噻托溴铵不同给药方式用于治疗哮喘合并慢性阻塞性肺疾病的价值研究

Research on value of different administration models of tiotropium bromide applied to treat asthma combined with COPD

目的探讨噻托溴铵不同给药方式用于治疗哮喘合并慢性阻塞性肺疾病（COPD）的临床价值。方法回顾分析宁夏医科大学附属石嘴山市第一人民医院2013年6月~2015年6月呼吸内科收治的180例支气管哮喘合并COPD患者临床资料,按随机交叉双盲法分为3组,对照组58例、观察A组60例、观察B组62例。对照组给予安慰剂（每日早、晚各1次）治疗,观察A组给予噻托溴铵2.5μg（每日早、晚各1次）治疗,观察B组给予噻托溴铵5μg（每晚1次）治疗,对比观察3组治疗效果。结果观察A、B2组FEV1、AUC0~24 h、FEV1（0~24 h）峰值、FEV1谷值、PEFam、PEFpm、24 h后FEV1、ACQ-7问卷平均分数差异无统计学意义;观察A、B2组FEV1、AUC0~24 h、FEV1（0~24 h）峰值、FEV1谷值、PEFam、PEFpm、24 h后FEV1、ACQ-7问卷平均分数均明显高于对照组,差异有统计学意义（P〈0.05）。结论噻托溴铵每日5μg的2种不同给药方案均能显著舒张支气管达24 h,在哮喘合并COPD治疗中有明显疗效。

Objective To explore clinical value of different administration modes applied to treat the asthma combined with chronic obstructive pulmonary disease（ COPD）. Methods Clinical data of 180 patients with bronchial asthma combined with COPD admitted by the department of respiratory medicine of the Hospital from June 2013 to June 2015 were retrospectively analyzed,and such patients were divided into three groups including 58 patients in the control group,60 patients in the observation group A and 62 patients in observation group B（ n = 62） in random cross double-blind method. The patients in the control group were administered and treated with placebo（ once in the morning and at night daily respectively）,the patients in the observation group A were administered and treated with 2. 5 μg of tiotropium bromide（ once in the morning and at night daily respectively）,and the patients in the observation group B were treated with 2. 5 μg of tiotropium bromide（ once at night daily respectively）,and the treatment efficacy on three groups of patients were observed. Results Average questionnaire scores of FEV1,AUC0 ~ 24 h,FEV1（ 0 ~ 24 h）peak valley value,PEFam,PEFpm,FEV1 and ACQ-7 in 24 hours of patients in the observation group A and observation group B,there were no statistically significant differences between two groups; Questionnaire scores of FEV1,AUC0 ~ 24 h,FEV1（ 0 ~ 24 h）peak valley value,PEFam,PEFpm,FEV1 and ACQ-7 in 24 hours of patients in the observation group A and observation group B were significantly higher than such indexes of patients in the control group,and the differences were statistically significant（ P〈0. 05）. Conclusion Two different dosage regimens of tiotropium bromide with daily dose of 5 μg can significantly keep the bronchus expanding for 24 h,and delivers significant efficacy on the asthma combined with COPD treatment.