不同剂量噻托溴铵治疗COPD合并支气管扩张疗效观察

The Effect of Different Doses of Tiotropium Bromide in the Treatment of COPD Complicated with Bronchiectasis

目的探讨分析不同剂量噻托溴铵治疗慢性阻塞性肺疾病(COPD)合并支气管扩张的临床疗效。方法研究对象为2017年1月-2018年8月期间于本院肺病科住院治疗的COPD合并支气管扩张患者,共110例,按照噻托溴铵剂量的不同将其分为实验组与对照组各55例。两组患者均予噻托溴铵联合沙美特罗替卡松(50ug/次)进行治疗,对照组患者噻托溴铵的剂量为18ug/次,实验组患者噻托溴铵的剂量为36ug/次,治疗周期为32周。对比两组患者治疗效果。结果实验组总有效率(92.7%)显著高于对照组(76.4%)(P<0.05);治疗32周后,两组患者呼吸困难评分及肺功能均较前改善,实验组组患者呼吸困难评分及肺功能改善情况显著优于对照组(P<0.05)。结论噻托溴铵可有效改善COPD合并支气管扩张患者的临床症状,大剂量噻托溴铵较小剂量相比疗效更确切,可显著改善患者呼吸困难情况及肺功能,值得临床推广应用。

Objective To investigate and analyze the clinical effect of different doses of tiotropium bromide on chronic obstructive pulmonary disease(COPD)with bronchiectasis.Methods 110 COPD patients with bronchiectasis who were hospitalized in our hospital from January 2017 to August 2018 were divided into experimental group and control group with 55 cases each according to the dosage of tiotropium bromide.Both groups were treated with tiotropium bromide combined with salmeterol and ticasone(50ug/time).The dose of tiotropium bromide in the control group was 18 ug/time,and that in the experimental group was 36 ug/time.The treatment period was 32 weeks.The therapeutic effects of the two groups were compared.Results The total effective rate of the experimental group(92.7%)was significantly higher than that of the control group(76.4%)(P<0.05);after 32 weeks of treatment,the dyspnea score and pulmonary function of the two groups were improved,and the dyspnea score and pulmonary function of the experimental group were significantly better than those of the control group(P<0.05).Conclusion Tiotropium bromide can effectively improve the clinical symptoms of COPD patients with bronchiectasis.Large dose of Tiotropium bromide is more effective than small dose of Tiotropium bromide.It can significantly improve the dyspnea and pulmonary function of patients.It is worthy of clinical application.