噻托溴铵干粉吸入剂与异丙托溴铵定量气雾剂治疗慢性阻塞性肺病近期疗效对比研究

Short-term curative effects of tiotropium bromide powder inhaler versus ipratropium bromide quantitativeaerosol for chronic obstructive pulmonary disease

目的探究与分析噻托溴铵干粉吸入剂与异丙托溴铵定量气雾剂治疗慢性阻塞性肺病的近期疗效。方法选取本院自2014年6月至2016年6月收治的90例慢性阻塞性肺病患者，采取随机数字表法分为对照组与观察组，各45例。对照组给予异丙托溴铵治疗，观察组给予噻托溴铵治疗，对比两组圣乔治呼吸问卷（SGRQ）评分、6 min步行试验（6MWT）、呼吸困难分级指数（MRC）、血氧分压（PaO2）、血二氧化碳分压（PaCO2）、用力肺活量比预计值（FVC%pred）、用力肺活量（FVC）、第1秒用力呼气容积占预计值百分比（FEV1%pred）、用力呼气量占用力肺活量比值（FEV1/FVC）。结果与治疗前相比，两组治疗后SGRQ评分及MRC分级降低，6MWT升高，观察组上述指标比对照组改善更显著，差异具有统计学意义（均P〈0.05）。与治疗前相比，两组治疗后FVC%pre、FVC、FEV1%pred、FEV1/FVC、PaO2升高，PaCO2降低，观察组上述指标比对照组改善更显著，差异具有统计学意义（均P〈0.05）。结论相比于异丙托溴铵定量气雾剂，噻托溴铵干粉吸入剂治疗慢性阻塞性肺病可充分发挥更好的支气管扩张作用，缓解临床症状及体征，患者耐受性较好。

ObjectiveTo explore and analyze the short-term curative effects of tiotropium bromide powder inhaler versus ipratropium bromide quantitative aerosol for chronic obstructive pulmonary disease （COPD）.Methods90 patients with COPD treated at our hospital from June, 2014 to June, 2016 were selected and divided into a control group and an observation group using random number table method, 45 for each group. The control group were treated with ipratropium bromide and the observation group tiotropium bromide. The George＇s respiratory questionnaire （SGRQ） scores, 6 min walk test （6 MWT）, dyspnea grading index （MRC）, blood oxygen partial pressure （PaO2）, blood CO2 partial pressure （PaCO2）, forced vital capacity to expected value （FVC % Pred）, forced vital capacity （FVC）, forced expiratory volume in 1 second taking up of the expected value （FEV1 % Pred）, forced expiratory volume to forced vital capacity （FEV1 / FVC） of the two groups were compared.ResultsThe SGRQ scores and MRC were reduced and the 6 MWT increased in the two groups after treatment compared with before, and the improvement about the indexes in the observation group were more significant than those in the control group, with statistical difference （all P〈0.05）. The FVC%pred, FVC, FEV1%pred, FEV1/FVC, and PaO2 increased and the PaCO2 decreased in the two groups after treatment compared with before, and the improvement about the indexes in the observation group were more significant than those the control group, with statistical differences （all P〈0.05）.ConclusionCompared with ipratropium bromide quantitative aerosol, tiotropium bromide powder inhaler for COPD is more effective in bronchiectasis and can relieve the clinical symptoms and signs and the patients have better tolerance.