双长效支气管扩张剂在慢性阻塞性肺疾病稳定期的应用效果

Application effect of dual long-acting bronchodilators in stable chronic obstructive pulmonary disease

目的探讨双长效支气管扩张剂在慢性阻塞性肺疾病(COPD)稳定期的应用效果。方法选取2019年1月至2021年3月宿迁市中医院收治的78例COPD稳定期患者,采用随机数字表法分为观察组和对照组,每组各39例。对照组患者采用噻托溴铵吸入粉雾剂治疗,观察组患者采用乌美溴铵维兰特罗吸入粉雾剂治疗。比较两组患者的血清肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-8、IL-10、C1q肿瘤坏死因子相关蛋白9(CTRP-9)、可溶性晚期糖基化终产物受体(sRAGE)水平、第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、呼气峰流速(PEF)及不良反应发生情况。结果两组治疗前TNF-α、IL-8、IL-10水平比较,差异无统计学意义(P>0.05);治疗后两组的TNF-α、IL-8水平低于治疗前,且观察组低于对照组,IL-10水平高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。两组治疗前FEV_(1)、FVC、PEF比较,差异无统计学意义(P>0.05);治疗后两组的FEV_(1)、FVC、PEF均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。两组治疗前血清CTRP-9、sRAGE比较,差异无统计学意义(P>0.05);治疗后两组的CTRP-9低于治疗前,sRAGE高于治疗前,且观察组治疗后的CTRP-9低于对照组,sRAGE高于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论双长效支气管扩张剂乌美溴铵维兰特罗治疗可减少COPD稳定期患者的炎症因子释放,改善肺功能,安全性高,同时还能降低患者的血清CTRP-9水平,提高血清sRAGE水平,改善疾病症状。

Objective To investigate the application effect of double long-acting bronchodilator in the stable stage of chronic obstructive pulmonary disease(COPD).Methods A total of 78 COPD stable patients admitted to Suqian Hospital of Traditional Chinese Medicine from January 2019 to March 2021 were selected and divided into observation group and control group by random number table method,with 39 cases in each group.Patients in control group were treated with Tiotropium Bromide Inhalation Powder,and patients in observation group were treated with Umeclidinium Bromide and Vilanterol Trifenatate Powder for Inhalation.Serum levels of tumor necrosis factorα(TNF-α),interleukin(IL)-8,IL-10,C1q tumor necrosis factor associated protein 9(CTRP-9),soluble late glycation end product receptor(sRAGE),forced expiratory volume in 1 second(FEV_(1)),forced vital capacity(FVC),peak expiratory flow rate(PEF)and the incidence of adverse reactions were compared between two groups.Results There were no significant differences in TNF-α,IL-8 and IL-10 levels between two groups before treatment(P>0.05).After treatment,the levels of TNF-α,IL-8 in the two groups were lower than those before treatment,and the observation group was lower than that in the control group,the levels of IL-10 in the two groups were higher than those before treatment,and the observation group was higher than that in control group,the differences were statistically significant(P<0.05).There were no significant differences in FEV_(1),FVC and PEF between the two groups before treatment(P>0.05).After treatment,FEV_(1),FVC and PEF in the two groups were higher than those before treatment,and the observation group was higher than the control group,the differences were statistically significant(P<0.05).There were no significant differences in serum CTRP-9 and sRAGE between the two groups before treatment(P>0.05).After treatment,the CTRP-9 of the two groups were lower than those before treatment,and the sRAGE of the observation group was lower than that in the control group,and the sRAGE was higher than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Treatment with dual long-acting bronchial dilator Umeclidinium Bromide and Vilanterol Trifenatate Powder for Inhalation can reduce the release of inflammatory factors in stable COPD patients and improve lung function,with high safety.At the same time,it can also reduce the level of serum CTRP-9,improve the level of serum sRAGE and improve the symptoms of disease.