特布他林联合福多司坦治疗缓解期慢性阻塞性肺疾病的临床研究

Clinical study on terbutaline combined with fudosteine in treatment of remission stage of chronic obstructive pulmonary disease

目的探讨硫酸特布他林雾化液联合福多司坦片治疗缓解期慢性阻塞性肺疾病的临床疗效。方法选取2015年1月—2016年1月天津市南开医院呼吸内科收治的缓解期慢性阻塞性肺疾病患者102例,采用随机数字表法将所有患者分为对照组和治疗组,每组各51例。对照组口服福多司坦片,2片/次,3次/d。治疗组在对照组基础上雾化吸入硫酸特布他林雾化液,2 mg/次,3次/d。两组患者均治疗2周。观察两组的临床疗效,比较两组的肺功能、血气指标和炎症因子。结果治疗后,对照组和治疗组的总有效率分别为76.5%、92.2%,两组比较差异有统计学意义(P<0.05)。治疗后,两组呼气高峰流量(PEFR)、用力呼气中期流速占预测值的百分比(MMF%)、用力肺活量占预测值的百分比(FVC%)和第1秒用力呼气量占预测值的百分比(FEV1%)均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标上升程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组pO_2和pH值均明显增高,pCO_2均明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清白细胞介素-6(IL-6)和白细胞介素-8(IL-8)水平均明显下降,α1-抗胰蛋白酶(α1-AT)水平均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论硫酸特布他林雾化液联合福多司坦片治疗缓解期慢性阻塞性肺疾病具有较好的治疗效果,可改善肺功能,调节血气指标和炎症因子,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Terbutaline Sulphate Solution for nebulization combined with Fudosteine Tablets in treatment of remission stage of chronic obstructive pulmonary disease. Methods Patients（102 cases） with remission stage of chronic obstructive pulmonary disease in Department of Respiratory Medicine of Tianjin Nankai Hospital from January 2015 to January 2016 were randomly divided into control and treatment groups according to the random number table method, and each group had 51 cases. Patients in the control group were po administered with Fudosteine Tablets, 2 tablets/time, three times daily. Patients in the treatment group were administered with aerosol inhalation of Terbutaline Sulphate Solution for nebulization on the basis of the control group, 2 mg/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and pulmonary function, blood gas indexes, and inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.5% and 92.2%, respectively, and there was difference between two groups（P〈0.05）. After treatment, PEFR, MMF%, FVC%, FEV1%, and MVV% in two groups were significantly increased, and the difference was statistically significant in the same group（P〈0.05）. The observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, pO2 and pH value in two groups were significantly increased, but the pCO2 in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. The observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, thelevels of IL-6 and IL-8 in two groups were significantly decreased, but the levels of α1-AT in two groups were significantly increased, and the difference was statistically significant in the same group（P〈0.05）. The observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Terbutaline Sulphate Solution for nebulization combined with Fudosteine Tablets has clinical curative effect in treatment of remission stage of chronic obstructive pulmonary disease, can improve pulmonary function, and regulate blood gas indexes and inflammatory factors, which has a certain clinical application value.