氟替美维吸入粉雾剂联合呼吸康复训练对慢性阻塞性肺疾病患者呼吸困难及焦虑的改善效果

Improvement effect of fluticasone furoate,umeclidinium bromide and vilanterol trifenatate powder for inhalation combined with pulmonary rehabilitation training on dyspnea and anxiety in patients with chronic obstructive pulmonary

目的探讨氟替美维吸入粉雾剂联合呼吸康复训练对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者呼吸困难及焦虑的改善效果。方法选取2021年12月至2022年5月萍乡矿业集团有限责任公司总医院收治的COPD患者作为研究对象,采用随机数字表法分为对照组与实验组,每组40例。对照组采用开放三联常规吸入治疗联合呼吸康复训练(pulmonary rehabilitation training,PR),实验组采用闭合三联氟替美维吸入粉雾剂治疗联合PR。比较两组治疗前后肺功能[用力肺活量(forced vital capacity,FVC)、第1秒用力呼气容积(forced expiratory volume in one second,FEV_(1))、FEV_(1)/FVC],COPD评估量表(COPD assessment test,CAT)评分、改良版英国医学研究委员会问卷(Modified British medical research council,mMRC)评分,6 min步行试验(6 min walking test,6MWT)、心理状态[焦虑自评量表(self-rating anxiety scale,SAS)评分、抑郁自评量表(self-rating depression scale,SDS)评分]及临床疗效和不良反应发生情况。结果治疗12周后,两组FVC、FEV_(1)均大于治疗前,FEV_(1)/FVC均高于治疗前,且实验组FVC、FEV_(1)均大于对照组,FEV_(1)/FVC高于对照组,差异有统计学意义(P<0.05)。治疗12周后,两组CAT、mMRC评分均低于治疗前,且实验组低于对照组,差异有统计学意义(P<0.05)。治疗12周后,两组6MWT均长于治疗前,且实验组长于对照组,差异有统计学意义(P<0.05)。治疗12周后,两组SAS、SDS评分均低于治疗前,且实验组低于对照组,差异有统计学意义(P<0.05)。实验组治疗总有效率为87.50%,高于对照组的45.00%,差异有统计学意义(P<0.05)。实验组不良反应发生率为5.41%,低于对照组的24.32%,差异有统计学意义(P<0.05)。结论闭合三联氟替美维吸入粉雾剂联合PR可显著改善COPD患者呼吸困难症状、活动能力,并缓解患者焦虑,提升患者肺功能,值得临床推广应用。

Objective To investigate the improvement effect of fluticasone furoate,umeclidinium bromide and vilanterol trifenatate powder for inhalation combined with pulmonary rehabilitation(PR)on dyspnea and anxiety in patients with chronic obstructive pulmonary disease(COPD).Methods 80 patients with COPD admitted to General Hospital of Pingxiang Mining Group Co.from December 2021 to May 2022 were selected as the research subjects,and they were divided into the control group and the experimental group according to the random number table method,with 40 cases in each group.The control group was given conventional open triple inhalation therapy combined with pulmonary rehabilitation training(PR),while the experimental group was given closed triple therapy with fluticasone furoate,umeclidinium bromide and vilanterol trifenatate powder for inhalation combined with PR.The pulmonary function(forced vital capacity[FVC],forced expiratory volume in one second[FEV_(1)]and FEV_(1)/FVC),COPD assessment test(CAT)scores,modified medical research council(mMRC)scores,6 min walking test(6MWT)results and psychological states(self-rating anxiety scale[SAS]scores and self-rating depression scale[SDS]scores)before and after treatment,clinical efficacy,and the incidence of adverse reactions were compared between the two groups.Results After 12 weeks of treatment,FVC and FEV_(1)of the two groups were higher than before treatment,and FEV_(1)/FVC of the two groups were higher than before treatment,and FVC and FEV_(1)/FVC in the experimental group were greater than those in the control group,and FEV_(1)/FVC in the experimental group was higher than that in the control group,and the differences were statistically significant(P<0.05).After 12 weeks of treatment,CAT and mMRC scores of the two groups were lower than before treatment,and the experimental group was lower than the control group,the differences were statistically significant(P<0.05).After 12 weeks of treatment,6MWT of the two groups were longer than before treatment,and the experimental group was longer than the control group,the differences were statistically significant(P<0.05).After 12 weeks of treatment,SAS and SDS scores of the two groups were lower than before treatment,and the experimental group was lower than the control group,the differences were statistically significant(P<0.05).The total effective rate in the experimental group was 87.50%,which was higher than 45.00%in the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the experimental group was 5.41%,which was lower than 24.32%in the control group,and the difference was statistically significant(P<0.05).Conclusion Closed triple therapy with fluticasone furoate,umeclidinium bromide and vilanterol trifenatate powder for inhalation combined with PR can significantly improve dyspnea symptoms and activities of daily living in patients with COPD,alleviate anxiety,and improve pulmonary function.