论文部分内容阅读
目的:通过双盲、随机、前瞻性并行分组研究,比较慢性阻塞性肺部疾病病人长期单用异丙阿托品或沙丁胺醇与联合用药的疗效和安全性,并进行药物经济学评估。对象:慢性阻塞性肺部疾病病人1067例。方法:每种支气管扩张剂每天4次,每次2揿(溴化异丙阿托品42μg,硫酸沙丁胺醇240μg)。疗程的第1、29、57、85天进行肺功能检查。1067例慢性阻塞性肺部疾病病人随机分为3组(单用沙丁胺醇者347例,单用异丙阿托品者362例,两药合用者358例),比较3组病人在85天疗程中的发作情况、卫生资源消耗和治疗费用。结果:在整个治疗期间每次复查时,异丙阿托品与沙丁胺醇合用组FEV_1改善程度高于单用组,吸解痉剂的FEV_1反应(用0到4小时FEV_1曲线下面积FEV_1AUC_(0～4)表达)也以合用组为高。与沙丁胺醇组相比,合用组病人发作次数及因发作住院天数较少。沙丁胺醇组病人发作次数较多,且入院天数和抗生素类、肾上腺皮质激素类药物用量明显增加。因此,研究期间总的治疗费用,异丙阿托品单用组与两药合用组较低,分别为159美元/例和197美元/例,而单用沙丁胺醇组高达269美元/例。通过比较FEV_1AUC(0～4)单位改变所需治疗费用,发现使用异丙阿托品的两组费用-效益比较好。结论:慢性阻塞性肺部疾病药物治疗中应用异丙阿托品能减少急性发作,减少?
OBJECTIVE: To compare the efficacy and safety of long-term single-dose of propofol or salbutamol with combination therapy in patients with chronic obstructive pulmonary disease by double-blind, randomized, prospective and concurrent grouping, and to evaluate their pharmacology. Patients: 1067 patients with chronic obstructive pulmonary disease. Methods: Each bronchodilator was given 4 times a day (42 μg of ibuprofen bromide and 240 μg of salbutamol sulfate). The course of 1,29,57,85 days for pulmonary function tests. One hundred and sixty-seven patients with chronic obstructive pulmonary disease were randomly divided into three groups (347 with salbutamol alone, 362 with prodrug alone, and 358 with dual-drug combination). The seizures were compared over a course of 85 days in three groups Situation, health resource consumption and treatment costs. RESULTS: FEV 1 response to isoprenal and salbutamol was higher at each review during the entire treatment period than FEV_1 (p <0.05) FEV 1 (FEV 1 AUC 0 to 4) Expression) is also high for the combined group. Compared with the salbutamol group, patients in the combined group had fewer seizures and fewer days of hospitalization for seizures. Patients in the salbutamol group had more episodes, and the number of admission days and antibiotics, adrenocorticotropic hormone dosage was significantly increased. Therefore, the total cost of treatment during the study period was lower for isoprazole alone and in combination with both drugs, at $ 159 per case and $ 197 per patient, compared with $ 269 per patient on albuterol alone. By comparing FEV_1AUC (0-4) units with the required treatment costs, two sets of costs-benefit measures were found to be more effective with isoprazole. CONCLUSIONS: Isopropytropin can reduce the incidence of acute exacerbations and reduce the incidence of COPD in the treatment of chronic obstructive pulmonary disease.