噻托溴铵治疗中重度稳定期慢性阻塞性肺疾病的疗效与安全性分析

The effect and safety of tiotropium bromide in the treatment of moderate-severe stable chronic obstructive pulmonary disease

目的探讨噻托溴铵治疗中重度稳定期慢性阻塞性肺疾病（COPD）的疗效与安全性。方法收集本院2013年10月至2014年6月入院的80例中重度稳定期COPD患者随机分为两组，对照组患者给予异丙托溴铵治疗，实验组患者则给予噻托溴铵治疗，比较两组患者治疗前后肺功能、呼吸困难程度、耐力、生活质量与药物副作用等。结果实验组患者治疗后FEV1、FVC、FEV1／％与FEV1／FVC水平均显著高于对照组；MMRC评分均显著低于对照组[（0．96±0．39）vs．（1．58±0．76）]，6-MWT高于对照组[（223．24±17．55）m vs．（185．98±19．20）m]；治疗后6个月前三个月呼吸困难、现阶段呼吸困难、导致呼吸困难原因、咳嗽与气喘、呼吸困难的影响与治疗效果评分均显著低于对照组，两组比较差异有统计学意义（P〈0．01）；两组患者总体药物副作用发生率比较差异无统计学意义（P〉0．05）。结论噻托溴铵在治疗中重度稳定期COPD的疗效显著，安全性较高，具有借鉴性。

Objective To explore the effect and safety of tiotropium bromide in the treatment of moderate-severe stable chronic obstructive pulmonary disease （COPD）. Methods 80 cases of moderate-severe stable COPD in our hospital from October 2013 to June 2014 were randomly divided into control group and experimental group. Control group was given ipratropium bromide, and experimental group was given tiotropium bromide. Compared pulmonary function, the degree of dyspnea, endurance, the quality of life, and side effects of two groups. Results The levels of FEV1, FVC, FEV1/%, and FEV1/FVC in experimental group after treatment were significantly higher than those in control group; MMRC score was significantly lower than that in control group [（0.96±0.39） vs.（1.58±0.76）]; 6-MWT was significantly higher than that in control group [（223.24±17.55）m vs.（185.98±19.20）m]. The scores of dyspnea during the first three months, dyspnea at present stage, the reasons of dyspnea, cough and asthma, the effect of dyspnea, treatment effect in experimental group 6 months after treatment were significantly lower than those in control group, with statistically significant differences （P〈0.01）. There was no statistically significant difference in the incidence of side effects between two groups （P〉0.05）. Conclusion Tiotropium bromide has obvious effect in the treatment of moderate-severe stable COPD, with high safety.