孟鲁司特钠联合布地奈德、福莫特罗治疗哮喘——慢阻肺重叠征的临床效果

Clinical effect of montelukast sodium combined with budesonide and formotero in the treatment of asthma-COPD overlap syndrome

目的探讨孟鲁司特钠联合布地奈德/福莫特罗治疗不同FEV1%pred水平哮喘——慢阻肺重叠征患者疗效。方法选取2016年4月到2018年10月间,乌鲁木齐市友谊医院收治的60例哮喘——慢阻肺重叠征患者作为研究对象。以舒张后FEV1%pred是否大于50%和治疗方案进行患者分组,总计分为4个组。FEV1%pred>50%组中对照组15例,治疗组15例。FEV1%pred<50%组中对照组15例,治疗组15例。对照组采用布地奈德/福莫特罗治疗,治疗组采用孟鲁司特钠联合布地奈德/福莫特罗治疗。观察治疗3个月后,肺功能指标、CAT评分和ACT评分的差异。结果FEV1%pred>50%组中,治疗前后对比,治疗组和对照组肺功能指标和ACT评分显著性高于治疗前,CAT评分显著性低于治疗前(P<0.05)。FEV1%pred>50%组中,治疗组治疗后肺功能指标和ACT评分显著性高于对照组,CAT评分显著性低于对照组(P<0.05)。FEV1%pred<50%组中,治疗前后对比,治疗组肺功能指标和ACT评分显著性高于治疗前,CAT评分显著性低于治疗前(P<0.05),而对照组肺功能指标与治疗前对比无显著性差异(P>0.05)。FEV1%pred<50%组中,治疗组肺功能指标和ACT评分显著性高于对照组,CAT评分显著性低于对照组(P<0.05)。结论当哮喘——慢阻肺重叠征患者FEV1%pred<50%时,孟鲁司特钠联合布地奈德/福莫特罗可进一步的改善肺功能和生活质量。

Objective To investigate the efficacy of Bumontelukast sodium combined with budesonide and formoterol in the treatment of asthma-COPD overlap syndrome with different FEV1%pred levels.Methods 120 patients with asthma-COPD overlap syndrome admitted to our hospital from June 2016 to November 2019 were selected as the study subjects.Patients were grouped according to whether FEV1%pred was more than 50%and treatment regimen.All patients were divided into four groups.In FEV1%pred>50%group,there were 30 cases in control group and 30 cases in treatment group.The FEV1%pred<50%group had 30 cases in the control group and 30 cases in the treatment group.The control group was treated with budesonide and formoterol,while the treatment group was treated with montelukast sodium combined with budesonide and formoterol.After 3 months of treatment,the difference of pulmonary function index,CAT score and ACT score were observed.Results①In the FEV1%pred>50%group,the pulmonary function index and ACT score in the treatment group and the control group were significantly higher than that before treatment,the CAT score in the treatment group and the control group were significantly lower than that before treatment(P<0.05).②In the FEV1%pred>50%group,the pulmonary function index and ACT score in the treatment group were significantly higher than that of the control group,CAT score was significantly lower than that of the control group(P>0.05).③In the FEV1%pred<50%group,the pulmonary function index and ACT score in the treatment group were significantly higher than that before treatment,CAT score in the treatment group were significantly lower than that before treatment,while the pulmonary function index in the control group had no significant difference compared with those before treatment(P>0.05).④In the FEV1%pred<50%group,the pulmonary function index and ACT score in the treatment group were significantly higher than that of the control group,CAT score was significantly lower than that of the control group(P>0.05).Conclusions When FEV1%pred<50%in patients with asthma-COPD overlap syndrome,montelukast sodium combined with budesonide and formoterol can further improve the pulmonary function and quality of life.