舒利迭与噻托溴铵联合肺康复运动对中重度COPD患者临床症状、运动耐力和肺功能的影响

Effect of Seretide and tiotropium bromide bombined with pulmonary rehabilitation exercise on the clinical symptoms,exercise endurance and pulmonary function of patients with moderate and Severe COPD

目的观察沙美特罗替卡松粉吸入剂(舒利迭)与噻托溴铵联合肺康复运动对中重度慢性阻塞性肺疾病(COPD)患者临床症状、运动耐力和肺功能的影响。方法选取2018年10月-2019年2月宁夏医科大学附属吴忠市人民医院收治的中重度COPD患者50例为研究对象,采取随机数字表法分为观察组和对照组,每组25例。对照组仅给予取舒利迭+噻托溴铵吸入治疗,观察组在对照组治疗基础上进行肺康复运动,比较2组入组时、治疗第1天及第2、4、8周第一秒用力呼气容积/用力肺活量(FEV1/FVC)、第一秒用力呼气容积占预计值百分比(FEV1%Pre)、每分钟最大通气量(MVV)水平及生活质量评分(CAT)。结果对照组治疗第4周FEV1%Pre较入组时升高(P<0.05),但治疗第8周有所减弱(P>0.05);观察组治疗第2周FEV1/FVC、MVV较入组时均升高(P<0.05),治疗第4、8周时各项肺功能指标均持续改善。其中,治疗8周时各项肺功能指标方面,观察组改善程度均优于同期对照组(P<0.05)。治疗后,对照组不同时间点CAT评分均未表现出显著变化(P>0.05);观察组治疗后第2、4、8周在CAT评分方面相比入组时均显著降低,且均低于同时间点对照组评分值(P<0.05)。结论在中重度COPD患者的治疗中,实施舒利迭+噻托溴铵吸入治疗同时进行肺康复运动,不仅可有效减轻患者临床症状,还有利于改善患者肺功能,增强其运动耐力,值得临床推广应用。

Objective To observe the effect of salmeterol ticasone powder inhalation(seretide)and tiotropium bromide combined with pulmonary rehabilitation exercise on the clinical symptoms,exercise endurance and lung function of patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods From October 2018 to February2019,50 patients with moderate to severe COPD admitted to Wuzhong People’s Hospital Affiliated to Ningxia Medical University were selected as the research objects,and they were divided into observation group and control group by random number table method,with 25 cases in each group.The control group was only given seretide and tiotropium bromide inhalation treatment,and the observation group was given pulmonary rehabilitation exercise based on the treatment of the control group.The forced expiratory volume in the first second/forced vital capacity(FEV1/FVC),percentage of the forced expiratory volume in the first second to the predicted value(FEV1%Pre),maximum ventilation per minute(MVV)level and quality of life score(CAT)were compared when the two groups were enrolled at the first day of treatment and 2,4,8 weeks.Results In the control group,FEV1%Pre increased at 4 weeks of treatment(P<0.05),but weakened at 8 weeks of treatment(P>0.05);In the observation group,FEV1/FVC and MVV were higher at 2 weeks of treatment when than they they were enrolled group(P<0.05),and all lung function indexes continued to improve at 4 and 8 weeks of treatment.Among them,the improvement of the observation group was better than that of the control group in the same period in terms of lung function indicators at 8 weeks of treatment(P<0.05).After treatment,the CAT scores of the control group has no show significant changes at different time points(P>0.05);The CAT scores of the observation group were significantly lower at 2,4,8 weeks after treatment than when they were enrolled.It was lower than the score of the control group at the same time point(P<0.05).Conclusion In the treatment of patients with moderate to severe COPD,the implementation of inhalation therapy with seretide+tiotropium bromide and pulmonary rehabilitation exercise can not only effectively reduce the patient’s clinical symptoms,but also improve the patient’s lung function and enhance their exercise endurance.It is worth clinical application.