噻托溴铵联合吸气肌训练对稳定期慢性阻塞性肺疾病患者临床疗效、免疫功能及肺功能的影响

Effects of Tiotropium Bromide Combined with Inspiratory Muscle Training on Clinical Efficacy,Immune Function and Lung Function in Patients with Stable COPD

目的:探讨噻托溴铵联合吸气肌训练对稳定期慢性阻塞性肺疾病(COPD)患者临床疗效、免疫功能及肺功能的影响。方法:选择2017年10月~2019年12月在本院接受治疗的62例稳定期COPD患者,按照随机数字表法分为对照组(31例)和观察组(31例)。对照组在常规治疗基础上加以噻托溴铵粉雾剂治疗,观察组在对照组基础上加以吸气肌训练治疗。比较两组患者临床疗效、免疫功能[细胞免疫指标(CD4+、CD4+/CD8+)及免疫球蛋白A(IgA)、免疫球蛋白G(IgG)]、肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV 1)]及不良反应。结果:观察组总有效率(83.87%)高于对照组(61.29%,P<0.05)。治疗后,两组患者FEV 1及FVC水平均升高,且观察组升高幅度更大(P<0.05)。对照组患者治疗前和治疗后的CD4+及CD4+/CD8+无统计学差异(P>0.05),观察组治疗后CD4+及CD4+/CD8+均升高(P<0.05)。对照组患者治疗前和治疗后IgA及IgG无统计学差异(P>0.05),观察组治疗后IgA及IgG均升高(P<0.05)。对照组出现2例(6.45%)不良反应与观察组出现3例(9.68%)不良反应无统计学差异(P>0.05)。结论:噻托溴铵联合吸气肌训练治疗稳定期COPD患者较单独使用噻托溴铵更能提高患者临床疗效,改善肺功能及免疫功能,且具有较高的安全性。

Objective:To investigate the effect of tiotropium bromide combined with inspiratory muscle training on clinical efficacy,immune function and lung function in patients with stable chronic obstructive pulmonary disease(COPD).Methods:62 patients with stable COPD who were treated in our hospital from October 2017 to December 2019 were divided into two groups according to the random number table method,31 cases in the control group and 31 cases in the observation group.The control group received tiotropium bromide powder inhalation on the basis of conventional treatment,while the observation group received additional inhalation muscle training based on that of the control group.The clinical efficacy,immune function[cell immune indexes(CD4+、CD4+/CD8+)and immunoglobulin A(IgA),immunoglobulin G(IgG)],lung function[forced vital capacity(FVC),forced expiratory volume in the 1st second(FEV 1)]and adverse reactions of the two groups were compared.Results:The effective rate in the observation group was 83.87%,which was higher than 61.29%in the control group(P<0.05).After treatment,the levels of FEV 1 and FVC in the two groups were significantly increased,but the increase in the observation group was greater(P<0.05).There was no significant difference in CD4+and CD4+/CD8+before and after treatment in the control group(P>0.05).After treatment,the CD4+and CD4+/CD8+in the observation group were significantly increased,comparing with before treatment(P<0.05).There was no significant difference in IgA and IgG in the control group before and after treatment(P>0.05).And IgA and IgG in the observation group were significantly increased after treatment(P<0.05).A total of 2 cases(6.45%)of adverse reactions occurred in the control group,which was not statistically different from that in the observation group with 3 cases found(9.68%)(P>0.05).Conclusion:Tiotropium bromide combined with inspiratory muscle training for patients with stable COPD can significantly improve the clinical efficacy,lung function and immune function,and have higher safety than tiotropium bromide alone.