运动锻炼配合噻托溴铵、沙美特罗／替卡松联合吸人治疗慢性阻塞性肺疾病稳定期疗效分析被引量：10

Therapeutic effects of exercise combined with tiotropium bromide and inhaling on stable chronic obstructive pulmonary disease

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摘要目的观察运动锻炼配合噻托溴铵、沙美特罗／替卡松吸入对慢性阻塞性肺疾病（COPD）稳定期的疗效。方法将COPD稳定期Ⅲ～Ⅳ级患者60例依据随机数字表法分为对照组（药物）和试验组（药物＋锻炼），对照组联合吸入噻托溴铵粉雾剂及沙美特罗，替卡松干粉剂，试验组在药物治疗同时配合运动锻炼（缩唇呼吸和踏阶梯运动），疗程均为8周；治疗前后以第1秒用力呼气容积（FEV，）、FEV．占预计值百分比（FEV，％）、FEV．／用力肺活量（FVC）、MRC评分、日常生活活动能力（ADL）评分、6rain步行距离（6MwD）等指标评价疗效。结果试验组、对照组治疗前后组内各指标比较差异均有统计学意义（P〈0．01）；治疗后试验组、对照组FEV1[（1．41±0．25）L比（1．28±0．23）L]、FEV，％i（53．76±11．17）％比（46．27±8．85）％]、FEV1／FVc【（62．12±10．78）％比（55．76±8．57）％]、MRC评分[（1．56±1．16）分比（2．29±1．13）分]、ADL评分[（5．51±0．18）分比（4．47±O．13）分]、6MWD[（342．7±19．7）m^（280．6±17．8）m]比较差异有统计学意义（P〈0．05）。结论配合运动锻炼能显著改进噻托溴铵、沙美特罗，替卡松联合吸入对COPD稳定期患者的疗效。 Objective To observe the therapeutic effects of exercise combined with tiotropium bromide and salmeterol/fluticasone inhaling on stable chronic obstructive pulmonary diseases （COPD）. Methods Sixty COPD patients with pulmonary function Ⅲ- Ⅳ grade were randomly allocated into experiment group and control group （30 cases in each group）. The patients in experiment group were treated with inhaled tiotropium bromide and salmeterol/fluticasone combined With excise, while the patients in control group were treated only with inhaled tiotropium bromide and salmeterol/fluticasone. Respiratory training with shrinkage lip respiration and steps training was given to the patients in experiment group for 8 weeks. Main outcome measures included forced expiratory volume in one second （FEV1）, FEV1 in the anticipation value （FEVI%）,FEVi/forced vital capacity （FVC）,Medical Research Council （MRC） score,activities of daily living （ADL） score and 6-minute walking distance （6MWD）. Results MRC score in control group and experiment group was both lower than that of pre-treatment （P 〈 0.01 ）. ADL score,6MWD and pulmonary functional parameters in both groups were improved than those of pre-treatment （P 〈 O.01 ）. FEV1, FEV%, FEVJFVC,MRC score,ADL score and 6MWD were （1.41 ±0.25） L, （53.76 ± 11.17）% , （62.12 ± 10.78）%, （1.56 ± 1.16） scores, （5.51 ± 0.18） scores and （342.7 ± 19.7） m after treatment in experiment group,and （ 1.28 ± 0.23 ） L, （46.27 ± 8.85 ）%, （55.76 ± 8.57 ）%, （2.29 ±1.13 ）scores, （4.47 ± 0.13 ）scores and （280.6 ±17.8）m after treatment in control group. There were significant differences between two groups （P 〈 0.05 ）. Conclusion Tiotropium bromide, salmeterol/fluticasone inhaling can improve life quality and pulmonary functional parameters in patients with stable COPD,while exercise combined with that can significantly enhance the therapeutic effects.

作者张靖方怀天周世陇陈春兰

机构地区甘肃省金昌市金川集团公司医院呼吸科甘肃省金昌市第一人民医院呼吸科

出处《中国医师进修杂志》 2010年第10期17-20,共4页 Chinese Journal of Postgraduates of Medicine

关键词肺疾病慢性阻塞性噻托溴铵沙美特罗替卡松运动锻炼 Pulmonary disease, chronic obstructive Tiotropiumbromide Salmeterol/fluticasone Exercise

分类号 R563.9 [医药卫生—呼吸系统]

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