摘要
目的观察布地奈德福莫特罗吸入辅助治疗哮喘伴慢性阻塞性肺疾病对肺功能及炎性因子的影响。方法选择2016年3月—2017年3月西双版纳傣族自治州人民医院呼吸内科收治的哮喘伴慢性阻塞性肺疾病患者90例作为研究对象,随机数字表法分为观察组和对照组各45例。2组患者均减少运动负荷,给予吸氧、家庭氧疗。对照组给予抗胆碱药物、抗感染、氨茶碱类、镇咳剂等常规治疗。观察组在对照组治疗基础上给予布地奈德福莫特罗吸入剂吸入治疗,160μg/吸,2吸/次,2次/d;2组疗程为6个月。比较2组患者治疗前后肺功能、炎性因子,慢阻肺自我评估测试(CAT)评分、哮喘控制测评(ACT)评分、急性加重次数变化情况,并对2组患者安全性进行评价。结果治疗后2组FVC、FEV_1、PEF、DLCO、IC/TLC明显高于治疗前,RV/TLC低于治疗前(P<0.05),且治疗后观察组优于对照组(t=2.069、4.919、6.379、2.169、6.841、5.138,P=0.021、0.000、0.000、0.016、0.000、0.000);与治疗前比较,2组治疗后炎性因子均改善(P<0.05),且治疗后观察组TNF-α、IL-5、IL-6、hs-CRP水平显著低于对照组(t=2.256、2.791、3.479、2.060,P=0.027、0.003、0.000、0.021);观察组CAT评分、急性加重次数明显低于对照组,ACT评分显著高于对照组(t=6.534、4.243、10.146,P=0.000、0.000、0.000);2组患者治疗过程中发生口干、心悸、烦躁、便秘、急性尿潴留等不良反应发生率比较,差异无统计学意义(X^2=0.758、2.381、0.505、0.000、0.758,P=0.384、0.123、0.477、1.000、0.384)。结论布地奈德福莫特罗吸入治疗哮喘伴慢性阻塞性肺疾病能有效改善肺功能指标,降低炎性因子水平,缓解临床症状,安全可靠,值得临床推广。
Objective To investigate the effects of budesonide formoterol on lung function and inflammatory mediators in the treatment of asthma with chronic obstructive pulmonary disease. Methods Ninety cases of children with asthma and chronic obstructive pulmonary disease were selected, which were treated in hospital from March 2016 to March 2017, and they were divided into the observation group （45 cases） and control group （45 cases）. The patients of two groups were all treated with reduce exercise load, give oxygen and family oxygen therapy. The patients of control group were treated with anticholinergic drugs, anti-infection, aminophylline, antitussive and other conventional treatment. Based on control group, the patients of observation group were treated with budesonide formoterol inhalation （160μg / suction, 2 suction / time, 2 times / d; treatment for 6 months）. The safety and changes of the levels of lung function index, inflammatory mediators＇ level, CAT score, ACT score, acute exacerbation of two groups were compared. Results After the appropriate treatment, the FVC, FEV 1, PEF, DLCO, IC/TLC levels of the observation group were significantly higher than those of the control group, and the RV/ TLC levels of the observation group were significantly lower than those of the control group （t = 2.069, t =4. 919, t = 6. 379, t =2. 169, t =6.841, t =5. 138; P= 0.021, P =0.000, P =0.000, P =0.016, P =0.000, P=0.000） ; The TNF-α, IL- 5, IL-6, hs-CRP levels of the observation group were significantly lower than those of the control group （ t = 2. 256, t = 2.791, t = 3. 479, t = 2. 060 ; P = 0. 027, P = 0. 003, P = 0. 000, P = 0.021 ） ; The CAT score, acute exacerbations of the observation group were significantly lower than those of the control group, and the ACT score of the observation group were significantly higher than those of the control group （t = 6. 534, t = 4. 243, t = 10. 146 ; P = 0.000, P = 0. 000, P = 0.000） ; There were dry mouth, palpitations, irritability, constipation, acute urinary retention and other adverse reactions occurred in both two groups, but there were no statistically significant between the two groups （ χ^2 = 0. 758, χ^2 = 2. 381,χ^2 = 0. 505, χ^2=0.000,χ^2=0.758; P= 0.384, P=0.123, P=0.477, P=1.000, P=0.384）. Conclusion Inhalation of budesonide formoterol in the treatment of asthma with chronic obstructive pulmonary disease can effectively improve lung function, reduce the levd of inflammatory mediators, relieve clinical symptoms, and it is safe and reliable, which makes it worthy of clinical promotion.
出处
《疑难病杂志》
CAS
2018年第1期5-9,共5页
Chinese Journal of Difficult and Complicated Cases
