噻托溴铵与沙丁胺醇联合布地奈德雾化吸入治疗重度慢性阻塞性肺疾病患者的临床疗效

Clinical efficacy of tiotropium bromide and salbutamol combined with budesonide aerosol inhalation in the treatment of patients with severe chronic obstructive pulmonary disease

目的探究噻托溴铵与沙丁胺醇联合布地奈德雾化吸入治疗重度慢性阻塞性肺疾病(COPD)患者的临床疗效。方法选取2019年5月至2020年5月本院收治的88例重度COPD患者作为研究对象,采用随机信封法分为单一组与联合组,每组44例。单一组给予噻托溴铵治疗,联合组给予噻托溴铵与沙丁胺醇联合布地奈德雾化吸入治疗,比较两组临床疗效、肺功能、炎症因子水平及不良反应发生情况。结果联合组治疗总有效率(95.45%)高于单一组(77.27%),差异有统计学意义(P<0.05)。用药前,两组第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC比较差异无统计学意义;用药后,两组FEV_(1)、FVC均大于用药前,FEV_(1)/FVC均高于用药前,且联合组FEV_(1)、FVC均大于单一组,FEV_(1)/FVC高于单一组,差异有统计学意义(P<0.05)。用药前,两组白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)水平及多形核白细胞(PMN)比较差异无统计学意义;用药后,两组IL-8、TNF-α、hs-CRP水平均低于用药前,PMN均少于用药前,且联合组IL-8、TNF-α、hs-CRP水平均低于单一组,PMN少于单一组,差异有统计学意义(P<0.05)。两组均无不良反应发生。结论噻托溴铵与沙丁胺醇联合布地奈德雾化吸入治疗重度COPD效果显著,可改善肺功能,减轻炎症反应,值得临床推广应用。

objective To investigate the clinical efficacy of tiotropium bromide and salbutamol combined with budesonide aerosol inhalation in the treatment of patients with severe chronic obstructive pulmonary disease(COPD).Methods A total of 88 patients with severe COPD admitted to our hospital from May 2019 to May 2020 were selected as the study subjects,and they were divided into the single group and the combined group by random envelope method,with 44 cases in each group.The single group was treated with tiotropium bromide,and the combined group was treated with tiotropium bromide and salbutamol combined with budesonide aerosol inhalation,the clinical efficacy,pulmonary function and inflammatory factors levels and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate in the combined group(95.45%)was significantly higher than that in the single group(77.27%),and the difference was statistically significant(P<0.05).Before med-ication,there was no significant difference in forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC)and FEV_(1)/FVC between the two groups;after medication,the FEV_(1) and FVC of the two groups were greater than those before medication,and the FEV_(1)/FVC was higher than that before medication,and FEV_(1),FVC in the combined group were greater than those in the single group,and FEV_(1)/FVC was higher than that in the single group,and the differences were statistically significant(P<0.05).Before medication,there were no significant differences in the levels of in-terleukin8(IL-8),tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)and polymorphonuclear leukocytes(PMN)between the two groups;after medication,the levels of IL-8,TNF-αand hs-CRP of the two groups were lower than those before medication,and the levels of PMN were less than those before medication,and the levels of IL-8,TNFα,hs-CRP in the combined group were lower than those in the single group,and the PMN was less than that in the single group,the differences were statistically significant(P<0.05).There were no adverse reactions occurred in the two groups.Conclusion Tiotropium bromide and salbutamol combined with budesonide aerosol inhalation in the treatment of severe COPD is effective,which can improve pulmonary function and reduce inflammatory,and is worthy of clinical promotion and application.