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目的对噻托溴铵治疗老年慢性阻塞性肺疾病的临床疗效以及安全性进行分析,为临床应用提供理论依据。方法 64例Ⅱ、Ⅲ级慢性阻塞性肺疾病(COPD)稳定期患者随机分为2组,每组32例,对照组(男性24例,女性8例,年龄51~78岁)采用常规治疗,实验组(男性23例,女性9例,年龄53~82岁)在对照组的基础上,进行噻托溴铵吸入治疗(18μg/d,每日1次),连续治疗12周。比较治疗前,治疗4周和治疗12周时2组患者临床指征以及肺功能指标。结果 2组患者的病症都有改善。实验组患者的COPD治疗效果明显优于对照组,治疗4周和12周后,实验组的FEV1、FVC、FEV1/FVC各数值均有改善,且12周的改善效果最好。运动试验中,实验组在治疗后4、12周分别为(302.0±20.7)m和(348.0±22.1)m,与治疗前相比有统计学意义,在相同治疗条件下,噻托溴铵对疾病的治疗随着治疗时间的延长,治疗效果更好。2组患者均为未现严重不良反应。实验组患者满意率(96.875%)显著高于对照组患者满意率(84.375%)。结论噻托溴铵对老年慢性阻塞性肺疾病临床疗效显著,值得临床推广。
Objective To analyze the clinical efficacy and safety of tiotropium in the treatment of senile chronic obstructive pulmonary disease (COPD), and provide a theoretical basis for its clinical application. Methods Sixty-four patients with stage Ⅱ and Ⅲ chronic obstructive pulmonary disease (COPD) were randomly divided into two groups (n = 32 in each group). The control group (24 males and 8 females, aged 51-78 years) Experimental group (23 males, 9 females, aged 53-82 years) on the basis of the control group, tiotropium inhalation therapy (18μg / d, once daily), continuous treatment for 12 weeks. The clinical indications and lung function indexes of two groups before treatment, 4 weeks after treatment and 12 weeks after treatment were compared. Results Both groups had improved symptoms. In the experimental group, the effect of COPD was better than that of the control group. After 4 weeks and 12 weeks of treatment, the values of FEV1, FVC and FEV1 / FVC in the experimental group all improved, and the improvement effect of 12 weeks was the best. In the exercise test, the experimental group was (302.0 ± 20.7) m and (348.0 ± 22.1) m at 4 and 12 weeks after treatment, respectively, which was statistically significant compared with that before treatment. Under the same treatment conditions, Treatment of diseases With the extension of treatment time, the treatment effect is better. Two groups of patients were not serious adverse reactions. The satisfaction rate of the experimental group (96.875%) was significantly higher than that of the control group (84.375%). Conclusions Tiotropium bromide has significant clinical effect on senile chronic obstructive pulmonary disease and deserves clinical promotion.