持续肺康复训练联合沙美特罗替卡松粉吸入剂与噻托溴铵对中重度COPD患者肺功能和生活质量的影响

Effects of continuous pulmonary rehabilitation training combined with salmeterol and tiotropium bromide on lung function and quality of life in patients with moderate to severe COPD

目的:分析持续肺康复训练联合沙美特罗替卡松粉吸入剂与噻托溴铵对中重度慢性阻塞性肺疾病(COPD)患者肺功能和生活质量的影响。方法:选取枣庄市峄城区人民医院2017年8月至2018年12月收治的60例中重度COPD患者资料进行回顾性研究。按随机数字表法分为观察组和对照组,每组30例,观察组实施持续肺康复训练联合沙美特罗替卡松粉吸入剂与噻托溴铵治疗,对照组实施常规肺康复训练联合沙美特罗替卡松粉吸入剂与噻托溴铵治疗。观察并记录2组患者入组时、治疗第1天、治疗后第2周、第4周和第8周的肺功能指标[第1秒用力呼气容积与用力肺活量的比值(FEV 1/FVC)、第1秒用力呼气容积占预计值百分比(FEV 1%pred)、最大自主通气量(MVV)]、生活质量COPD评估测试(CAT)评分、焦虑自评量表(SAS)评分及抑郁自评量表(SDS)评分,然后进行统计学分析。结果:观察组治疗后第2周、第4周和第8周FEV 1/FVC、FEV 1%pred和MVV明显较入组时提高,对照组治疗后第2周FEV 1/FVC、MVV及治疗后第2周和第4周FEV 1%pred均明显高于入组时,差异有统计学意义(P<0.05),且2组治疗后第4周、第8周FEV 1/FVC、FEV 1%pred和MVV相比差异也有统计学意义(P<0.05);观察组治疗后第2周、第4周、第8周CAT评分明显低于入组时,对照组治疗后第2周CAT评分明显低于入组时,差异有统计学意义(P<0.05),且2组治疗后第4周、第8周CAT评分相比差异也有统计学意义(P<0.05);观察组治疗后第2周、第4周、第8周SAS评分和SDS评分均明显低于入组时,对照组治疗后第2周SAS评分和SDS评分均明显低于入组时,差异有统计学意义(P<0.05),且2组治疗后第4周、第8周SAS评分和SDS评分相比,差异也有统计学意义(P<0.05)。结论:持续肺康复训练联合沙美特罗替卡松粉吸入剂与噻托溴铵能更好地改善COPD患者气道阻塞症状和心理状态,增强其肺功能,提高其生活质量。

Objective:To analyze the effects of continuous pulmonary rehabilitation training combined with salmeterol and tiotropium bromide on the lung function and quality of life of patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods:A total of sixty patients with moderate to severe COPD treated in People′s Hospital of Yicheng District of Zaozhuang from August 2017 to December 2018 were selected as the research objects.Divided into 2 groups according to the random number table method.The observation group received 30 patients,who received continuous pulmonary rehabilitation training combined with salmeterol and tiotropium bromide treatment.The control group received 30 patients who received conventional pulmonary rehabilitation training combined with salmeter.Roticasone powder inhalation and tiotropium bromide treatment.Observe and record the pulmonary function indexes of the two groups of patients when they were enrolled,on the first day of treatment,2 weeks,4 weeks and 8 weeks after treatment[ratio of forced expiratory volume to forced vital capacity in the first second(FEV 1/FVC),the percentage of forced expiratory volume in the first second(FEV 1%pred),and maximum voluntary ventilation(MVV)],quality of life COPD assessment test(CAT)score,self-rating anxiety scale(SAS)score and self-rating depression scale(SDS)score,and then proceed statistical analysis.Results:The FEV 1/FVC,FEV 1%pred and MVV of the observation group were significantly increased at 2 weeks,4 weeks and 8 weeks after treatment compared to the time when the group was enrolled.The FEV 1/FVC,MVV at 2 weeks after treatment in the control group and FEV 1%pred at 2 weeks and 4 weeks after treatment.The pred was significantly higher than that at the time of entry,the difference was statistically significant(P<0.05),and the difference in FEV 1/FVC,FEV 1%pred and MVV was also statistically significant in the two groups at 4 and 8 weeks after treatment(P<0.05).The CAT scores of the observation group at 2,4,and 8 weeks after treatment were significantly lower than those at the time of entry,and the CAT scores of the control group at 2 weeks after treatment were significantly lower than those at the time of entry,the difference was statistically significant(P<0.05),and the difference in CAT scores between the two groups at 4 and 8 weeks after treatment was also statistically significant(P<0.05).The SAS score and SDS score in the observation group were significantly lower than those in the enrolled group at 2 weeks,4 weeks,and 8 weeks after treatment.At that time,the SAS score and SDS score of the control group 2 weeks after treatment were significantly lower than those at the time of enrollment,the difference was statistically significant(P<0.05),and the SAS score and SDS score of the two groups were similar at 4 and 8 weeks after treatment.The ratio difference was also statistically significant(P<0.05).Conclusions:Continuous pulmonary rehabilitation training combined with salmeterol ticasone powder inhalation and tiotropium bromide can better improve the symptoms of airway obstruction and psychological state of COPD patients,enhance their lung function,and improve their quality of life.