社区中重度COPD稳定期患者不同治疗方案的临床对照研究

Clinical control study of different treatment protocol for community moderate and sereve stable COPD patients

目的探索不同治疗方案对社区稳定期中重度慢性阻塞性肺疾病(COPD)患者的肺功能、生活质量的影响。方法选取80名诊断为中重度COPD的稳定期患者,随机分为2组,对照组采用COPD健康教育、肺功能康复锻炼、茶碱等药物治疗及沙丁胺醇按需吸入治疗。实验组在对照组治疗的基础上接受布地奈德/福莫特罗80/4.5μg(2次/d)治疗。2组均按需吸入沙丁胺醇治疗并记录使用次数。采用重复测量设计的两因素方差分析、t检验、单因素方差分析等统计学方法对实验数据进行分析。结果 2组患者治疗后FEV1、FEV1%和FVC、6分钟步行试验等均比治疗前有所提高;而实验组患者提高量较明显(P<0.05)。2组患者治疗后呼吸困难评分、SGRQ总分以及BODE指数、使用沙丁胺醇雾化吸入缓解药物的使用量明显低于治疗前(P<0.05)。结论在社区中重度COPD患者治疗中,通过长期、按需吸入布地奈德/福莫特罗联合健康教育与肺康复治疗对患者的病情改善明显。

Objective To explore the impact of different treatment options on lung function, quality of life of patients with community stable moderate to severe chronic obstructive pulmonary disease （COPD）. Methods 80 The community diag- nosis of moderate to severe stable COPD patients were randomly divided into two groups, the control group （ n = 35 ） using COPD health education, pulmonary rehabilitation exercises, the ophylline and albuterol on demand. Experimental group （n = 35） received budesonide/formoterol 80/4.5 g BID treatment. Two treatment groups were inhaled salbutamol as needed. Results The two groups of patients after treatment, FEV1, FEV1% and FVC, the 6 minute walk test were im- proved when compared with those before treatment;while the patients in the experimental group increased significantly （P 〈 0.05）. Two groups of patients after the treatment of dyspnea score, SGRQ score and BODE index, using salbutamol atomization inhalation in the use of rescue medication was obviously lower than those of before treatment（ P 〈 0.05 ）. Con- clusion In the community, in the treatment of patients with severe COPD, the long-term , on-demand inhaled budes- onide/formoterol health education and pulmonary rehabilitation therapy can improve the patients obviously.