噻托溴铵联合沙美特罗替卡松治疗老年重度COPD的临床观察

发布时间：2018-04-13 15:54

本文选题：噻托溴铵 + 沙美特罗替卡松　；参考：《中国药房》2017年20期

【摘要】：目的:观察噻托溴铵联合沙美特罗替卡松治疗老年重度慢性阻塞性肺疾病(COPD)的临床疗效及安全性。方法:选取2013年5月-2015年5月我院收治的老年重度COPD患者共90例,按随机数字表法分为对照组和观察组,各45例。对照组患者给予沙美特罗替卡松气雾剂1揿/次,bid;观察组患者在对照组基础上加用噻托溴铵粉吸入剂18μg,qd。两组患者均治疗8周。观察两组患者近期疗效及治疗前后呼吸困难评分、肺部通气功能指标[用力肺活量(FVC)、一秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1%)]、血气分析指标{氧分压[p(O_2)、二氧化碳分压[p(CO_2)]}、Spitzer生活质量指数表(QLI)评分,比较两组患者再住院次数及不良反应发生情况。结果:观察组患者近期治疗总有效率为97.78%,显著高于对照组的80.00%,差异有统计学意义(P0.05)。治疗前,两组患者呼吸困难评分、肺部通气功能指标、血气分析指标、QLI评分比较,差异均无统计学意义(P0.05);治疗后,两组患者呼吸困难评分、p(CO_2)水平显著降低,肺部通气功能指标、p(O_2)水平、QLI评分显著升高,且观察组患者显著优于对照组,差异均有统计学意义(P0.05)。观察组患者再住院次数显著少于对照组,差异有统计学意义(P0.05)。两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论:噻托溴铵辅助沙美特罗替卡松治疗老年重度COPD疗效显著,可有效缓解患者呼吸困难症状,改善肺部通气功能,提高日常生活质量,降低再次住院风险,且未增加不良反应发生率。
[Abstract]:Objective: to observe the efficacy and safety of tiotropium bromide combined with salmeterticasone in the treatment of severe chronic obstructive pulmonary disease (COPD) in elderly patients.Methods: a total of 90 elderly patients with severe COPD were selected from May 2013 to May 2015 in our hospital. According to the method of random digital table, they were divided into control group and observation group with 45 cases each.The patients in the control group were given salmeterol roticasone aerosol, and the patients in the observation group were given tiotropium bromide powder inhalation of 18 渭 g / L QD on the basis of the control group.Both groups were treated for 8 weeks.The short term curative effect and the score of dyspnea before and after treatment were observed in the two groups.The frequency of re-hospitalization and the incidence of adverse reactions were compared between the two groups.Results: the total effective rate of recent treatment in the observation group was 97.78, which was significantly higher than that in the control group (80.005%), and the difference was statistically significant (P 0.05).Before treatment, there was no significant difference in the score of dyspnea, pulmonary ventilation function index, blood gas analysis index and QLI score between the two groups (P 0.05), but after treatment, the score of dyspnea was significantly lower in the two groups than that in the control group (P < 0.05).The QLI score of the patients in the observation group was significantly higher than that in the control group, and the difference was statistically significant (P 0.05).The number of re-hospitalization in the observation group was significantly less than that in the control group (P 0. 05).There was no significant difference in the incidence of adverse reactions between the two groups (P 0.05).Conclusion: tiotropium bromide plus salmeterticasone is effective in the treatment of elderly patients with severe COPD. It can effectively relieve the symptoms of dyspnea, improve pulmonary ventilation function, improve the quality of daily life, and reduce the risk of re-hospitalization.The incidence of adverse reactions was not increased.
【作者单位】：河北北方学院附属第二医院呼吸内科;
【分类号】：R563.9

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