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目的探究胸腺肽α-1联合布地奈德混悬液雾化吸入对哮喘-慢阻肺重叠综合征(ACOS)患者的影响。方法选取上海市宝山区仁和医院2015年7月—2016年11月收治的ACOS患者83例,采用随机数字表法分为对照组41例和研究组42例。对照组患者给予胸腺肽α-1静脉滴注,持续治疗20 d;研究组患者在对照组基础上加用布地奈德混悬液雾化吸入,持续治疗7 d。比较两组患者临床疗效,治疗前后呼气峰流速(PEF)、第1秒用力呼气容积(FEV_1)、用力肺活量(FVC)、氧分压(PaO_2)、二氧化碳分压(PaCO_2)、英国医学研究委员会呼吸困难量表(MMRC)评分、不良反应及生活质量。结果研究组患者临床疗效优于对照组(P<0.05)。治疗前两组患者PaO_2、PaCO_2、PEF、FEV_1、FVC、MMRC评分比较,差异无统计学意义(P>0.05);治疗后研究组患者PaCO_2、MMRC评分低于对照组,PaO_2、PEF、FEV_1、FVC高于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。治疗前两组患者SF-36简明量表评分比较,差异无统计学意义(P>0.05);治疗后研究组患者SF-36简明量表评分高于对照组(P<0.05)。结论胸腺肽α-1联合布地奈德混悬液雾化吸入治疗ACOS的临床疗效确切,可有效改善患者肺功能、呼吸困难状况及生活质量,且安全性较高。
Objective To investigate the effect of inhalation of thymosin α-1 combined with budesonide suspension on patients with asthma-COPD (ACOS). Methods Eighty-three ACOS patients admitted to Renhe Hospital of Baoshan District, Shanghai from July 2015 to November 2016 were divided into control group (n = 41) and study group (n = 42) by random number table. Patients in the control group were treated with intravenous thymosin α-1 for 20 days. Patients in the study group were treated with inhaled budesonide for 8 days on the basis of the control group. The clinical curative effect, the peak expiratory flow (PEF), FEV 1, FVC, PaCO 2 and British medicine before and after treatment were compared between the two groups. Research Board Respiratory Difficulty Scale (MMRC) score, adverse reactions, and quality of life. Results The clinical efficacy of the study group was better than that of the control group (P <0.05). There was no significant difference in PaCO_2, PaCO_2, PEF, FEV_1, FVC and MMRC scores between the two groups before treatment (P> 0.05). PaCO_2 and MMRC scores in the study group were lower than those in the control group, PaO_2, PEF, FEV_1, FVC higher than the control group (P <0.05). Two groups of patients with adverse reactions, the difference was not statistically significant (P> 0.05). The SF-36 concordance score of the two groups before treatment had no significant difference (P> 0.05). After treatment, SF-36 concatant score of the study group was higher than that of the control group (P <0.05). Conclusion The clinical efficacy of thymosin α-1 combined with budesonide aerosol inhalation in the treatment of ACOS is definite and can effectively improve pulmonary function, dyspnea status and quality of life in patients with high safety.