噻托溴铵粉雾剂维持治疗慢性阻塞性肺疾病180例

Tiotropium Powder Inhaler Maintenance Treatment for Chronic Obstructive Pulmonary Disease in 180 Cases

目的观察噻托溴铵粉雾剂用于慢性阻塞性肺疾病(COPD)患者维持治疗,改善肺功能、提高生活质量和减少急性加重的作用。方法选择收治的COPD稳定期患者360例,随机分为观察组与对照组,各180例。两组均予抗炎、止咳、祛痰、吸氧等常规治疗,若出现急性加重情况,予沙丁胺醇气雾剂行应急治疗。对照组予异丙托溴铵气雾吸入剂雾化吸入(每次5 mg,3次/日),观察组予噻托溴铵粉雾剂经Handi Haler吸入(1粒/次,1次/日)。两组患者均连续治疗12周为1个疗程。结果与治疗前比较,两组患者在治疗后第6周、12周肺功能指标、6 min步行距离、呼吸困难指数评分均有改善,观察组较对照组改善更显著(P<0.05);观察组急性加重发生率明显低于对照组(P<0.05)。治疗过程中,两组患者不良反应均较轻微,无统计学差异(P>0.05)。结论噻托溴铵粉雾剂用于COPD患者的维持治疗,可明显改善肺功能,减轻气道阻碍和呼吸困难,提高生活质量,可显著降低患者急性加重的风险,值得临床推广。

Objective To observe the tiotroPium Powder inhaler in the maintenance treatment of COPD Patients to imProve lung function, the quality of life and reduce the role of the acute exacerbation. Methods 360 cases of Patients in the hosPital with chronic obstruc-tive Pulmonary disease were randomly divided into the control grouP and the observation grouP, 180 cases in each grouP. Both grouPs were given conventional anti-inflammatory, antitussive, exPectorant, oxygen and other treatment, if acute exacerbation aPPeared, the salbu-tamol aerosol agent for emergency treatment was aPPlied. The control grouP were treated with iPratroPium bromide aerosol inhalation （ inhaled 5 mg/time, tid. ） , the observation grouP were treated with tiotroPium Powder inhalation （ inhaled 1 Pill/time, qd. ） . Two grouPs were treated for 12 weeks as 1 course of treatment. Results ComPared with before treatment, Pulmonary function, 6 MWD and dysPnea index scores of the two grouPs after 6 and 12 weeks of treatment were imProved, the observation grouP imProved more significantly than the control grouP （ P 〈 0. 05 ）;the acute exacerbation incidence of the observation grouP was significantly lower than that of the control grouP （ P 〈 0. 05 ） . The adverse reactions of the two grouPs were mild and had no significant difference between the grouPs （ P 〉0. 05 ） . Conclusion TiotroPium Powder inhal in the maintenance treatment of Patients with COPD can obviously imProve the lung func-tion, reduce the airway and breathing difficulties, imProve the quality of life, has the good function to reduce the risk of Patients with a-cute aggravating, and is worth of clinical Promotion.