噻托溴铵治疗中重度支气管哮喘30例临床观察

Clinical effectiveness of tiotropium bromide on the moderate to severe bronchial asthma

目的：探讨噻托溴铵在中重度支气管哮喘治疗中的意义.方法：将60例中重度支气管哮喘患者随机分为观察组和对照组,两组患者均依据2009 GINA规范治疗3个月,其中观察组每天增加吸入一次噻托溴铵18μg.比较两组患者治疗前后性别、年龄、病程、哮喘控制测试（ACT）评分、血清免疫球蛋白E（IgE）、嗜酸细胞计数（EOS）、吸入支气管扩张剂后一秒钟用力呼气量（FEV1）、用力呼气中期流速（FEF25％～75％）值、用力呼气峰速（PEF）及每周急救药使用次数等指标变化并进行统计学分析.结果：①两组间患者性别、年龄、病程、治疗前各指标差异无统计学意义（P＞0.05）.②治疗后两组各指标与治疗前比较,差异有统计学意义（P＜0.01）.③治疗后,观察组的ACT评分、FEV1、PEF、FEF及每周急救药使用喷数与对照组比较,差异有统计学意义（P＜0.01）.治疗后观察组EOS、IgE与对照组比较,差异无统计学意义（P＞0.05）.结论：噻托溴铵治疗中重度支气管哮喘有效,且以扩张气道、改善症状和肺功能为主,其是否有非特异性抗炎作用还需进一步研究论证.

Objective：To observe the effectiveness of tiotropium bromide on moderate to severe bronchial asthma.Methods：A total of 60 cases of moderate to severe bronchial asthma were randomly divided into two groups：the treatment group and the control group.According to asthma control strategy in 2009 GINA,two groups were all treated for 3 months,and the treatment group was managed with an additional 18ug tiotropium bromide once daily.Before and after treatment,gender,age,course of disease,asthma control test （ACT） score,serum immune globulin E （IgE）,eosinophil （EOS） count,forced expiratory volume in one second （FEV1） after bronchodilation,forced expiratory flow（FEF25 ％ ～ 75 ％）,peak expiratory flow （PEF） and need for rescue treatment of the two groups per week were collected and analyzed.Results：① Gender,age,course of disease showed no statistical significance between the two groups （P ＞ 0.05） before the treatment.②Mter the treatment,the data of the two groups showed significant statistical difference （P ＜ O.O1）.③After the treatment,ACT,FEV1,PEF,FEF and need for rescue treatment per week had significant statistical difference between the two groups（P ＜0.O1）.However,EOS and IgE had no statistical difference between control group and treatment group （P ＞ O.05）.Conclusion：Tiotropium bromide has curative effect on moderate to severe bronchial asthma,and mainly dilates airways and improves symptoms and lung function.More research is needed for its nonspecific anti-inflammatory effects in the future.