盐酸氨溴索及异丙托溴铵联合布地奈德治疗慢性阻塞性肺疾病急性加重患者的疗效观察

摘要

目的 评价盐酸氨溴索及异丙托溴铵联合布地奈德在治疗慢性阻塞性肺病急性加重期(AECOPD)的临床疗效. 方法 选择209例AECOPD患者,按随机原则分为两组,其中对照组101例,给予布地奈德2 mg雾化吸入3次/d,异丙托溴铵20 μg吸入3次/d,联合抗生素,鼓励饮水;试验组108例在上述用药基础上,加用盐酸氨溴索30 mg静滴3次/d. 结果 治疗7d后,试验组改良呼吸困难指数(mMRC)、COPD评估测试(CAT)评分分别为(1.51±0.15)分、(16.80±1.31)分,明显低于对照组(2.93±0.20)分、(27.14±1.61)分,差异有统计学意义(t=5.757、5.876,均P=0.000);试验组痰液量和二氧化碳分压(pCO2)分别为(20.12±2.14)ml和(47.34±2.13) mmHg(1 mmHg=0.133 kPa),均低于对照组(39.86±3.53)ml和(65.36±2.59) mmHg,差异有统计学意义(t=6.351、5.965,均P=0.0000) 结论 盐酸氨溴索、异丙托溴铵联合布地奈德雾化治疗AECOPD患者疗效显著,可明显改善患者呼吸困难症状及生活质量,且安全性好.%Objective To evaluated the clinical curative effect of budesonide combined with mucosolvin and atrovent on acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A total of 209 patients with AECOPD were selected and divided into two groups:control group (n=101,patients receiving atomized inhalation of 2 mg budesonide tid,20 ug atrovent tid,with antibiotic drugs,avoiding drinking water) and observation group (n=108,patients treated with 30 mg mucosolvin iv drops tid additionally on the basis of the treatment in control group).Results The modified British medical research council (mMRC) and COPD evaluation test (CAT) score were lower in observation group than in control group [(1.51±0.15) vs.(2.93±0.20),(16.80±1.31) vs.(27.14±1.61),t=5.757 and 5.876,both P=0.000].The sputum volume and carbon dioxide partial pressure (pCO2) (1 mmHg=0.133 kPa) were lower in observation group than in control group [(20.12±2.14) vs.(39.86±3.53),(47.34±2.13) vs.(65.36±2.59),t=5.9651 and 6.3507,both P=0.0000].Conclusions The treatment of budesonide combined with mucosolvin and atrovent has an obvious therapeutic effect in AECOPD patients,which can significantly improve the symptom of dyspnea and quality of life,and it has a good security.