噻托溴铵吸入剂治疗稳定期C和D类慢性阻塞性肺疾病的疗效评估

Effects of tiotropium bromide on the patients in the stationary phase of C,D chronic obstructive pulmonary disease

目的探讨噻托溴铵吸入剂对稳定期C、D类慢性阻塞性肺疾病(COPD)患者的临床症状及肺功能的改善情况。方法 82例稳定期C、D类COPD患者采用随机数字表法随机分为治疗组41例,给予噻托溴铵吸入剂(18μg,1次/d)治疗;对照组41例,按照COPD诊治指南给予抗感染、扩张气道、祛痰、氧疗等常规治疗。观察患者治疗前、治疗后肺功能,运动耐量,呼吸困难评分的变化。结果治疗后2组用力肺活量(FVC)、第1秒用力呼气容积(FEV1)和第1秒用力呼气容积占预计值百分比(FEV1%pred)值均较治疗前明显增加(P<0.05),治疗组指标改善显著优于对照组(P<0.05);2组6min步行距离(6MWD)值均较治疗前明显增加,治疗组优于对照组;呼吸困难评分(MRC)均较治疗前显著下降(P<0.05),而治疗组中各项指标改善显著优于对照组(P<0.05)。结论长期使用噻托溴铵吸入剂能显著提高COPD患者肺功能、呼吸困难等症状,改善生活质量。

Objective To explore the effects of tiotropium bromide on the patients in the stationary phase of C,D chronic obstructive pulmonary disease （COPD）. Methods Eighty-two cases of stationary phase C, D COPD patients were randomly divided into the treatment group and the control group, 41 cases in both croups. The treatment group was given tiotropium bromide inhalant treatment （18 /ag, inhalation, l/d）, while control group was given anti-infective therapy, expansion airway treatment, eliminating phlegm oxgen therapy and other conven- tional treatment in accordance with COPD treatment guidelines. Then the differences of the pulmonary function, exercise tolerance, breathing difficulties assessment changes between both groups were observed. Results After treatment, FVC,FEV1 and FEVI~ pred value of two groups increased significantly （P^0.05）, and that of treatment group was superior to the control group （P^0.05）; the six minutes walking distance was obviously longer; MRC breathing difficulties assessment was notably lower （P^0.05）, and that of treatment group was su- perior to the control group （P〈~0.05） ; the frequency of acute aggravation and the times of hospitalization due to acute aggravation in treatment group were significantly lower than those in the control gorup （P〈0.05）. Conclu- sion The effects of tiotropium bromide and salmeterol/fluticasone propionate combined inhalant treatment is bet- ter than that of salmeterol/flutieasone propionate inhalant treatment.