不同药物吸入方案对COPD并支气管扩张症效果

EFFECT OF DIFFERENT DRUG INHALATION REGIMENS IN TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DI-SEASE WITH BRONCHIECTASIS

目的观察噻托溴铵联合福莫特罗吸入与布地奈德联合福莫特罗吸入两种方案,对慢性阻塞性肺疾病(COPD)稳定期合并支气管扩张症病人的治疗效果。方法将119例COPD稳定期合并支气管扩张症病人随机分为2组,治疗组61例,吸入噻托溴铵联合福莫特罗治疗;对照组58例,吸入布地奈德联合福莫特罗治疗,比较两组治疗前及治疗1、6个月后第1秒用力呼气容积(FEV1)占预计值的百分比(FEV1%pred)、FEV1、6个月内急性加重次数及肺炎发生次数。结果治疗前两组FEV1%pred、FEV1差异无显著性(P>0.05);治疗1个月后两组FEV1%pred及FEV1均有改善,治疗组改善更明显(t=2.629、3.401,P<0.05);治疗6个月后两组FEV1%pred及FEV1差异仍有显著性(t=3.295、4.052,P<0.05)。治疗组6个月内急性加重发作次数低于对照组,差异有统计学意义(t=3.468,P<0.05);治疗组6个月内肺炎发生率较对照组低,但差异无统计学意义(P>0.05)。结论噻托溴铵联合福莫特罗吸入可显著减缓稳定期COPD合并支气管扩张症病人肺功能下降,减少急性发作频次。

Objective To investigate the effect of tiotropium-fomoterol inhalation regimen versus budesonide-fomoterol inhalation regimen in the treatment of patients with bronchiectasis in the stable stage of chronic obstructive pulmonary disease(COPD).Methods A total of 119 patients with bronchiectasis in the stable stage of COPD were randomly divided into treatment group(61 patients treated with tiotropium-fomoterol inhalation)and control group(58 patients treated with budesonide-fomoterol inhalation).The two groups were compared in terms of forced expiratory volume in 1 second(FEV1)and predicted percentage of FEV1(FEV1%pred)before treatment and after 1 and 6 months of treatment,as well as the number of episodes of acute exacerbation and the number of pneumonia attacks within 6 months.Results There were no significant differences in FEV1%pred and FEV1 between two groups before treatment(P>0.05).Both groups had improvements in FEV1%pred and FEV1 after 1 month of treatment,and the treatment group had significantly greater improvements than the control group(t=2.629,3.401;P<0.05);there were still significant differences in FEV1%pred and FEV1 between the two groups after 6 months of treatment(t=3.295,4.052;P<0.05).Compared with the control group,the treatment group had a significantly lower number of episodes of acute exacerbation within 6 months(t=3.468,P<0.05)and a slightly lower incidence rate of pneumonia within 6 months(P>0.05).Conclusion Tiotropium-fomoterol inhalation can significantly delay the reduction in pulmonary function and reduce the frequency of acute exacerbation in patients with bronchiectasis in the stable stage of COPD.