噻托溴铵联合沙美特罗替卡松治疗哮喘-慢性阻塞性肺疾病重叠综合征患者的效果

Effects of Tiotropium bromide combined with Salmeterol fluticasone in treatment of patients with asthma-chronic obstructive pulmonary disease overlap syndrome

目的:观察噻托溴铵联合沙美特罗替卡松治疗哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)患者的临床效果。方法:选取2018年1月至2020年1月该院收治的80例ACOS患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各40例。两组患者入院后均接受基础治疗,在此基础上,对照组使用沙美特罗替卡松粉吸入剂治疗,观察组在对照组基础上联合噻托溴铵粉吸入剂治疗,比较两组肺功能指标[第1秒用力呼吸容积(FEV)、最大呼气中段流量(PEF)和用力肺活量(FVC)]水平、呼出气冷凝液(EBC)相关成分[白三烯B4(LTB4)、8-异前列腺素(8-isoPG)]水平、慢性阻塞性肺疾病自我评估测试(CAT)评分和不良反应发生率。结果:治疗后,两组FEV、PEF、FVC水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组LTB4、8-isoPG水平和CAT评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗期间,两组胃肠道反应、头痛、心动过速、口干等不良反应发生率比较,差异无统计学意义(P>0.05)。结论:噻托溴铵联合沙美特罗替卡松治疗ACOS患者可提高肺功能指标水平,降低EBC相关成分水平和CAT评分,效果优于单纯沙美特罗替卡松治疗。

Objective: To observe effects of Tiotropium bromide combined with Salmeterol fluticasone in treatment of patients with asthmachronic obstructive pulmonary disease overlap syndrome(ACOS). Methods: A prospective study was conducted on 80 patients with ACOS admitted to the hospital from January 2018 to January 2020. They were divided into observation group and control group according to the random number table method, 40 cases in each. Both groups received basic treatment after admission. On this basis, the control group was treated with Salmeterol fluticasone powder inhalation, while the observation group was treated with Tiotropium bromide powder inhalation on the basis of that of the control group. The levels of pulmonary function indexes [forced expiratory volume in the first second(FEV1), peak expiratory flow(PEF) and forced vital capacity(FVC)], the exhaled breath condensate(EBC) related component levels [leukotriene B4(LTB4), 8-isoprostaglandin(8-isoPG)], the selfassessment test(CAT) score and the incidence of adverse reactions were compared between the two groups. Results: After the treatment, the levels of FEV1, PEF and FVC in the two groups were higher than those before treatment, those in the observation group were higher than the control group,and the differences were statistically significant(P<0.05). After the treatment, the levels of LTB4, 8-isoPG and the CAT scores in the two groups were lower than those before the treatment, those in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). During the treatment, there was no significant difference in the incidence of adverse reactions such as gastrointestinal reaction,headache, tachycardia and dry mouth between the two groups(P>0.05). Conclusions: Tiotropium bromide combined with Salmeterol fluticasone in the treatment of THE ACOS patients can improve the levels of lung function indexes, and reduce the levels of EBC related components and the CAT scores. Moreover, it is superior to single Salmeterol fluticasone treatment.