多靶点抗炎治疗老年慢性阻塞性肺疾病急性加重期临床研究

Multi-targeted Anti-inflammatory Therapy for Treatment of Acute Episode of Chronic Pulmonary Disease in Elders

目的探讨白三烯受体拮抗剂孟鲁司特联合吸入布地奈德、异丙托溴铵多靶点抗炎治疗慢性阻塞性肺疾病急性加重(AECOPD)患者的临床疗效。方法 154例患者随机分为对照组及治疗组,各77例,对照组给予常规治疗;治疗组在给予对照组相同治疗的基础上应用氧气驱动气雾吸入布地奈德与异丙托溴铵,并同时每晚口服白三烯受体拮抗剂孟鲁司特10 mg。10 d后观察两组呼吸困难、运动耐力评分,治疗效果及不良反应。结果治疗后治疗组与对照组呼吸困难及运动耐力评分较治疗前明显改善,差异有统计学意义(P<0.01);治疗组治疗后呼吸困难及运动耐力评分较对照组呼吸困难及运动耐力评分显著改善,差异有统计学意义(P<0.05)。治疗组疗效明显优于对照组,差异有统计学意义(P<0.05)。结论白三烯受体拮抗剂孟鲁司特口服及氧气驱动气雾吸入糖皮质激素(布地奈德)和异丙托溴铵多靶点联合抗炎治疗AECOPD,疗效优于常规治疗组,可在临床应用。

Objective To investigate the clinic effects of leukotriene receptor antagonists combined with budesonide and ipratropium bromide in treatment of acute episode of chronic pulmonary disease（AECOPD） in elders.Methods Totally 154 patients with AECOPD were divided into 2 groups randomly.The patients in the control group（n=77） were treated by conventional therapy;while the patients in the trial group（n=77） were treated by additional montelukast（a leukotriene receptor antagonist） 10 mg q.n.orally,combined with nebulized budesonide and ipratropium bromide.The scores of dyspnea and exercise tolerance and treatment effectiveness and adverse reaction were compared between the two groups after 10 day＇s treatment.Results The scores of dyspnea and exercise tolerance of both groups were improved significantly after treatment（P0.01）.The scores of dyspnea and exercise tolerance of trial group were superior to those of control group（P0.05）.The effect of the trial group was higher than that of control group（P0.05）.Conclusion The multi-targeted anti-inflammatory therapy of leukotriene receptor antagonist montelukast combined with budesonide and ipratropium bromide in treatment of elderly AECOPD is more effective than that conventional therapy.