布地奈德福莫特罗联合噻托溴铵治疗慢性阻塞性肺疾病急性加重期的临床效果

Clinical efficacy of budesonide and formoterol fumarate combined with tiotropium bromide in the treatment of acute exacerbation of COPD

目的分析布地奈德福莫特罗联合噻托溴铵治疗慢性阻塞性肺疾病(简称“慢阻肺”)急性加重期的临床疗效。方法选择2019年1月至2020年12月高州市人民医院药剂科诊治的112例慢阻肺急性加重期患者,应用随机数字表法分为常规组和试验组,每组各56例。常规组应用布地奈德福莫特罗吸入粉雾剂治疗,试验组在常规组基础上应用噻托溴铵吸入剂治疗。比较两组临床疗效、临床症状缓解时间,治疗前后的肺功能指标、炎性指标及不良反应发生情况。结果试验组总有效率明显高于常规组(P<0.05)。试验组胸闷气短改善、肺部啰音消失及住院时间明显短于常规组(P<0.05)。治疗后两组第1秒时间肺活量(FEV_(1))、用力肺活量(FVC)、呼气峰流速(PEF)均显著提高,试验组明显高于常规组,差异有统计学意义(P<0.05)。治疗后两组C-反应蛋白(CRP)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)均显著降低,试验组明显低于常规组(P<0.05)。试验组和常规组的不良反应总发生率分别为7.14%(4/56)和5.36%(3/56),差异无统计学意义(P>0.05)。结论应用布地奈德福莫特罗联合噻托溴铵治疗慢阻肺急性加重期患者效果显著,能明显缩短临床症状缓解时间,改善肺功能指标,降低炎性指标,且安全性较高。

Objective To analyze the clinical efficacy of budesonide and formoterol fumarate combined with tiotropium bromide in the treatment of acute exacerbation of COPD.Methods A total of 112 patients with acute exacerbation of COPD treated in the Department of Pharmacy at the People’s Hospital of Gaozhou from January 2019 to December 2020 were selected and divided into the conventional group and the experimental group by the random number table method,with 56 cases in each group.The conventional group was treated with budesonide and formoterol fumarate powder for inhalation,while the experimental group was treated with tiotropium bromide powder for inhalation on the basis of the treatment of the conventional group.The clinical efficacy,clinical symptom relief time,as well as lung function index,inflammatory index and the occurrence of adverse reactions before and after treatment were compared between the two groups.Results The overall effective rate of the experimental group was significantly higher than that of the conventional group(P<0.05).The time for the improvement of chest tightness and shortness of breath,the disappearance of lung rales and hospitalization in the experimental group were significantly shorter than those in the conventional group(P<0.05).After treatment,FEV1,FVC and PEF significantly increased in both groups,and those in the experimental group were significantly higher than those in the conventional group(P<0.05).Meanwhile,the levels of CRP,IL-8 and TNF-α significantly decreased in both groups after treatment,and those in the experimental group were significantly lower than those in the conventional group(P<0.05).The total incidence of adverse reactions in the experimental group and conventional group were 7.14%(4/56)and 5.36%(3/56),respectively,with no statistically significant difference(P>0.05).Conclusion In the treatment of patients with acute exacerbation of COPD,the application of budesonide and formoterol fumarate combined with tiotropium bromide is effective in significantly shortening the clinical symptom relief time,improving pulmonary function indexes,and reducing inflammatory indexes,with high safety.