布地奈德联合异丙托溴铵雾化吸入治疗支气管哮喘急性发作期临床疗效

Clinical effect of atomized inhalation of budesonide combined with ipratropium bromide in the treatment of acute attack bronchial asthma

目的分析布地奈德联合异丙托溴铵雾化吸入治疗支气管哮喘急性发作期的效果及对肺功能和血清IgE水平的影响。方法选取我院2019年7月~2020年8月收治的支气管哮喘患者92例,均处于急性发作期。应用随机数表法分为对照组、观察组,各46例。对照组给予止咳、吸氧及布地奈德雾化吸入等基础治疗,观察组在此基础上给予异丙托溴铵雾化吸入治疗。观察两组肺功能、临床症状好转时间、免疫球蛋白、炎性因子水平及不良反应(皮疹、口干、呕吐、声音嘶哑、皮肤潮红)情况。结果治疗后两组用力肺活量(FVC)、呼气峰值流速(PEF)、第1秒用力呼气量(FEV1)/FVC水平均明显上升,且观察组高于对照组;气促好转时间、咳嗽好转时间、哮鸣音消失时间均低于对照组,差异均有统计学意义(P<0.05)。治疗后两组血清免疫球蛋白A(IgA)较治疗前上升,免疫球蛋白E(IgE)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平均有下降;且观察组IgA水平高于对照组,IgE、TNF-α、IL-6水平低于对照组,差异均有统计学意义(P<0.05)。观察组不良反应发生率(13.04%)高于对照组(10.87%),但差异无统计学意义(P>0.05)。结论支气管哮喘急性发作期应用布地奈德联合异丙托溴铵雾化吸入治疗能明显改善患者肺功能,缩短其临床症状的好转时间,在一定程度减轻炎性反应,改善免疫球蛋白水平,且用药安全性较好。

Objective To analyze the clinical effect of budesonide combined with ipratropium bromide aerosol inhalation in the treatment of acute attack bronchial asthma and its effects on lung function and serum IgE level.Methods 92 cases of patients with bronchial asthma were received in the acute phase from July 2019 to August 2020, application of meter method were divided into two groups through a table of random numbers, giving the control group(46 cases) cough, oxygen and budesonide aerosol inhalation treatment such as foundation, the observation group on the basis of the above the other implementation of isopropyl bromide atomization inhalation therapy. Lung function, time of improvement of clinical symptoms, levels of immunoglobulin, inflammatory factors and adverse reactions(rash, dry mouth, vomiting, hoarseness, skin flushing) were observed in both groups.Results After treatment, the forced vital capacity(FVC), peak expiratory flow rate(PEF), and forced expiratory volume(FEV1)/FVC levels in the first second increased significantly in the two groups after treatment, and the observation group was higher than the control group;the shortness of breath improved time.The time to improve cough and the disappearance of wheeze were lower than those in the control group, and the differences were statistically significant(P<0.05). After treatment, serum immunoglobulin A(IgA) increased in the two groups compared with before treatment, while immunoglobulin E(IgE), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6) levels decreased, and the level of IgA in the observation group was higher than that of the control group, and the levels of IgE, TNF-α, and IL-6 were lower than those of the control group, the differences were statistically significant(P<0.05). The incidence of adverse reactions in the observation group(13.04%) was higher than that in the control group(10.87%), but the difference was not statistically significant(P>0.05).Conclusion The application of budesonide combined with ipratropium bromide nebulized inhalation therapy during the acute attack of bronchial asthma can significantly improve the patient’s lung function, shorten the improvement time of their clinical symptoms, reduce the inflammatory response to a certain extent, and improve the level of immunoglobulin, and the medication safety is better.