噻托溴铵联合布地奈德福莫特罗吸入剂治疗稳定期慢性阻塞性肺疾病的临床疗效研究

Clinical effect of budesonide/formoterol single inhaler combined with tiotropium bromide in stable chronic obstructive pulmonary disease

目的分析噻托溴铵联合布地奈德福莫特罗吸入剂治疗稳定期慢性阻塞性肺疾病(COPD)的临床疗效。方法以2014年5月—2016年5月中航工业西安医院收治的稳定期COPD患者80例为研究对象,根据随机数字表法分为观察组和对照组,每组40例。对照组给予布地奈德福莫特罗吸入剂,观察组在此基础上加用噻托溴铵粉吸入剂。两组均连续治疗2个月。比较两组治疗前后的肺功能,包括第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1占预计值百分比(FEV1%),并计算FEV1/FVC的值,以及生活质量、血清基质金属蛋白酶-9(MMP-9)和白介素-6(IL-6)水平,用药期间不良反应及治疗后半年内的急性加重发作次数。结果治疗后,两组的FEV1、FEV1/FVC、FEV1%均较治疗前显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且观察组的以上指标均显著高于对照组,组间比较差异有统计学意义(P<0.05)。两组治疗后的SGRQ评分、血清MMP-9、IL-6水平均较治疗前显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且观察组的显著低于对照组,组间比较差异有统计学意义(P<0.05)。两组的总不良反应发生率比较,差异均无统计学意义;观察组发生急性加重1次及以上的人数显著少于对照组,且平均急性加重次数亦显著低于对照组,组间比较差异有统计学意义(P<0.05)。结论噻托溴铵联合布地奈德福莫特罗吸入剂治疗稳定期慢性阻塞性肺疾病的临床疗效显著,可有效改善患者的肺功能、生活质量,降低急性加重的发生次数,且可显著降低患者血清中MMP-9、IL-6水平。

Objective To investigate the clinical effect of budesonide/formoterol single inhaler combined with tiotropium bromide in stable chronic obstructive pulmonary disease（COPD）. Methods 80 cases of patients with stable COPD in China Aviation Industrial Xi‘an Hospital from May 2014 to May 2016 were divided into observation group and control group, 40 cases in each group. Patients in the control group were treated with budesonide/formoterol single inhaler, and in the observation group were treated with budesonide/formoterol single inhaler combined with tiotropium bromide. Compared the pulmonary function, life quality, serum levels of matrix metalloproteinases 9（MMP-9） and interleukin 6（IL-6）, drug adverse reaction during the treatment and exacerbations episodes within the next six months. Results After treatment, the FEV1, FEV1/FVC, FEV1% of two groups were significantly higher than before treatment（P〈0.05）, and in the observation group were significantly higher than that in control group（P〈0.05）. SGRQ scores, serum levels of MMP-9 and IL-6 of two groups were significantly lower than before treatment（P〈0.05）, and these indexes in the observation group were significantly lower than that in control group（P〈0.05）. The differences in the adverse reaction rate of two groups has no significant, the number of acute exacerbation in observation group were significantly lower than that of control group（P〈0.05）. Conclusion Budesonide/formoterol single inhaler combined with tiotropium bromide has remarkable clinical effect in stable COPD, and can effectively improve the pulmonary function, life quality, reduce the number of acute exacerbation, and reduce the serum levels of MMP-9, IL-6.