噻托溴铵治疗慢性阻塞性肺疾病的疗效分析

Effect of tiotropium bromide in patients with COPD and its influence on adverse reactions occurrence

目的分析噻托溴铵治疗慢性阻塞性肺疾病(COPD)的效果及不良反应。方法将2016年6月至2017年12月石河子大学医学院第一附属医院收治的COPD患者166例,采用随机数字表法分为观察组(n=83)和对照组(n=83)。对照组给予常规内科治疗及康复疗法,观察组在此基础上辅以噻托溴铵治疗。分析两组患者治疗前后肺功能指标肺活量(VC)、呼气流速峰值(PEF)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、50%用力肺活量的呼气流量(V50):、免疫功能指标免疫球蛋白A/G(IgA/G)、分化簇3/4/8(CD3^+/CD4^+/CD8^+):、呼吸困难(MRC)评分、日常生活独立活动量表(ADL)、炎性因子超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平:以及不良反应变化。结果治疗3个月后,两组的肺功能指标VC、PEF、FEV1、FEV1/FEV、V50、ADL评分、免疫功能指标IgA、IgG、CD3^+及CD4^+均明显上升(P<0.05),MRC评分与hs-CRP、TNF-α水平均明显降低,但观察组上述指标改善明显优于对照组(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)。结论噻托溴铵辅助治疗COPD患者可以明显改善患者的肺功能,减轻炎性反应,增强免疫功能,改善患者的生活质量。

Objective To analyze the effect of tiotropium bromide on chronic obstructive pulmonary disease (COPD) and its influence on the occurrence of adverse reactions in the patients. Methods One hundred and sixty-eight patients with COPD treated in the hospital from June 2016 to December 2017 were selected and divided into the observation group ( n =83) and control group ( n =83) by according the random number table method.The control group was given the routine medical treatment and rehabilitation therapy,and on this basis the observation group was assisted by tiotropium bromide treatment.The pulmonary function indicators(VC,FVC,FEV 1,V 50 ),immune function indicators (IgA/G,differentiation clusters CD3^+/CD4^+/CD8^+),dyspnea (MRC),ADL score,inflammatory factors(hs-CRP,TNF-α) before and after treatment,and adverse reactions were analyzed in the two groups. Results After 3- month treatment,the lung function indexes VC,PEF,FEV 1,FEV 1/FEV,V 50 ,ADL scores,immune function indicators IgA,IgG,CD3^+ and CD4^+ in the two groups were significantly increased ( P <0.05).The MRC scores and hs-CRP and TNF-α levels were significantly decreased,but the improvement of above indicators in the observation group were significantly better than those in the control group ( P <0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P >0.05). Conclusion Tiotropium bromide adjuvant treatment of COPD patients can significantly improve the patient′s lung function,reduce the inflammatory action,enhance the immune function,the safety is good,finally improve the quality of life of patients,which is worthy of clinical promotion.