噻托溴铵联合盐酸氨溴索治疗老年COPD急性期的疗效观察

The curative effect of tiotropium combined with ambroxol hydrochloride in the treatment of senile acute COPD

目的：观察噻托溴铵联合盐酸氨溴索应用于老年COPD急性加重期的治疗效果。方法：选取2015年1月~2016年6月在我院就诊的老年COPD急性加重期患者168例,采用随机数字表法平均分为对照组、噻托溴铵治疗组（A组）、盐酸氨溴索治疗组（B组）和联合治疗组（C组）。对照组给予抗炎、化痰、止喘等基础治疗,治疗组在对照组基础上增加药物治疗,按照方案连续治疗1周后对比观察各组FVC、FEV1与FEV1/FVC肺功能指标变化、血气分析Pa O2和Pa CO2结果、COPD评估测试（CAT）评分及总治疗有效率。结果：与对照组相比,三组治疗组治疗后肺功能、血气分析及CAT评分均有明显改善,联合治疗组的改善情况明显优于单独治疗组;在治疗有效率上,三组治疗组明显高于对照组,联合治疗组明显高于单独治疗组,以上差异均有统计学意义。结论：噻托溴铵与盐酸氨溴索联合治疗能明显改善老年COPD急性加重期患者的肺功能和临床症状,疗效比单独用药更佳,值得临床应用。

Objective：To investigate the effect of tiotropium combined with ambroxol hydrochloride used in the treatment of old patients with acute exacerbation of COPD. Methods：168 cases of elderly patients with acute exacerbation of COPD who were treated in our hospital from January 2015 to June 2016 were selected and divided randomly into the control group,the tiotropium group（group A）,the ambroxol hydrochloride group（group B）and the combined treatment group（group C）by using a random number table method. The control group were given basic treatment such as anti inflammation,eliminating phlegm and stopping asthma. The treatment group was added with corresponding drug treatment on the basis of the control group. After 1 weeks of continuous treatment,the changes of FVC,FEV1 and FEV1/FVC,Pa O2 and Pa CO2 analysis results,COPD evaluation test（CAT） score and total treatment efficiency were compared. Results：Compared with the control group,the lung function,blood gas analysis and CAT score were significantly improved in the three groups after treatment,and the improvement of the combined treatment group was significantly better than that of the single treatment group. In the effective rate of treatment,the three groups of observation group was significantly higher than the control group,and the combined treatment group was significantly higher than the single treatment group. All the above differences were statistically significant. Conclusion：The tiotropium combined with ambroxol hydrochloride can significantly improve the lung function and clinical symptoms in patients with acute exacerbation of COPD,and the combined therapy has better curative effect,which is worth clinical application.