糖皮质激素联合特布他林治疗慢阻肺急性加重期的临床分析

Clinical Analysis of Glucocorticoid Combined with Terbutaline in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的探讨糖皮质激素联合特布他林治疗慢阻肺急性加重期的临床效果。方法选取2016年8月-2018年8月期间该院内科收治的96例慢阻肺急性加重期患者,按治疗方式不同分为联合组(n=48)与对照组(n=48)。两组常规给予相同药物抗感染、祛痰、低流量吸氧治疗。对照组加用特布他林治疗,联合组在对照组基础上增加糖皮质激素治疗,比较两组治疗效果、血气分析指标[动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、pH值、生活质量以及不良反应发生情况。结果联合组治疗总有效率97.9%较对照组79.2%明显增高,差异有统计学意义(χ^2=9.317,P<0.05);治疗后,两组PaO2水平、各项SF-36评分均明显上升,而PaCO2水平明显下降,其中联合组变化幅度更大,差异有统计学意义(P<0.05)。治疗前后两组pH值、不良反应总发生率相比[(7.3±1.3) vs (7.3±1.2)、2.1%vs 4.2%],差异无统计学意义(t=0.000、χ^2=0.344,P>0.05)。结论糖皮质激素联合特布他林治疗慢阻肺急性加重期疗效确切,可显著改善患者呼吸功能、促进机体酸碱平衡,同时提高患者的生活质量,临床安全性高,值得推广。

Objective To investigate the clinical effect of glucocorticoid combined with terbutaline in the treatment of acute exacerbation of COPD. Methods A total of 96 patients with acute exacerbation of COPD were selected from August 2016 to August 2018 in our hospital. According to the treatment methods, 96 patients were divided into two groups: the combined group(n=48) and the control group(n=48). The two groups were routinely treated with the same drugs as anti-infection, expectorant and low-flow oxygen inhalation. The control group was treated with terbutaline, and the combined group was treated with glucocorticoid and terbutaline. The therapeutic effects of the two groups were compared. The blood gas analysis index [arterial partial pressure of oxygen(PaO2), arterial partial pressure of carbon dioxide(PaCO2), pH)], quality of life and adverse reactions were compared. Results The total effective rate of the combined group was 97.9%, which was significantly higher than that of the control group(79.2%)(χ^2=9.317, P<0.05). After treatment, the level of PaO2 and the scores of SF-36 in the two groups were significantly increased, while the level of PaCO2 was obviously decreased. And the range of changes was greater in the combined group(P<0. 05). Before and after treatment, the total incidence of adverse reactions in the two groups was(7.3 ±1.3) vs(7.3 ±1.2), 2.1% vs 4.2%, and there was no significant difference between the two groups(t =0.000,χ^2=0.344, P >0.05). Conclusion Glucocorticoid combined with terbutaline is effective in the treatment of acute exacerbation of chronic obstructive pulmonary disease.It can significantly improve the respiratory function and the quality of life of patients, promote the balance of acid and base, and has high clinical safety, which is worth popularizing.