布地奈德粉吸入剂联合噻托溴铵粉雾剂治疗哮喘-慢阻肺重叠综合征的临床疗效

摘要

Objective To observe the clinical effect of budesonide powder for inhalation combined with tiotropium bromide powder for inhalation on asthma and COPD overlap syndrome(ACOS).Methods From October 2014 to October 2015,a total of 118 patients with ACOS were selected in Shunyi District Hospital,Beijing,and in Electricity Teaching Hospital of Capital Medical University,and they were divided into control group and observation group according to random number table,each of 59 cases.Patients of control group received tiotropium bromide powder for inhalation,while patients of observation group received budesonide powder for inhalation combined with tiotropium bromide powder for inhalation;both groups continuously treated for 20 days.Index of pulmonary(including FEV1,FVC,FEV1/FVC,DLCO,IC/TLC and RV/TLC),ACT score,CAT score and acute attack/acute exacerbation frequency before and after treatment were compared between the two groups,and the incidence of adverse reactions was observed.Results No statistically significant differences of FEV1,FVC,FEV1/FVC,DLCO,IC/TLC or RV/TLC was found between the two groups before treatment(P>0.05);after treatment,FEV1,FVC,FEV1/FVC,DLCO and IC/TLC of observation group were statistically significantly higher than those of control group,while RV/TLC of observation group was statistically significantly lower than that of control group(P<0.05).No statistically significant differences of ACT score,CAT score or acute attack/acute exacerbation frequency was found between the two groups before treatment(P>0.05);after treatment,ACT score of observation group was statistically significantly higher than that of control group,CAT score of observation group was statistically significantly lower than that of control group,meanwhile acute attack/acute exacerbation frequency of observation group was statistically significantly less than that of control group(P<0.05).No statistically significant differences of incidence of xerostomia,palpitation,trachyphonia,dysuria or oral candida infection was found between the two groups(P>0.05).Conclusion Budesonide powder for inhalation combined with tiotropium bromide powder for inhalation has certain clinical effect in treating patients with ACOS,can effectively improve the pulmonary function and is helpful to disease controlling,with relatively high safety.%目的 观察布地奈德粉吸入剂联合噻托溴铵粉雾剂治疗哮喘-慢阻肺重叠综合征(ACOS)的临床疗效.方法 选取2014年10月-2015年10月北京市顺义区医院和首都医科大学电力教学医院收治的ACOS患者118例,采用随机数字表法分为对照组与观察组,每组59例.对照组患者予以噻托溴铵粉雾剂治疗,观察组患者在对照组基础上加用布地奈德粉吸入剂治疗;两组患者均连续治疗20 d.比较两组患者治疗前后肺功能指标〔第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、一氧化碳弥散量(DLCO)、吸气分数(IC/TLC)、残气量与肺总量比值(RV/TLC)〕、哮喘控制测试评分表(ACT)评分、慢性阻塞性肺病评估测试(CAT)评分、急性发作/加重频次,并观察两组患者治疗期间不良反应发生情况.结果 治疗前两组患者FEV1、FVC、FEV1/FVC、DLCO、IC/TLC、RV/TLC比较,差异无统计学意义(P>0.05);治疗后观察组患者FEV1、FVC、FEV1/FVC、DLCO、IC/TLC高于对照组,RV/TLC低于对照组(P<0.05).治疗前两组患者ACT评分、CAT评分、急性发作/加重频次比较,差异无统计学意义(P>0.05);治疗后观察组患者ACT评分高于对照组,CAT评分低于对照组,急性发作/加重频次少于对照组(P<0.05).两组患者口干、心悸、声嘶、排尿困难、口腔假丝酵母菌感染发生率比较,差异无统计学意义(P>0.05).结论 布地奈德粉吸入剂联合噻托溴铵粉雾剂治疗ACOS的临床疗效确切,可有效改善患者肺功能,有利于控制病情发展,且安全性较高.