噻托溴铵联合布地奈德福莫特罗治疗老年稳定期慢性阻塞性肺疾病的效果观察

Observation on the Efficacy of Tiotropium Bromide Combined with Budesonide Fomotrol in Elderly Patients with Stable Chronic Obstructive Pulmonary Disease

目的观察联合应用噻托溴铵与布地奈德福莫特罗对老年稳定期慢性阻塞性肺疾病(简称慢阻肺)患者的治疗效果。方法选择2021年1月-2022年12月该院收治的78例老年稳定期慢阻肺患者为研究对象,采用抽签法将研究对象随机分为对照组和观察组,各39例。对照组采用布地奈德福莫特罗治疗,观察组在对照组基础上采用噻托溴铵治疗。比较两组症状缓解时间、肺功能、炎症因子和不良反应发生情况。结果观察组咳嗽缓解时间(4.69±1.33)d、咳痰缓解时间(4.29±1.27)d、喘息缓解时间(3.87±0.92)d、肺部阳性体征缓解时间(7.92±1.34)d均短于对照组,组间差异有统计学意义(P<0.05)。治疗后,两组肺活量(FVC)、呼气峰流速(PEF)、最大呼气中期流速(MMEF)均大于治疗前,且观察组FVC、PEF和MMEF均大于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清C反应蛋白(CRP)、降钙素原(PCT)水平均低于治疗前,且观察组血清CRP、PCT水平均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论噻托溴铵联合布地奈德福莫特罗能缓解老年稳定期慢阻肺患者的临床症状,改善肺功能,减轻炎症反应,且不增加不良反应。

Objective To observe the effect of tiotropium bromide combined with budesonide and formoterol on elderly patients with stable COPD.Methods 78 elderly patients with stable chronic obstructive pulmonary disease admitted to the hospital from January 2021 to December 2022 were selected as the study subjects.The study subjects were randomly divided into a control group and an observation group using a lottery method,with 39 cases in each group.The control group was treated with budesonide and formoterol alone,while the experimental group was treated with tiotropium bromide in combination.Compare the time of symptom remission time,lung function,inflammatory factors,and adverse reactions between the two groups.Results The cough relief time(4.69±1.33)d,sputum relief time(4.29±1.27)d,wheezing relief time(3.87±0.92)d and positive pulmonary signs relief time(7.92±1.34)d in observation group were shorter than those in control group,and the differences between groups were statistically significant(P<0.05).After treatment,the lung capacity(FVC),peak expiratory flow rate(PEF),and maximum mid expiratory flow rate(MMEF)of both groups were greater than before treatment,and the FVC,PEF,and MMEF of the observation group were greater than those of the control group,with statistical significance(P<0.05).After treatment,the serum levels of C-reactive protein(CRP)and procalcitonin(PCT)in both groups were lower than before treatment,and the serum levels of CRP and PCT in the observation group were lower than those in the control group,with statistical significance(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Tiotropium combined with budesonide and formoterol can relieve clinical symptoms,improve lung function,reduce inflammatory response,and do not increase adverse reactions in elderly patients with stable COPD.