射流雾化吸入维拉帕米治疗COPD的临床探讨

Exploration of inhaled verapamil by jet nebulizer in treatment of AECOPD patients

目的探讨射流雾化吸入维拉帕米治疗慢性阻塞性肺疾病(COPD)急性加重期的临床价值及不良反应。方法34例轻、中度COPD急性加重期住院病人,分为维拉帕米组15例,万托林组19例。用氧启动的射流雾化器分别吸入上述药物,每日2次,5-7天一疗程。结果维拉帕米组治疗前后PEF自身对照有统计学意义(t=3.14,P=0.016)。万托林组治疗前后PEF自身对照有高度统计学意义(t=3.75,P=0.0045)。维拉帕米组显效0例,有效13例,无效2例;万托林组显效1例,有效18例,无效0例;两组疗效经秩和检验无统计学意义(Z=1.7626,P=0.0780)。结论轻至中度COPD急性加重期在常规治疗基础上,射流雾化吸入维拉帕米后,患者临床症状和体征得到较好改善,PEF得到明显提高,两组疗效相近但无心悸、手抖等不良反应。射流雾化吸入维拉帕米治疗COPD急性加重期特别是合并高血压、冠心病、甲亢等并发症者,有较好的应用前景。

Objective To study the efficacy as well as the side-effects of the therapy inhaled verapamil by jet nebulizer in treatment of acute exacerbation of the chronic obstructive disease(AECOPD).Methods 34 cases of mild to moderate AECOPD were divided into two groups;one was the study group in which 15 cases were treated with verapamil;the other was the control group in which 19 cases were treated with salbutamol.both groups inhaled each drug by jet nebulizer started with oxygen,twice daily for 5 to 7 days.Results In the study group the PEF before treatment was (105.63±48.07)L/M,while after treatment was(183.75±105.96)L/M,with self contrast being t=3.14,P=0.016.In the control group the PEF before treatment was(52.00±50.29)L/M,while after treatment was(135.00±95.60)L/M,with self contrast being t=3.75,P=0.0045.The curative effets were as follows;The study group significant effective 0 case、effective 13 cases、in-effective 2 cases;The control group significant offective 1 cases、effective 13 cases、in-effective 2 cases;The control group significant offective 1 cases、effective 18 cases、ineffective 0 case.(Z=1.7626,P=0.0780).Conclusion After the treatment of inhaled verapamil by jet nebulizer to cure mild to moderate AECOPD based on the general medical treatment,the patients chinical symptoms had been improved,the PEF was increased obviously Without the side-effect such as heart beat-rate increasing and hand trembling.Thus to AECOPD,especially coexisted with hypertension、coronary atheroselerotic heart disease and hyperthryroidism et al.this therapy has a applied value in future.