沙丁胺醇联合布地奈德在慢性阻塞性肺疾病急性期呼吸道雾化吸入中的临床研究

Effect of Salbutamol combined with budesonide in treatment of acute exacerbation phase of chronic obstructive pulmonary disease

目的探讨沙丁胺醇联合布地奈德在慢性阻塞性肺疾病(COPD)急性期患者呼吸道雾化吸入中的方法和疗效,为临床治疗提供参考。方法回顾性分析本院于2010年1月至2011年1月收治的50例COPD急性期患者。用机械抽样法随机分成两组,对照组25例,在给予常规治疗的同时行沙丁胺醇雾化吸入;实验组25例,在常规治疗的基础上行沙丁胺醇联合布地奈德雾化吸入。两组均治疗10d,随访1～2周,比较治疗前后两组患者总有效率(显效+有效)和pH,PaCO2,PaO2,FEV1/FVC、FEV占预计值百分比等肺功能、血气指标变化。结果两组相比,治疗后实验组患者的总有效率(显效+有效)为92%,优于对照组的76%,差异有统计学意义(P<0.05);随访期间两组内相比,治疗后两组患者的肺功能、血气指标变化等均优于治疗前,差异有统计学意义(P<0.05);两组间比较,实验组患者的上述指标均优于对照组,差异有统计学意义(P<0.05)。结论应用沙丁胺醇联合布地奈德早期对COPD急性期患者进行呼吸道雾化吸入,可以有效改善患者的预后,显著改善其血气指标,应当在临床中推广使用。

Objective To evaluate the effect of salbutamol combined with budesonide in the treatment of acute exacerbation phase of chronic obstructive pulmonary disease （COPD）.Methods A retrospective analysis was performed on 50 patients with acute exacerbation phase of COPD admitted to hospital from January 2010 to January 2011.The 50 patients were randomly divided into the study group and the control group by mechanical sampling,each with 25 cases.The control group received salbutamol inhalation plus conventional therapy,while the study group was treated by inhalation of salbutamol combined with budesonide based on conventional treatment.Both groups were treated for 10 days,and followed up for 1～2 weeks.The total effective rate （CR＋ effective）,PH,PaCO2,PaO2,FEV1/FVC,FEV% predicted,and blood gas changes before and after treatment in the two groups were compared.Results After treatment,the total effective rate （effective and markedly effective） in the study group was 92%,which is significantly higher than 76% in the control group （P0.05）.Comparison within group showed that lung function and blood gas changes after treatment were significantly better than that before treatment （P0.05）.Comparison between the two groups showed that all the indexes tested were significantly better than those in the control group （P0.05）.Conclusion Salbutamol combined with budesonide was effective in treating acute exacerbation phase of COPD patients,by improving the prognosis and blood-like,which is worthy to be extended in clinical practice