糖皮质激素结合特布他林治疗慢阻肺急性加重期的疗效及不良反应观察

Observation on efficacy and adverse reactions of glucocorticoid combined with Terbutaline in the treatment of acute exacerbation of chronic obstructive pulmonary disease

目的观察糖皮质激素结合特布他林治疗慢性阻塞性肺疾病(慢阻肺)急性加重期的疗效及安全性。方法 40例慢阻肺急性加重期患者,随机分为对照组和观察组,各20例。对照组给予特布他林治疗,观察组给予糖皮质激素结合特布他林治疗,比较两组患者治疗前后血气指标[动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)]变化情况、不良反应发生情况及治疗效果。结果治疗前,两组患者PaO2、PaCO2比较差异无统计学意义(P>0.05);治疗后两组患者PaO2、PaCO2均优于治疗前,且观察组优于对照组,差异有统计学意义(P<0.05)。观察组出现1例不良反应,发生率为5%;对照组出现6例不良反应,发生率为30%;观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。观察组治疗显效、有效、无效分别为11、7、2例,总有效率为90%;对照组治疗显效、有效、无效分别为6、6、8例,总有效率为60%;观察组总有效率显著高于对照组,差异有统计学意义(P<0.05)。结论慢阻肺急性加重期患者采用糖皮质激素联合特布他林进行治疗能够有效改善患者的血气指标,减少不良反应的发生,治疗效果显著,值得大力的推广和应用于临床治疗上。

Objective To observe the efficacy and safety of glucocorticoid combined with Terbutaline in the treatment of acute exacerbation of chronic obstructive pulmonary disease.Methods A total of 40 patients with acute exacerbation of chronic obstructive pulmonary disease were randomly divided into control group and observation group,with 20 cases in each group.The control group was treated with Terbutaline,and the observation group was treated with glucocorticoid combined with terbutaline.Comparison were made on changes of blood gas indexes[partial pressure of arterial oxygen(PaO2),partial pressure of carbon dioxide(PaCO2)]before and after treatment,occurrence of adverse reactions and treatment effect between the two groups.Results Before treatment,both groups had no statistically significant difference in PaO2 and PaCO2(P>0.05).After treatment,both groups had better PaO2 and PaCO2 than those before treatment,and the observation group was better than the control group.The differences were statistically significant(P<0.05).The observation group had 1 case with adverse reactions,with incidence rate as 5%,while the control group had 6 cases with adverse reactions,with incidence rate as 30%.The observation group had lower incidence of adverse reactions than the control group,and the difference was statistically significant(P<0.05).The observation group was markedly effective,effective and ineffective respectively in 11,7 and 2 cases,with a total effective rate of 90%,which were 6,6 and 8 cases and 60%in the control.The observation group had obviously higher total effective rate than the control group,and the difference was statistically significant(P<0.05).Conclusion Combination of glucocorticoid and Terbutaline shows remarkable treatment effect in patients with acute exacerbation of chronic obstructive pulmonary disease,and it can effectively improve the blood gas indexes,reduce the occurrence of adverse reactions.It is worthy of vigorous promotion and application in clinical treatment.