噻托溴胺对慢性阻塞性肺疾病稳定期治疗的临床观察

Clinical observation of tiotropium bromide powder in treatment on chronic obstructive pulmonary diease during stable period

目的观察噻托溴胺粉吸入剂对慢性阻塞性肺疾病(COPD)患者的临床疗效。方法将我院呼吸科门诊就诊的确诊为稳定期COPD(Ⅱ-Ⅲ级)患者60例,随机分成对照组和治疗组,治疗组(n=30)患者给予噻托溴胺粉吸入剂治疗,对照组(n=30)按需使用短效抗胆碱能支气管扩张剂,观察期为12个月,以治疗前后肺功能的变化、6分钟步行试验、急性加重和住院的次数为观察指标。结果经3个月治疗后,对照组治疗前后FEV1、FEV1%、FEVl/FVC、6MWD比较,差异无统计意义(P>0.05);治疗组治疗前后FEV1、FEV1%、FEV1/FVc、6MWD比较及两组治疗后各项指标比较,差异有显著性(P<0.01),随访3-12个月治疗组急性加重的次数明显减少,与对照组比较有显著性差异(P<0.05),治疗组用药后3个月、6个月、1年后肺功能比较无显著差异。结论噻托溴胺吸入治疗能够改善COPD稳定期(Ⅱ-Ⅲ级)患者的肺功能和运动耐力,减少急性发作。

Objective To observe the effects of tiotropium bromide powder for inhalation in the treatment of chronic obstructive pulmonary diease（COPD）. Methods 60 cases outpatients （ Level Ⅱ -Ⅲ ） with diagnosis of stable COPD were randomly divided into control group and treatment group. 30 patients in treatment group received tiotropium bromide powder inhalation. The other 30 patients in con- trol group used anticholinergic short-acting bronchodilators on demand. The Observation period is 12 monthes. Observation indexes includ- ed： changes in respiratory functions,6 mim walk test （6MWT）, and acute exacerbation and hospitalization time before and after treatment of the two groups . Results After three monthes, no statistical significance differences （ P 〉 0.05 ） were in the values of FEV1 , FEV1%, FEVI/FVC and 6MWT of the control group before and after treatment; while significant differences （P 〈 0.01 ） existed in the values of FEVt , FEV1%, FEV1/FVC and 6MWT of the treatment group before and after treatment and the comparison of the above values between the two groups. The times of acute exacerbation decreased in the follow-up visit for the treatment group, with significant difference （P 〈 0.05 ） as compared with the control group. There was no marked difference of pulmonary function after treatment of 3 months,6 months and 12 months in the treatment group. Conclusion Tiotropium bromide inhalation can effectively improve pulmonary function and exercise endurance, and reduce the acute attack frequency in the treatment of Chronic obstructive pulmonary disease patients （ Level Ⅱ -Ⅲ） during the stable period.