探讨噻托溴铵治疗慢性阻塞性肺疾病患者不同组间的疗效差异
发布时间：2018-11-09 18:00
【摘要】：目的：探讨慢性阻塞性肺疾病患者规律使用噻托溴铵粉吸入剂1年后，在临床症状、肺功能、急性加重风险等，在各组的变化情况。 方法：本试验采用病例对照研究。依照中华医学会制定的COPD相关诊断标准诊断为慢性阻塞性肺疾病的64例患者，分为使用噻托溴铵粉吸入剂治疗的噻托溴铵组和常规治疗未使用噻托溴铵患者的对照组。按2011年GOLD全球策略的病情严重程度评估标准，分为A、B、C、D组，每组取8人入组噻托溴铵组。1年后评估两组及各项对应分组间患者，，在呼吸困难指数、肺功能、急性加重次数方面的变化情况。 结果：两组患者及各项对应分组间，入组时在性别、年龄、呼吸困难指数、肺功能及过去1年急性加重次数等均无统计学差异。1年后评估，发现噻托溴铵组患者呼吸困难指数有明显下降(P0.05)、年急性加重次数明显减少(P0.05)，但肺功能也有明显下降(P0.05)；对照组患者呼吸困难指数没有差异，年急性加重次数也没有变化，而肺功能下降明显（P0.001）。提示噻托溴铵粉吸入剂能改善慢阻肺的临床症状和年急性加重次数。分析噻托溴铵组和对照组肺功能的差异时发现噻托溴铵组肺功能下降程度明显低于对照组(P0.05)，说明噻托溴铵粉吸入剂能延缓慢阻肺患者肺功能下降。在A、B、C、D相应组间分析上，发现A组间呼吸困难指数、年急性加重次数无差别，但肺功能下降程度噻托溴铵组低于对照组(P0.05)；B组间呼吸困难指数噻托溴铵组低于对照组(P0.05)，肺功能下降程度噻托溴铵组低于对照组(P0.05)，但年急性加重次数无差别。C组间噻托溴铵组年急性加重次数明显低于对照组(P0.05)，肺功能下降程度也低于对照组(P0.05)，但呼吸困难指数两组间无差别。D组间噻托溴铵组呼吸困难指数低于对照组(P0.05)，年急性加重次数少于对照组(P0.05)，但肺功能下降程度两者间没有差异。提示噻托溴铵能延缓A组、B组、C组患者的肺功能下降速度，而对D组没有作用。噻托溴铵能减少B组、D组的年急性加重次数，改善B组、D组的呼吸困难症状。 结论：噻托溴铵粉可以延缓肺功能下降的速度，改善呼吸困难指数、减少急性加重次数。 噻托溴铵能延缓A组、B组、C组患者的肺功能下降速度，减少B组、D组的年急性加重次数，改善B组、D组的呼吸困难症状。
[Abstract]:Objective: to investigate the changes of clinical symptoms, pulmonary function, acute exacerbation risk and so on in patients with chronic obstructive pulmonary disease (COPD) after regular use of tiotropium bromide powder inhalation for one year. Methods: a case-control study was conducted. Sixty-four patients with chronic obstructive pulmonary disease (COPD) were divided into two groups: tiotropium group treated with tiotropium powder inhalation and control group with routine treatment without tiotropium bromide according to the COPD diagnostic criteria established by the Chinese Medical Association. According to the criteria for evaluating the severity of GOLD's global strategy in 2011, the patients were divided into two groups: group A (n = 8) and group D (n = 8). One year later, patients in two groups and their corresponding groups were evaluated for dyspnea index and pulmonary function. Changes in the number of acute exacerbations. Results: there were no significant differences in sex, age, dyspnea index, pulmonary function and acute exacerbation in the past year between the two groups. It was found that the dyspnea index of patients in tiotropium group was significantly decreased (P0.05), the number of acute exacerbations was significantly decreased (P0.05), but the pulmonary function was also significantly decreased (P0.05). There was no difference in dyspnea index and the number of acute exacerbations in the control group, but the pulmonary function decreased significantly (P0.001). The results suggest that tiotropium bromide powder inhalation can improve the clinical symptoms and acute exacerbation times of COPD. After analyzing the difference of pulmonary function between tiotropium group and control group, it was found that the decrease of pulmonary function in tiotropium group was significantly lower than that in control group (P0.05), which indicated that tiotropium powder inhalation could delay the decline of pulmonary function in patients with chronic obstructive pulmonary disease. There was no significant difference in dyspnea index and acute exacerbation between group A and group A, but the degree of pulmonary function decline was lower in tiotropium group than that in control group (P0.05). The index of dyspnea in group B was lower than that in control group (P0.05), and the degree of pulmonary function decline in group B was lower than that in group B (P0.05). The number of acute exacerbations in group C was significantly lower than that in control group (P0.05), and the degree of pulmonary function decline was also lower than that in control group (P0.05). But there was no difference in dyspnea index between two groups. The dyspnea index of group D was lower than that of control group (P0.05), the number of acute exacerbation was less than that of control group (P0.05), but there was no difference between the two groups in the degree of pulmonary function decline. It suggested that tiotropium bromide could delay the decline of pulmonary function in group A, group B and group C, but had no effect on group D. Tiotropium bromide decreased the number of acute exacerbations in group B and D, and improved dyspnea in group B and D. Conclusion: tiotropium bromide powder can delay the decline of pulmonary function, improve the index of dyspnea and decrease the times of acute exacerbation. Tiotropium bromide could delay the decline of pulmonary function in group A, group B and group C, decrease the number of acute exacerbations in group B and group D, and improve the symptoms of dyspnea in group B and group D.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R563.9
本文编号：2321153
[Abstract]:Objective: to investigate the changes of clinical symptoms, pulmonary function, acute exacerbation risk and so on in patients with chronic obstructive pulmonary disease (COPD) after regular use of tiotropium bromide powder inhalation for one year. Methods: a case-control study was conducted. Sixty-four patients with chronic obstructive pulmonary disease (COPD) were divided into two groups: tiotropium group treated with tiotropium powder inhalation and control group with routine treatment without tiotropium bromide according to the COPD diagnostic criteria established by the Chinese Medical Association. According to the criteria for evaluating the severity of GOLD's global strategy in 2011, the patients were divided into two groups: group A (n = 8) and group D (n = 8). One year later, patients in two groups and their corresponding groups were evaluated for dyspnea index and pulmonary function. Changes in the number of acute exacerbations. Results: there were no significant differences in sex, age, dyspnea index, pulmonary function and acute exacerbation in the past year between the two groups. It was found that the dyspnea index of patients in tiotropium group was significantly decreased (P0.05), the number of acute exacerbations was significantly decreased (P0.05), but the pulmonary function was also significantly decreased (P0.05). There was no difference in dyspnea index and the number of acute exacerbations in the control group, but the pulmonary function decreased significantly (P0.001). The results suggest that tiotropium bromide powder inhalation can improve the clinical symptoms and acute exacerbation times of COPD. After analyzing the difference of pulmonary function between tiotropium group and control group, it was found that the decrease of pulmonary function in tiotropium group was significantly lower than that in control group (P0.05), which indicated that tiotropium powder inhalation could delay the decline of pulmonary function in patients with chronic obstructive pulmonary disease. There was no significant difference in dyspnea index and acute exacerbation between group A and group A, but the degree of pulmonary function decline was lower in tiotropium group than that in control group (P0.05). The index of dyspnea in group B was lower than that in control group (P0.05), and the degree of pulmonary function decline in group B was lower than that in group B (P0.05). The number of acute exacerbations in group C was significantly lower than that in control group (P0.05), and the degree of pulmonary function decline was also lower than that in control group (P0.05). But there was no difference in dyspnea index between two groups. The dyspnea index of group D was lower than that of control group (P0.05), the number of acute exacerbation was less than that of control group (P0.05), but there was no difference between the two groups in the degree of pulmonary function decline. It suggested that tiotropium bromide could delay the decline of pulmonary function in group A, group B and group C, but had no effect on group D. Tiotropium bromide decreased the number of acute exacerbations in group B and D, and improved dyspnea in group B and D. Conclusion: tiotropium bromide powder can delay the decline of pulmonary function, improve the index of dyspnea and decrease the times of acute exacerbation. Tiotropium bromide could delay the decline of pulmonary function in group A, group B and group C, decrease the number of acute exacerbations in group B and group D, and improve the symptoms of dyspnea in group B and group D.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R563.9
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