噻托溴铵治疗哮喘的疗效及自主神经功能变化研究

目的研究噻托溴铵治疗哮喘的临床疗效及自主神经功能变化。方法将2013年2月~2015年1月我院收治的哮喘患者118例纳入研究对象,按照随机数字表法分为实验组与对照组各59例,两组一般资料比较无统计学差异(P0.05)。实验组在给予抗感染、吸氧、β_2受体激动剂、糖皮质激素以及营养支持等常规治疗基础上使用噻托溴铵粉吸入剂治疗,对照组仅行常规治疗。观察两组临床疗效、治疗前后PaO_2、PaCO_2、FVC、FEV_1、FEV_1%、SDANN、PNN50、IL-6、IL-8、TNF-α及不良反应。结果治疗后,两组患者PaO_2、PaCO_2、FVC、FEV_1、FEV_1%、IL-6、IL-8、TNF-α显著优于治疗前(P0.05),实验组PaO_2、PaCO_2、FVC、FEV_1、FEV_1%、IL-6、IL-8、TNF-α显著优于对照组(P0.05),实验组PNN50较治疗前显著降低(P0.05),且降低水平优于对照组(P0.05),实验组SDANN较治疗前显著升高(P0.05),且升高水平优于对照组(P0.05)。实验组总控制率(93.22%)显著高于对照组(79.66%)(P0.05),实验组不良反应(11.86%)与对照组(6.78%)无统计学差异(P0.05)。结论噻托溴铵治疗哮喘可有效降低自主神经的兴奋性,改善患者临床症状、炎性因子水平、血气水平及通气功能,不良反应发生率低。

Clinical effect of tiotropium bromide in the treatment of patients with asthma and the changes of autonomic nervous function

Objective To study the clinical effect of tiotropium bromide in the treatment of patients with asthma and the changes of autonomic nervous function. Methods From February 2013 to January 2015 in our hospi-tal, 118 patients included were randomly divided into the experimental group and the control group, 59 cases in each group. The experimental group was given tiotropium bromide inhalation on the basis of conventional treatment, such as anti-infection, oxygen inhalation, β-2 receptor agonist, sugar cortical hormone and nutritional support, and the control group only received conventional treatment. Their clinical curative effect was observed, and so were the levels of PaO2 , PaCO2 , FVC, FEV1 , FEV1%, SDANN, pNN50, IL-6, IL-8, TNF-a and adverse reactions before and af-ter the treatment. Results After the treatment, the levels of PaO2 , PaCO2 , FVC, FEV1 , FEV1%, IL-6, IL-8 and TNF-a were significantly better than before ( P<0. 05 ) , and they were more pronounced in the experimental group than in the control group (P<0. 05). The value of PNN50 in the experimental group decreased after the treatment (P<0. 05), and the decrease was better than that in the control group (P<0. 05). The value of SDANN in the ex-perimental group increased significantly after the treatment (P<0. 05), and the increase was more pronounced than that in the control group (P<0. 05). The total control rate (93. 22%) was significantly higher than that of the con-trol group (79. 66%) (P <0. 05). The adverse reaction showed no significant difference between the two groups (11. 86% Vs 6. 78%) (P>0. 05). Conclusion Tiotropium bromide can effectively reduce the excitability of auto-nomic nerve, improve the clinical symptoms, inflammatory factors, blood gas and ventilation function in the treatment of patients with asthma, with low adverse reactions.