ICS与SABA和SAMA三联吸入治疗慢性阻塞性肺疾病急性加重期的临床价值

The Value of Triple Inhalation of ICS and SABA and SAMA in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的探讨吸入型糖皮质激素(ICS)、速效β2受体激动剂(SABA)和短效胆碱受体拮抗剂(SAMA)三联吸入治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床效果。方法选取2019年1月至2021年1月在我院治疗的AECOPD患者120例,随机分为观察组60例和对照组60例。对照组采用速效β2受体激动剂(SABA)特布他林和短效胆碱受体拮抗剂(SAMA)异丙托溴铵雾化吸入治疗,观察组在对照组基础上联合应用糖皮质激素(ICS)布地奈德雾化吸入治疗,两组患者均持续治疗1周。治疗后,比较两组患者的临床疗效;比较两组患者治疗前后的肺功能水平;比较两组患者的血清学水平和血气分析结果,包括降钙素原(PCT)、超敏C反应蛋白(CRP)、氧分压(PO_(2))和二氧化碳分压(PCO_(2));比较两组患者治疗期间的不良反应发生情况。结果治疗后观察组患者的临床疗效高于对照组(P<0.05);治疗后观察组患者肺功能指标FVC、FEV1和FEV1/FVC高于对照组(P<0.05);观察组患者PCT、CRP和PCO_(2)显著低于对照组(P<0.05),PO_(2)显著高于对照组(P<0.05);两组患者治疗期间发生咽喉不适、咳嗽、口干和皮疹等不良反应发生率无显著差异(P<0.05)。结论对AECOPD患者采用ICS、SABA和SAMA三联吸入的治疗方法有良好的临床效果,可以有效缓解患者的临床症状,值得临床推广应用。

Objective Inhaled glucocorticoid(ICS),quick-actingβ2 receptor agonist(SABA)and short-acting choline receptor antagonist(SAMA)triple inhalation treatment of chronic obstructive pulmonary disease in acute exacerbation(AECOPD)clinical effect.Methods A total of 120 AECOPD patients treated in our hospital from January 2019 to January 2021 were selected and randomly divided into two groups:observation group(n=60)and control group(n=60).The control group was treated with the rapid-actingβ2 receptor agonist(SABA)terbutaline and the short-acting choline receptor antagonist(SAMA)ipratropium bromide nebulized inhalation treatment,and the observation group was treated with glucocorticoids on the basis of the control group.(ICS)Budesonide nebulized inhalation treatment,both groups of patients continued treatment for 1 week.After treatment,compare the clinical efficacy of the two groups of patients;compare the pulmonary function levels of the two groups before and after treatment;compare the serum levels and blood gas analysis results of the two groups of patients,including procalcitonin(PCT),high-sensitivity C-reactive protein(CRP),partial pressure of oxygen(PO_(2))and partial pressure of carbon dioxide(PCO_(2));compare the occurrence of adverse reactions during treatment between the two groups.Results After treatment,the clinical efficacy of the observation group was higher than that of the control group(P<0.05);after treatment,the pulmonary function indexes FVC,FEV1 and FEV1/FVC of the observation group were higher than those of the control group(P<0.05);CRP and PCO_(2) were significantly lower than the control group(P<0.05),and PO_(2) was significantly higher than the control group(P<0.05);there was no significant difference in the incidence of adverse reactions such as throat discomfort,cough,dry mouth,and rash during treatment between the two groups(P<0.05).Conclusion The triple inhalation of ICS,SABA and SAMA for AECOPD patients has a good clinical effect,can effectively alleviate the clinical symptoms of patients,and is worthy of clinical application.