摘要
目的探讨M胆碱受体阻断剂联合缩唇腹式呼吸治疗慢性阻塞性肺疾病(COPD)稳定期患者的临床疗效。方法80例COPD稳定期患者,采用随机数字表法分成对照组及观察组,每组40例。对照组采用噻托溴铵粉雾剂治疗,观察组采用噻托溴铵粉雾剂^(+)缩唇腹式呼吸治疗。对比两组患者的临床疗效,治疗前后的肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、FEV1占预计值的百分比(FEV1%pred)]、细胞免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、6 min步行试验距离(6MWD)、Borg呼吸困难评分、圣乔治呼吸问卷评分,不良反应发生率。结果观察组患者的临床总有效率为90.00%,高于对照组的70.00%,差异具有统计学意义(P<0.05)。治疗后,两组患者的FEV1、FVC、FEV1/FVC、FEV1%pred均高于本组治疗前,且观察组患者的FEV1(2.12±0.34)L、FVC(2.66±0.39)L、FEV1/FVC(79.85±8.12)%、FEV1%pred(79.12±7.25)%均高于对照组的(1.66±0.27)L、(2.33±0.35)L、(71.77±8.33)%、(68.79±7.36)%,差异具有统计学意义(P<0.05)。治疗后,两组患者的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于本组治疗前,CD8^(+)水平低于本组治疗前,且观察组患者的CD3^(+)(69.62±4.14)%、CD4^(+)(32.27±4.53)%、CD4^(+)/CD8^(+)(1.46±0.25)均高于对照组的(64.19±4.21)%、(27.44±3.76)%、(0.95±0.17),CD8^(+)(22.52±3.23)%低于对照组的(29.16±3.36)%,差异具有统计学意义(P<0.05)。治疗后,两组患者的6MWD长于本组治疗前,Borg呼吸困难评分、圣乔治呼吸问卷评分低于本组治疗前,且观察组患者的6MWD(458.63±43.12)m长于对照组的(413.16±42.25)m,Borg呼吸困难评分(2.50±0.34)分、圣乔治呼吸问卷评分(40.53±5.22)分低于对照组的(3.13±0.48)、(48.16±5.37)分,差异具有统计学意义(P<0.05)。治疗期间,观察组患者的不良反应发生率为5.00%,与对照组的10.00%对比,差异无统计学意义(P>0.05)。结论在COPD稳定期患者中应用M胆碱受体阻断剂联合缩唇腹式呼吸治疗可对临床症状起到缓解作用,对肺功能和免疫功能起到改善作用,对运动耐力恢复起到促进作用,使生活质量得到提高。
Objective To discuss the clinical efficacy of M-cholinoceptor blocking drugs combined with abdominal breathing through pursed lips in the treatment of stable chronic obstructive pulmonary disease(COPD)patients.Methods A total of 80 patients with stable COPD were divided into control group and observation group according to the random numerical table,with 40 cases in each group.The control group was treated with tiotropium bromide powder for inhalation,and the observation group was treated with tiotropium bromide powder for inhalation and abdominal breathing through pursed lips.Both groups were compared in terms of clinical efficacy,lung function indicators[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC,FEV1 as a percentage of the predicted value(FEV1%pred)],cellular immune function indicators(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),6 min walking distance(6MWD),Borg dyspnea score,St.George's respiratory questionnaire score before and after treatment,and incidence of adverse reactions.Results The total clinical effective rate of the observation group was 90.00%,which was higher than that of 70.00%of the control group,and the difference was statistically significant(P<0.05).After treatment,FEV1,FVC,FEV1/FVC and FEV1%pred in both groups were higher than those before treatment in this group;the observation group had FEV1 of(2.12±0.34)L,FVC of(2.66±0.39)L,FEV1/FVC of(79.85±8.12)%,and FEV1%pred of(79.12±7.25)%,which were higher than those of(1.66±0.27)L,(2.33±0.35)L,(71.77±8.33)%,and(68.79±7.36)%in the control group;the differences were statistically significant(P<0.05).After treatment,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in both groups were higher than those before treatment in this group,and the level of CD8^(+)was lower than that before treatment in this group;the observation group had CD3^(+)of(69.62±4.14)%,CD4^(+)of(32.27±4.53)%,and CD4^(+)/CD8^(+)of(1.46±0.25),which were higher than those of(64.19±4.21)%,(27.44±3.76)%,and(0.95±0.17)in the control group;CD8^(+)of(22.52±3.23)%in the observation group was lower than that of(29.16±3.36)%in the control group;the differences were statistically significant(P<0.05).After treatment,6MWD in both groups was longer than that before treatment in this group,and Borg dyspnea score and St.George's respiratory questionnaire score was lower than that before treatment in this group;6MWD of(458.63±43.12)m in the observation group was longer than that of(413.16±42.25)m in the control group;Borg dyspnea score of(2.50±0.34)points and St.George's respiratory questionnaire score of(40.53±5.22)points in the observation group were lower than those of(3.13±0.48)and(48.16±5.37)points in the control group;the differences were statistically significant(P<0.05).During treatment,the incidence of adverse reactions in the observation group was 5.00%,and the difference was not statistically significant when compared with that of 10.00%in the control group(P>0.05).Conclusion In stable COPD patients,the application of M-cholinoceptor blocking drugs combined with abdominal breathing through pursed lips can alleviate clinical symptoms,improve lung function and immune function,promote the recovery of exercise endurance,and improve the quality of life.
作者
杨丽琳
YANG Li-lin(Department of Internal Medicine,Xinjian District People's Hospital,Nanchang 330100,China)
出处
《中国现代药物应用》
2023年第17期34-38,共5页
Chinese Journal of Modern Drug Application
关键词
慢性阻塞性肺疾病
稳定期
缩唇腹式呼吸
噻托溴铵
免疫功能
肺功能
Chronic obstructive pulmonary disease
Stable period
Abdominal breathing through pursed lips
Tiotropium bromide
Immune function
Lung function
