M受体阻断剂及吸入糖皮质激素对不同分型慢性阻塞性肺疾病临床疗效及气道炎症的影响

Influence of M receptor blockers and inhaled corticosteroids on clinic effect and airway inflammation of different types COPD

①目的以吸入糖皮质激素为对照,观察M受体阻断剂对不同分型慢性阻塞性肺疾病(COPD)患者临床症状和气道炎症等的影响,为COPD的治疗提供更多依据。②方法选取104例符合2019年中华医学会制定的COPD诊断标准的中重度COPD急性加重期临床患者为研究对象,随机分为试验组(噻托溴铵组52例)和对照组(糖皮质激素组52例),两组均给以常规治疗、护理和随访。最后通过对患者进行肺功能和支气管舒张等试验,分析评估患者临床症状及肺功能等各项指标的变化。③结果治疗后,两组患者临床症状和治疗组患者生活质量评分下降,与治疗前相比有统计学意义(P<0.05)。对照组患者生活质量无显著性变化。治疗组B组患者中性粒细胞显著性降低(P<0.05),对照组A组患者嗜酸粒细胞显著性降低(P<0.05)。④结论噻托溴铵能够改善患者临床症状,提高肺功能;吸入糖皮质激素对嗜酸性气道炎具有很好作用效果。

Objective:With inhaled corticosteroid(control group),we will explore the influence of M receptor blockers on clinic symptom and airway inflammation with different types of chronic obstruetive pulmonary disease(COPD),to find the theoretical basement for the antieholinergic bronchodilator treatment.Methods 104 acute exacerbated COPD patients accepted the test of pulmonary function and bronchodilatation were selected as the study object.RandomLy set up the experimental group(tiotropium group)and control group(corticosteroids group),all of the patients received routine nursing and follow-up.Record clinie symptom scores,quality of life scores,FEV1 and FEV1%.Results The difference is statistically significant in symptom scores between each groups before treatment and after treatment(P>0.05).After treatment,two groups in clinic symptom scores and experimental group in quality of life scores decreased(P<0.05),but in control group B,there were no significant difference aftert reatment(P>0.05).After treatment,the percentage of neutrophils were declined in Tiotropium group B(P<0.05);the percentage of eosinophils were declined in ICS group A(P<0.05).Conclusion Inhaled tiotropium could improve clinic symptom and pulmonary function;inhaled corticosteroids could improve eosinophilic infiltation COPD patients.