噻托溴铵治疗慢性阻塞性肺疾病疗效观察

目的：评价噻托溴铵治疗慢性阻塞性肺疾病的疗效。方法：86例稳定期COPD患者随机平均分为噻托溴铵组和对照组。对照组给予常规治疗,噻托溴铵组在对照组治疗的基础上给予每日1次18μg噻托溴铵经干粉器吸入,两组均治疗12周,观察两组治疗前后肺功能改变情况[一秒钟用力呼气量（FEV1）和FEV1/用力肺活量（FVC）]、运动耐力改变（6 min步行距离）和生活质量评分变化,并评价不良反应发生情况。结果：两组治疗前FEV1、FEV1/FVC、6 min步行距离、生活质量评分比较,差异无统计学意义（P〉0.05）。噻托溴铵组治疗后FEV1、FEV1/FVC均较治疗前提高[（46.23±11.02）%vs（39.19±7.47）%,t=3.237,P〈0.05;（59.70±9.42）%vs（55.46±8.25）%,t=2.974,P〈0.05]。治疗后噻托溴铵组FEV1、FEV1/FVC均较对照组改善明显[对照组FEV1（43.11±8.93）%,t=2.630,P〈0.05;FEV1/FVC（55.73±9.91）%,t=2.857,P〈0.05]。噻托溴铵组治疗前后FEV1改善率平均为（17.92±5.43）%,对照组为（6.41±3.98）%,两组比较,差异有统计学意义（t=2.73,P〈0.05）。噻托溴铵组治疗后6 min步行距离较治疗前提高[（351.2±43.7）m vs（271.3±39.0）m,t=3.090,P〈0.05],较对照组改善明显[对照组（299.5±56.4）m,t=3.012,P〈0.05]。噻托溴铵组治疗后生活质量评分较治疗前提高[（57.4±6.1）分vs（39.7±5.9）分,t=2.538,P〈0.05]。治疗后噻托溴铵组生活质量评分较对照组高[（42.1±6.0）分,t=3.204,P〈0.05]。两组均未发生严重不良反应。结论：噻托溴铵治疗稳定期COPD患者用药安全有效,可在临床上推广使用。

The efficacy observation of Tiotropium Bromide in the treatment of stable chronic obstructive pulmonary disease

Objective： To evaluate the efficacy of Tiotropium Bromide in the treatment of stable chronic obstructive pulmonary disease（COPD）.Methods： A total of 86 patients with stable COPD were randomly divided into Tiotropium Bromide group（43 cases） and control group（43 cases）.Control group was given routine treatment and besides that,Tiotropium Bromide group was given inhaled 18 μg Tiotropium Bromide once a day,the two groups were treated for 12 weeks,then pulmonary function change（FEV1 and FEV1/ FVC）,exercise tolerance change（6 min walk distance） and quality of life score change before and after treatment in the two groups were observed,and the adverse effects were also evaluated.Results： FEV1,FEV1/FVC,6 min walk distance and quality of life score before treatment in the two groups showed no statistical difference（P0.05）.FEV1 and FEV1/FVC after treatment in Tiotropium Bromide group were improved than those before treatment [（46.23±11.02）% vs（39.19±7.47）%,t=3.237,P0.05;（59.70±9.42）% vs（55.46±8.25）%,t=2.974,P0.05].After treatment,FEV1 and FEV1/FVC in Tiotropium Bromide group was higher than those in control group [control group： FEV1（43.11±8.93）%,t=2.630,P0.05;FEV1/FVC（55.73±9.91）%,t=2.857,P0.05].FEV1 improvement rate before and after treatment in Tiotropium Bromide group and control group were（17.92±5.43）% and（6.41±3.98）% respectively,there were significant difference（t=2.73,P0.05）.6 min walk distance after treatment in Tiotropium Bromide group was improved than that before treatment [（351.2±43.7） m vs（271.3±39.0） m,t=3.090,P0.05],and it was higher than control group [（299.5±56.4）m,t=3.012,P0.05].Quality of life after treatment of Tiotropium Bromide group was higher than that before treatment[（57.4±6.1） score vs（39.7±5.9） score,t=2.538,P0.05],and it was also higher than that of control group [（42.1±6.0）score,t=3.204,P0.05].No severe adverse effect was observed in both groups.Conclusion： Tiotropium Bromide is safe and effective in treatment of stable COPD,and it is worthy of application in clinic.