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目的研究吸入噻托溴铵联合舒利迭在稳定期中重度慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)治疗中的应用价值。方法选取2013年1月—2015年1月收治的稳定期中重度COPD患者116例作为研究对象,随机分为对照组和研究组各58例。对照组患者在常规治疗基础上给予舒利迭吸入治疗,1吸/次,2次/d。研究组患者在对照组基础上加用噻托溴铵吸入治疗,1支/次,1次/d。两组均治疗3个月。观察并比较患者临床疗效及肺功能、血气分析、英国医学研究委员会呼吸困难量表评分(modified British medical research council dyspnea scale,MMRC)、6分钟步行试验(6 minute walking test,6MWT)结果。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果研究组总有效率为91.38%,明显高于对照组的70.69%,差异有统计学意义(P<0.05)。治疗后,研究组患者FVC、FEV1、FEV1%分别为(3.32±0.41)、(2.25±0.32)L、(67.23±8.03)%,均明显高于对照组的(2.86±0.23)、(1.77±0.21)L、(56.73±6.42)%,差异均有统计学意义(均P<0.05)。研究组Pa O2为(74.23±4.19)mm Hg(1 mm Hg=0.133 k Pa),明显高于对照组的(65.63±3.23)mm Hg,研究组PaCO_2为(43.12±2.19)mm Hg,明显低于对照组的(48.62±2.42)mm Hg,差异均有统计学意义(均P<0.05)。研究组MMRC评分为(1.33±0.31)分,明显低于对照组的(1.82±0.41)分,研究组6MWT为(432.52±33.28)m,明显长于对照组的(390.23±24.38)m,差异均有统计学意义(均P<0.05)。结论在稳定期中重度COPD治疗中,噻托溴铵联合舒利迭吸入治疗可提高治疗效果,改善患者肺功能,提高血氧分压,提高患者日常生活质量,值得推广。
Objective To investigate the value of inhalation of tiotropium combined with seretide in the treatment of stable chronic obstructive pulmonary disease (COPD). Methods A total of 116 patients with moderate-to-severe COPD admitted to our hospital from January 2013 to January 2015 were selected and randomly divided into control group and study group with 58 cases each. Patients in the control group were given seretide inhalation therapy on the basis of routine treatment, 1 suction / time, 2 times / d. Patients in the study group were treated with tiotropium inhalation on the basis of the control group, 1 patient / time, once / d. Both groups were treated for 3 months. The clinical efficacy and pulmonary function, blood gas analysis, MMRC, 6-minute walking test (6MWT) results of the patients were observed and compared. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The total effective rate of the study group was 91.38%, which was significantly higher than that of the control group (70.69%), the difference was statistically significant (P <0.05). After treatment, the FVC, FEV1 and FEV1% of the study group were (3.32 ± 0.41) and (2.25 ± 0.32) L and (67.23 ± 8.03)%, respectively, which were significantly higher than those in the control group (2.86 ± 0.23 and 1.77 ± 0.21) L, (56.73 ± 6.42)% respectively, all with statistical significance (all P <0.05). PaO2 in the study group was (74.23 ± 4.19) mm Hg (1 mm Hg = 0.133 kPa), which was significantly higher than that in the control group (65.63 ± 3.23 mm Hg) In the control group (48.62 ± 2.42) mm Hg, the difference was statistically significant (all P <0.05). The MMRC score of the study group was (1.33 ± 0.31) points, which was significantly lower than that of the control group (1.82 ± 0.41), the study group 6MWT was (432.52 ± 33.28) m, significantly longer than the control group (390.23 ± 24.38) m, There was statistical significance (all P <0.05). Conclusion In the treatment of severe COPD in stable phase, tiotropium combined with seretide inhalation therapy can improve the therapeutic effect, improve pulmonary function, improve the oxygen partial pressure and improve the daily life quality of patients, which is worth popularizing.