噻托溴铵联合布地奈德/福莫特罗粉吸入剂治疗中重度慢性阻塞性肺疾病的临床疗效研究

Clinical effect study of tiotropium bromide combined with budinaide/fumoteluofen for inhalation in the treatment of moderate and severe chronic obstructive pulmonary disease

目的探讨噻托溴铵联合布地奈德/福莫特罗粉吸入剂治疗中重度慢性阻塞性肺病(COPD)的临床疗效。方法选取2012年6月—2014年8月新疆医科大学第二附属医院收治的中重度COPD患者54例,随机分为治疗组与对照组,各27例。两组患者均给予常规药物治疗,在此基础上治疗组予以噻托溴铵联合布地奈德/福莫特罗粉吸入剂治疗,对照组予以异丙托溴铵气雾剂联合布地奈德雾化吸入治疗,两组患者均持续治疗14 d。比较两组患者治疗前后肺功能指标[第1秒用力呼气容积(FEV_1)、FEV_1%]、血气分析指标[动脉血氧分压(PaO_2),动脉血二氧化碳分压(PaCO_2)]及不良反应发生情况。结果治疗前两组患者FEV_1、FEV_1%比较,差异无统计学意义(P>0.05);治疗后治疗组患者FEV_1、FEV_1%高于对照组(P<0.05)。治疗前两组患者PaO_2、PaCO_2水平比较,差异无统计学意义(P>0.05);治疗后治疗组患者PaO_2水平高于对照组,PaCO_2水平低于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论噻托溴铵联合布地奈德/福莫特罗粉吸入剂治疗中重度慢性阻塞性肺病的临床疗效确切,可有效改善患者肺功能指标及血气分析指标,且不良反应少。

Objective To investigate the clinical effect of tiotropium bromide combined with budinaide/fumoteluofen for inhalation in the treatment of moderate and severe chronic obstructive pulmonary disease. Methods A total of 54 cases of patients with moderate and severe chronic obstructive pulmonary disease were selected from June 2012 to August 2014 in the Second Affiliated Hospital of Xinjiang Medical University,which were randomly divided into treatment group and control group,27 cases in each group. Two groups of patients were treated with drug therapy in general,treatment group was given tiotropium bromide combined with budinaide/fumoteluofen for inhalation,control group was treated with isopropyl bromide aerosol combined with tiotropium bromide,both groups were treated for 14 d. The lung function indices（ FEV_1,FEV_1%）,blood gas analysis index（ PaO_2,PaCO_2） before and after treatment and the incidence of adverse reactions were compared between the two groups.Results Before treatment,no statistically significant differences of FEV_1、FEV_1% was found between the two groups（ P〈0. 05）; after treatment,the FEV_1、FEV_1% of treatment group were higher than control group（ P〈0. 05）. Before treatment,no statistically significant differences of PaO_2、PaCO_2 levels was found between the two groups（ P〈0. 05）; after treatment,the PaO_2 level was higher than control group,PaCO_2 level was lower than control group（ P〈0. 05）. There was no statistically significant differences of the incidence of adverse reactions between the two groups（ P〈0. 05）. Conclusion Tiotropium bromide combined with budinaide/fumoteluofen for inhalation have an obviously clinical effect in the treatment of moderate and severe chronic obstructive pulmonary disease,it can significantly improve the lung function indices and blood gas analysis index,and with less adverse reactions.