雾化吸入氨溴索排痰效果的临床观察
发布时间：2019-03-10 19:55
【摘要】：研究背景： 超说明书用药,即“药品未注册用法(unlabeled uses)",是指药品使用的适应证、给药方法或剂量不在药品监督管理部门批准的说明书之内的用法。虽然已有著作中介绍氨溴索气雾剂及氨溴索雾化吸入,并出现诸多氨溴索雾化吸入的相关文献报道,但多为国内小样本调查,可信度不高,且目前临床应用的氨溴索注射液说明书(2008年修订版)中仍未提及氨溴索雾化吸入这一用法,因此该用法尚属超说明书用药,需进一步寻找相关循证医学依据。 目的： 氨溴索注射液静脉滴注为临床常用祛痰方法,本文采用生理盐水、3%氯化钠、氨溴索注射液雾化吸入三种方法分别对三组患者进行诱导排痰,通过相关指标的比较进而观察氨溴索注射液30mg雾化吸入的祛痰效果。 资料和方法： 1.研究对象：收集2013年11月至2014年1月期间在山东省立医院东院呼吸内科住院治疗的咳嗽咳痰且能够耐受雾化吸入的慢性阻塞性肺病急性加重(AECOPD)患者30例,随机分为三组,A组(生理盐水组)10例,B组(3%氯化钠溶液组)9例,C组(氨溴索组)11例。 2.雾化吸入方法：本试验采取氧驱动雾化,给予A组患者：生理盐水(NS)8ml雾化吸入一天两次(bid)；B组患者：NS6ml+10%NaCl2ml雾化吸入bid；C组患者：NS4ml+氨溴索4ml雾化吸入bid。每次雾化吸入时间均为15min左右。 3.痰标本的收集：收集每位入组患者雾化吸入前一天(d0)和雾化后三天(d1、d2、d3)每天的痰液,标本收集当日早上7点至次日早上7点的24小时痰。 4.观测指标：观察并记录三组患者d1、d2、d3痰液量、干/湿重、粘度,进行平行比较以观察不同诱导方法对痰液性质影响的差异。分别将三组患者每位患者d0、d1的痰液量进行比较观察诱导排痰效果。 5.统计分析：将收集所得原始数据以Excel形式分天保存,应用统计软件SPSS20.0进行数据统计,采用SPSS中单因素方差分析、fisher精确检验及独立样本的非参数检验进行统计学分析,P0.05表示差异具有统计学意义。 结果： 1.痰液量：C组患者每日痰量多于A组、B组(P均0.05,差异明显,具有统计学意义)。 2.粘度：C组每日痰液粘度低于A组、B组(P0.05)。 3.痰液干重/湿重：C组每日痰液干/湿重低于A组、B组(P0.05)。 4.不良反应：B组患者雾化过程中存在明显口腔咸味感,其他组未诉特殊不适。 结论： 1.生理盐水、3%氯化钠溶液、氨溴索雾化吸入均有利于患者痰液排出； 2.氨溴索雾化吸入的排痰效果优于生理盐水、3%氯化钠溶液组。
[Abstract]:Background: ultra-prescriptive drug use, that is, "unregistered drug usage (unlabeled uses)", refers to the indication of drug use, the use of drug delivery methods or doses that are not in the instructions approved by the drug regulatory department. Although some books have introduced the aerosol of ambroxol and the atomization inhalation of ambroxol, and there are many related literature reports of the atomization inhalation of ambroxol, most of them are small sample investigation in China, and the reliability is not high. The current clinical application of ambroxol injection manual (revised 2008 edition) still does not mention the use of ambroxol atomization inhalation, so the use of ambroxol is still ultra-prescriptive, it is necessary to look for evidence-based medicine. Objective: intravenous infusion of ambroxol injection is a common clinical expectorant method. In this paper, normal saline, 3% sodium chloride and aerosol inhalation of ambroxol injection were used to induce expectoration in three groups of patients, respectively. The expectorant effect of 30mg atomization inhalation of ambroxol injection was observed by comparing the relative indexes. Information and methods: 1. Participants: from November 2013 to January 2014, 30 patients with acute exacerbation of (AECOPD) with chronic obstructive pulmonary disease (COPD) who were hospitalized in the Department of Respiratory Medicine, Eastern Hospital of Shandong Provincial Hospital, were randomly divided into three groups. There were 10 cases in group A (saline group), 9 cases in group B (3% sodium chloride solution group) and 11 cases in group C (ambroxol group). 2. Atomization inhalation method: in this experiment, oxygen-driven atomization was given to patients in group A: normal saline (NS) 8ml atomized inhalation twice a day in (bid); B group; NS6ml 10%NaCl2ml atomization inhalation in bid;C group; NS4ml ambroxol 4ml atomization inhalation in bid. group Each atomization inhalation time is about 15min. 3. Collection of sputum specimens: the sputum was collected one day before atomization inhalation (day 0) and three days after atomization (day 1, day 2, day 3). The sputum samples were collected from 7: 00 a.m. to 7: 00 a.m. on the same day and 24-hour sputum from 7: 00 a.m. to 7: 00 a.m. on the following day (day 1, day 2, day 3). 4. Observation indexes: the sputum volume, dry / wet weight and viscosity of the three groups were observed and recorded on day 1, day 2 and day 3. The effects of different induction methods on sputum properties were observed by parallel comparison. The sputum volume on day 0 and day 1 of each patient in three groups were compared to observe the effect of induced sputum discharge. 5. Statistical analysis: the original data collected were stored in the form of Excel day by day. The data were counted by SPSS20.0, and analyzed by single factor analysis of variance (ANOVA) in SPSS, accurate fisher test and non-parametric test of independent samples. P0.05 indicates that the difference is statistically significant. Results: 1. Sputum volume: the daily sputum volume in group C was more than that in group A and group B (P all 0.05, the difference was significant, statistically significant). 2. Viscosity: daily sputum viscosity in group C was lower than that in group A and group B (P0.05). 3. Sputum dry / wet weight: daily sputum dry / wet weight in group C was lower than that in group A and group B (P0.05). 4. Side effects: there was a significant oral salty sensation in the atomization process in group B, and no special discomfort was reported in the other groups. Conclusions: 1. Normal saline, 3% sodium chloride solution and ambroxol atomization inhalation are beneficial to the sputum efflux of the patients. The expectoration effect of ambroxol atomization inhalation was better than that of normal saline, 3% sodium chloride solution group.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R974
本文编号：2437968
[Abstract]:Background: ultra-prescriptive drug use, that is, "unregistered drug usage (unlabeled uses)", refers to the indication of drug use, the use of drug delivery methods or doses that are not in the instructions approved by the drug regulatory department. Although some books have introduced the aerosol of ambroxol and the atomization inhalation of ambroxol, and there are many related literature reports of the atomization inhalation of ambroxol, most of them are small sample investigation in China, and the reliability is not high. The current clinical application of ambroxol injection manual (revised 2008 edition) still does not mention the use of ambroxol atomization inhalation, so the use of ambroxol is still ultra-prescriptive, it is necessary to look for evidence-based medicine. Objective: intravenous infusion of ambroxol injection is a common clinical expectorant method. In this paper, normal saline, 3% sodium chloride and aerosol inhalation of ambroxol injection were used to induce expectoration in three groups of patients, respectively. The expectorant effect of 30mg atomization inhalation of ambroxol injection was observed by comparing the relative indexes. Information and methods: 1. Participants: from November 2013 to January 2014, 30 patients with acute exacerbation of (AECOPD) with chronic obstructive pulmonary disease (COPD) who were hospitalized in the Department of Respiratory Medicine, Eastern Hospital of Shandong Provincial Hospital, were randomly divided into three groups. There were 10 cases in group A (saline group), 9 cases in group B (3% sodium chloride solution group) and 11 cases in group C (ambroxol group). 2. Atomization inhalation method: in this experiment, oxygen-driven atomization was given to patients in group A: normal saline (NS) 8ml atomized inhalation twice a day in (bid); B group; NS6ml 10%NaCl2ml atomization inhalation in bid;C group; NS4ml ambroxol 4ml atomization inhalation in bid. group Each atomization inhalation time is about 15min. 3. Collection of sputum specimens: the sputum was collected one day before atomization inhalation (day 0) and three days after atomization (day 1, day 2, day 3). The sputum samples were collected from 7: 00 a.m. to 7: 00 a.m. on the same day and 24-hour sputum from 7: 00 a.m. to 7: 00 a.m. on the following day (day 1, day 2, day 3). 4. Observation indexes: the sputum volume, dry / wet weight and viscosity of the three groups were observed and recorded on day 1, day 2 and day 3. The effects of different induction methods on sputum properties were observed by parallel comparison. The sputum volume on day 0 and day 1 of each patient in three groups were compared to observe the effect of induced sputum discharge. 5. Statistical analysis: the original data collected were stored in the form of Excel day by day. The data were counted by SPSS20.0, and analyzed by single factor analysis of variance (ANOVA) in SPSS, accurate fisher test and non-parametric test of independent samples. P0.05 indicates that the difference is statistically significant. Results: 1. Sputum volume: the daily sputum volume in group C was more than that in group A and group B (P all 0.05, the difference was significant, statistically significant). 2. Viscosity: daily sputum viscosity in group C was lower than that in group A and group B (P0.05). 3. Sputum dry / wet weight: daily sputum dry / wet weight in group C was lower than that in group A and group B (P0.05). 4. Side effects: there was a significant oral salty sensation in the atomization process in group B, and no special discomfort was reported in the other groups. Conclusions: 1. Normal saline, 3% sodium chloride solution and ambroxol atomization inhalation are beneficial to the sputum efflux of the patients. The expectoration effect of ambroxol atomization inhalation was better than that of normal saline, 3% sodium chloride solution group.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R974
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