰流速(PEF)及1秒用力呼气容积(FEV1)、FEV1/FVC、FEV1%高于对照组,差异均有统计学意义(P<0.05);观察组治疗后动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))均高于对照组,而动脉血二氧化碳分压(PaCO_(2))低于对照组,差异有统计学意义(P<0.05);对照组、观察组轻度不良反应总发生率分别为4.00%、6.00%,差异无统计学意义(P>0.05)。结论COPD伴哮喘患者临床治疗中将布地奈德福莫特罗吸入粉雾剂和噻托溴铵粉吸入剂联合使用,可有效提高炎症控制效果,使患者肺功能、血气分析得到更理想改善,且不会增加药物不良反应。

Objective To evaluate the clinical effect of tiotropium bromide powder combined with budesonide formoterol powder inhalation on the treatment of chronic obstructive pulmonary disease(COPD)with asthma.Methods From February 2019 to February 2020,100 COPD patients with asthma were randomly divided into two groups.The control group(n=50)was treated with routine treatment plus budesonide formoterol inhalation powder,and the observation group(n=50)was treated with tiotropium bromide powder based on the treatment of the control group.Both groups were treatedfor 3 months.The improvement of inflammatory reaction,lung function and blood gas in the two groups were observed.Results The levels of interleukin-5(IL-5),interleukin-6(IL-6),tumor necrosis factors-α(TNF-α),and high sensitive C-reactive protein(hs-CRP)in the observation group were significantly lower than those in the control group(P<0.05).Peak expiratory flow(PEF),forced expiratory volume in one second(FEV1),FEV1/forced vital capacity(FVC)and FEV1 as a percentage of expected value(FEV1%)in the observation group were significantly higher than those in the control group(P<0.05).Arterial partial pressure of oxygen(PaO_(2))and arterial oxygen saturation(SaO_(2))in the observation group were significantly higher than those in the control group,and arterial partial pressure of carbon dioxide(PaCO_(2))was lower than that in the control group(P<0.05).The total incidence of mild adverse reactions in the control group and the observation group were 4.00%and 6.00%,respectively(P>0.05).Conclusion For patients with COPD and asthma,tiotropium bromide powder combined with budesonide formoterol powder inhalation can effectively improve their inflammation level,lung function,and blood gas,and it will not increase the adverse drug reactions.