布地奈德福莫特罗联合噻托溴铵治疗慢阻肺稳定期的临床疗效及药理学分析

Clinical Efficacy and Pharmacological Analysis of Budesonide Formoterol Combined with Tiotropium Bromide in the Treatment of Stable Chronic Obstructive Pulmonary Disease

目的分析布地奈德福莫特罗(BD/FM)联合噻托溴铵(TB)治疗慢阻肺(COPD)稳定期的临床疗效及药理学作用。方法选取2020年1月-2021年9月于上饶市广信区人民医院就诊的76例COPD稳定期患者,按照随机数字表法分为对照组与观察组,每组38例。对照组应用BD/FM治疗,观察组在对照组基础上联合TB治疗,比较两组临床治疗效果、肺功能指标[第1 s用力呼气量(FEV_(1))、肺活量(FVC)、第1 s用力呼气量占肺活量百分比(FEV_(1)/FVC)]、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、临床症状改善情况[6 min步行实验(6MWT)、COPD患者自我评估测(CAT)、圣乔治呼吸问卷(SGRQ)]、生活质量[健康调查简表(SF-36)评分]以及不良反应发生情况。结果观察组治疗总有效率高于对照组(P<0.05);观察组FVC、FEV_(1)、FEV_(1)/FVC高于对照组(P<0.05);观察组PaO_(2)高于对照组,PaCO_(2)低于对照组(P<0.05);观察组6MWT结果高于对照组,CAT、SGRQ评分低于对照组(P<0.05);观察组SF-36评分高于对照组(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BD/FM联合TB治疗COPD稳定期的效果确切,有利于缓解症状,控制病情,可提升患者肺功能及血气状态,改善患者生活质量,且不增加不良反应。

Objective To analyze the clinical efficacy and pharmacological effects of budesonide formoterol(BD/FM)combined with tiotropium bromide(TB)in the treatment of stable chronic obstructive pulmonary disease(COPD).Methods A total of 76 patients with stable COPD who were treated in Guangxin District People's Hospital of Shangrao from January 2020 to September 2021 were selected and divided into control group and observation group according to random number table method,with 38 cases in each group.The control group was treated with BD/FM,and the observation group was treated with TB on the basis of the control group.The clinical treatment effect,pulmonary function indexes[forced expiratory volume in the first second(FEV_(1)),vital capacity(FVC),forced expiratory volume in the first second as a percentage of vital capacity(FEV_(1)/FVC)],blood gas indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))],improvement of clinical symptoms[6 min walking test(6MWT),COPD patient self-assessment test(CAT),St.George's respiratory questionnaire(SGRQ)],quality of life[health survey summary(SF-36)score]and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).FVC,FEV_(1) and FEV_(1)/FVC in the observation group were higher than those in the control group(P<0.05).PaO_(2) in the observation group was higher than that in the control group,and PaCO_(2) was lower than that in the control group(P<0.05).The results of 6MWT in the observation group were higher than those in the control group,and the scores of CAT and SGRQ were lower than those in the control group(P<0.05).The SF-36 score of the observation group was higher than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion BD/FM combined with TB is effective in the treatment of stable COPD,which is beneficial to relieve symptoms,control the disease,improve the lung function and blood gas status of patients,improve the quality of life of patients,and do not increase adverse reactions.