联合吸入沙丁胺醇布地奈德对AECOPD的疗效及安全性评估

Effects and safety of nebulizations inhalation of salbutamol plus budesonide in the treatment of patients with acute exacerbations of chronic obstructive pulmonary disease

目的评估联合吸入沙丁胺醇、布地奈德对慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)患者的疗效及安全性。方法将80例AECOPD患者随机分为四组,沙丁胺醇联合布地奈德组(联合组)、沙丁胺醇组或布地奈德组(单药组)和对照组各20例。四组患者均给予低流量吸氧、抗感染、解痉平喘化痰等常规治疗。联合组在常规治疗的基础上加沙丁胺醇5 mg和布地奈德2 ml氧气驱动雾化吸入,2次/d;单药组在常规治疗的基础上分别加沙丁胺醇5 mg或布地奈德2 ml氧气驱动雾化吸入,2次/d;对照组仅采取上述常规治疗。四组患者均于治疗前及首次治疗后1、10d测定肺功能、动脉血气。治疗前、治疗结束后测空腹血糖、血钙浓度。结果治疗前四组间各指标比较差异无统计学意义(P>0.05)。首次治疗后1d联合组与治疗前比较差异有统计学意义(P<0.05),而其余三组与治疗前比较差异均无统计学意义(P>0.05)。治疗后10 d四组均与治疗前比较差异有统计学意义(P<0.05)。而联合组与单药组比较差异无统计学意义(P>0.05)。与对照组比较仍有显著性差异。治疗后四组间血糖、骨代谢各指标与治疗前比较差异无统计学意义(P>0.05)。结论沙丁胺醇、布地奈德雾化吸入治疗AECOPD疗效肯定,联合沙丁胺醇、布地奈德起效快而安全。

Objective To expIore the effects and safety of nebulizations inhalation of salbutamol plus budesonide in the treatment of patients with acute exacerbations of chronic obstructive pulmonary disease （AECOPD）. Methods Eighty patients with AECOPD were randomly divided into four groups： the salbutamol plus budcsonide group （combination group）, the salbutamol or budesonide group （sole medicine group） and the control group. The basic treatments for the four groups included oxygen, antibiotics, antiasthmatics and apophlegmatisant. The combination group was given nebulizations inhalation of salbutamol plus budesonide, the sole medicine group was only given salbutamol inhalation or budesonide inhalation. All patients underwent pulmonary function test and arterial blood gas analysis before treatment and 1 day, 10 days after therapy. All patients underwent blood glucose test and calcium test before and after treatment. Results There were no difference among four groups before treatments （P 〉 0. 05）. One day after therapy, there were significant difference in pulmonary function and arterial blood gas analysis in combina- tion group （P 〈0. 05）. Ten days after therapy, there were significant difference in pulmonary function and arterial blood gas analysis among four groups （ P 〈 0. 05 ） after treatment. There were no difference between combination group and sole medicine group （P 〉 0. 05 ）. There were significant difference between treatment group and control group. There were no difference in blood glucose and calcium in four groups. Conclusion Salbutamol and budes- onide are safe and effective drug in the treatment of AECOPD. Nebullzations inhalation of salbutamol plus budesonide can improve pulmonary function and arterial blood gas of patients with AECOPD in short period.