布地奈德联合特布他林雾化吸入治疗慢性阻塞性肺疾病47例临床观察

Clinical Observation of Aerosol Inhalation of Budesonide Combined with Terbutaline for Treating Chronic Obstructive Pulmonary Disease in 47 Cases

目的观察布地奈德联合特布他林雾化吸入治疗慢性阻塞性肺疾病(COPD)的疗效及对肺功能和血液流变学的影响。方法选择医院2012年3月至2017年3月收治的COPD患者94例,按密封信封法分为对照组和观察组,各47例。对照组患者给予止咳化痰、解痉平喘、低流量吸氧、抗感染等常规对症治疗,观察组患者在对照组治疗基础上加用特布他林+布地奈德雾化吸入治疗。结果观察组总有效率为89.36%,明显高于对照组的68.09%(P<0.05);治疗后,两组患者第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气中期流速(MMEF)、最大呼气流速(PEF)均显著升高,且观察组升高程度显著优于对照组(P<0.05);治疗后,两组患者全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原及血细胞比容均显著降低,且观察组降低程度显著优于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论布地奈德联合特布他林吸入治疗COPD可显著提高肺功能,改善机体血液高凝状态,不良反应少,安全性高,值得临床推广。

Objective To observe the c l in ic a l effect of aerosol inhalation of budesonide combined with terbutaline for treating chronic obstructive pulmonary disease （COPD） and its effect on pulmonary function and hemorheology. Methods Total ly 94 patients with COPD admitted to the hospital from March 2012 to March 2017 were selected and divided into the control group and the observation group by the sealed envelop method, 47 cases in each group. The control group was given routine symptomatic treatment, on the basis, the observation group was treated with aerosol inhalation of terbutaline and budesonide. Results The total effective rate of the observation group was 89.36% , which was significantly higher than 68.09% of the control group （ P 〈 0. 05）. A fte r treatment, the FEV1,F V C , MMEF and PEF in the two groups were significantly higher than those before treatment （ P 〈 0.05）, and the increase of the observation group was more obvious than that of the control group （ P 〈 0. 05）. The whole blood high shear v is co s ity,whole blood low shear viscosity,plasma viscosity, fibrinogen and hematocrit in the two groups were significantly lower than those before treatment （ P 〈 0.05）, and the decrease of the observation group was more obvious than the control group （ P 〈 0.05）. There was no significant difference between the two groups in the incidence rate of adverse reactions （ P 〉 0. 05）. Conclusion Aerosol inhalation of budesonide combined with terbutaline in the treatment of C0 PD can significantly improve the pulmonary function and blood coagulation, it has less adverse reactions and high safety, which is worthy of clinical promotion.