摘要
目的探讨噻托溴铵吸入辅助布地奈德/福莫特罗治疗重度支气管哮喘患者的疗效以及对肺部通气功能的影响。方法选取我院2015年1月至2016年1月收治的重度支气管哮喘患者80例为研究对象,按随机数字表法分为对照组(40例)和观察组(40例),分别给予布地奈德/福莫特罗单用和在此基础上加用噻托溴铵吸入辅助治疗,两组疗程均为6个月。比较两组患者近期疗效,急性发作频率,治疗前后哮喘控制测试量表(ACT)评分、肺部通气功能指标及不良反应发生率。结果观察组患者和近期治疗总有效率为95.00%,明显高于对照组的75.00%,差异有统计学意义(P<0.05);观察组患者治疗后1、3、6个月的急性发作频率分别为(8.09±0.67)次/月、(6.24±0.38)次/月、(2.94±0.31)次/月,呈逐渐下降趋势,且分别低于对照组的(11.78±1.10)次/月、(9.66±0.85)次/月、(6.56±0.72)次/月,差异均有统计学意义(P<0.05);观察组患者治疗后ACT评分为(21.77±5.24)分,明显高于治疗前的(7.27±2.26)分和对照组的(14.36±3.18)分、差异均有统计学意义(P<0.05);观察组患者治疗后1 s用力呼气量占预计值的百分率(FEV1%)、1 s用力呼气容积(FEV1)、呼气峰流速值(PEF)及呼气流量峰值昼夜波动率(PEFR)分别为(90.38±9.50)、(3.20±0.84)L、(6.54±0.54)L/s、(7.60±2.13)%,均明显优于治疗前的(61.70±5.80)、(2.01±0.48)L、(4.23±0.30)L/s、(34.75±7.99)%和对照组的(79.87±8.35)、(2.42±0.69)L、(5.70±0.44)L/s、(12.63±3.51)%,差异均有统计学意义(P<0.05);观察组患者的不良反应发生率为22.50%,与对照组的15.00%比较,差异无统计学意义(P>0.05)。结论噻托溴铵吸入辅助布地奈德/福莫特罗治疗重度支气管哮喘可有效降低急性发作频率,利于控制病情,提高肺部通气功能,且未增加不良反应。
Objective To investigate the effects of budesonide/formoterol plus tiotropium bromide in the treatment of patients with severe bronchial asthma and its influence on pulmonary ventilation function. Methods Form Jan-uary 2015 to January 2016, 80 patients with severe bronchial asthma in our hospital were recruited and divided into control group（n=40） and observation group（n=40）, according to random number table, which were treated with budesonide/formoterol alone and budesonide/formoterol plus tiotropium bromide, respectively, for 6 months. The short-term clinical efficacy, acute attack frequency, Asthma Control Test（ACT） score, and pulmonary ventilation function indexes before and after treatment were compared between the two groups, as well as adverse reactions. Results The total effective rate of the observation group was 95.00%, which was significantly higher than 75.00% in the control group（P〈0.05）. The acute attack frequencies after 1, 3 and 6 months were（8.09 ± 0.67） times/month,（6.24 ± 0.38） times/month,（2.94±0.31） times/month in the observation group, which showed a gradual downward trend and were lower than（11.78±1.10） times/month,（9.66 ± 0.85） times/month,（6.56 ± 0.72） times/month in the control group（P〈0.05）. After treatment,the ACT score of the observation group was（21.77±5.24）, which was significantly higher than（7.27±2.26） before treatment and（14.36±3.18） in the control group（P〈0.05）. The percentage of forced expiratory volume in 1 second（FEV1%）,forced expiratory volume in 1 second（FEV1）, peak expiratory flow（PEF） and peak expiratory flow rate（PEFR） of the observation group after treatment were（90.38±9.50）,（3.20±0.84） L and（6.54±0.54） L/s,（7.60±2.13）%, which were significantly better than（61.70 ± 5.80）,（2.01 ± 0.48） L,（4.23 ± 0.30） L/s,（34.75 ± 7.99）% before the treatment and（79.87 ±8.35）,（2.42±0.69） L,（5.70±0.44） L/s,（12.63±3.51）% in the control group, with statistically significant differences（P〈0.05）. The incidence of adverse reactions of the observation group was 22.50%, as compared with 15.00% in the control group（P〉0.05）. Conclusion Budesonide/formoterol plus tiotropium bromide in the treatment of patients with severe bronchial asthma can efficiently reduce the acute attack frequency, control disease condition, and improve the pulmonary ventilation function, without increasing the adverse reactions.
出处
《海南医学》
CAS
2017年第5期736-739,共4页
Hainan Medical Journal
