妥洛特罗贴剂辅助治疗小儿急性支气管炎疗效观察

支气管炎是小儿时期常见病之一,各个年龄段、一年四季均可发生。我院采用妥洛特罗贴剂辅助治疗小儿急性支气管炎取得满意疗效,现报道如下。     

妥洛特罗贴剂治疗儿童咳嗽变异性哮喘

目的观察妥洛特罗贴剂治疗咳嗽变异性哮喘(CVA)的临床疗效及不良反应发生情况。方法我院70例CVA患儿随机分为贴剂组和对照组,两组以小剂量吸入激素作为基础治疗。对照组给予盐酸丙卡特罗口服1.25μg/kg,2次/天;贴剂组给予妥洛特罗贴剂,4~9岁1 mg,9~14岁2 mg,每晚1次。治疗2周后,观察并比较两组的治疗效果。结果治疗2周后贴剂组的最大呼气流量(PEF)、咳嗽均显著改善,与对照组比较,差异有统计学意义(P<0.05)。结论使用妥洛特罗贴剂治疗CVA,可以控制患者的临床症状并改善肺功能,且患者的依从性好,安全有效。     

妥洛特罗贴剂治疗婴幼儿哮喘30例的疗效

目的观察妥洛特罗贴剂治疗婴幼儿哮喘的临床疗效。方法选择在江西省儿童医院呼吸科住院治疗的婴幼儿哮喘患儿60例,按随机数字表法分为观察组和对照组,每组30例。2组在常规治疗的基础上,观察组给予妥洛特罗贴片（阿米迪贴剂）0.5 mg.贴-1,每日20：00～21：00贴于前胸或后背处,每日更换部位;对照组给予硫酸特布他林2.5 mg＋生理盐水2 mL予6 L.min-1氧气驱动雾化吸入,2次.d-1。2组均5 d为1个疗程。观察2组患儿咳嗽、喘息、哮鸣音消失时间,住院时间,气道阻力的变化及药物的不良反应。结果 2组治疗5 d后咳嗽、喘息、哮鸣音消失及住院时间的比较差异均无统计学意义（均P〉0.05）;2组治疗后气道阻力与治疗前比较均有明显下降（均P〈0.05）;2组治疗前后气道阻力变化的比较差异均无统计学意义（均P〉0.05）。观察组出现局部皮肤瘙痒1例,通过更换妥洛特罗贴片的粘贴部位完成治疗,无全身不良反应。结论妥洛特罗贴剂治疗婴幼儿哮喘与特布他林雾化吸入治疗临床效果一致,且无严重不良反应发生,是一种安全有效的新型哮喘治疗药物。     

妥洛特罗贴剂佐治小儿哮喘急性发作的疗效及安全性评价

目的探讨妥洛特罗贴剂佐治小儿哮喘急性发作的疗效及安全性。方法选择2012年12月至2014年12月哮喘急性发作患儿90例,分为观察组和对照组,每组45例。对照组行布地奈德联合特布他林雾化吸入治疗,在此基础上观察组行加用妥洛特罗贴剂治疗。观察并比较两组的治疗效果。结果观察组哮鸣音、咳嗽、气急、湿啰音消失所需的治疗时间少于对照组,差异均有统计学意义(P<0.05)。两组晨间、睡前的最大呼吸流量水平均得到提升,且观察组提升更为显著,差异均有统计学意义(P<0.05)。对照组咳嗽2例、皮疹1例,不良反应率6.67%;观察组皮疹1例、贴药处红肿1例,不良反应率为4.44%。两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论小儿哮喘急性发作的治疗中用妥洛特罗贴剂佐治可降低治疗时间,提升最大呼吸流量,不良反应较少且严重,该佐治方法兼具疗效及安全性,具有较高的应用价值。     

糖皮质激素吸入联合妥洛特罗贴剂治疗喘息性支气管炎的效果

目的探讨吸入用糖皮质激素+妥洛特罗贴剂治疗喘息性支气管炎患儿的临床效果。方法选取2016年2月至2018年9月喘息性支气管炎患儿147例,依照治疗方式不同分为参照组与试验组,参照组73例采取布地奈德气雾剂治疗,试验组74例采取布地奈德气雾剂+妥洛特罗贴剂治疗。观察比较两组治疗前后昼夜咳嗽、气喘症状评分及疗效、不良反应发生率。结果试验组治疗总有效率(94.59%,70/74)高于参照组(80.82%,59/73),差异有统计学意义(P0.05);试验组治疗后昼夜咳嗽、气喘评分低于参照组,差异有统计学意义(P0.05);试验组不良反应总发生率(5.41%,4/74)与参照组(2.74%,2/73)比较,差异未见统计学意义(P0.05)。结论喘息性支气管炎患儿采取布地奈德气雾剂+妥洛特罗贴剂治疗,效果确切,能减少不良反应,减轻气喘、咳嗽症状。     

妥洛特罗贴剂治疗轻中度婴幼儿支气管哮喘临床观察

目的 观察妥洛特罗贴剂对轻中度婴幼儿支气管哮喘的治疗效果及其安全性.方法 将62例支气管哮喘患儿分为妥洛特罗贴剂组(32例)和对照组(30例),在丙酸氟替卡松气雾剂治疗基础上分别加用妥洛特罗贴刑和盐酸丙卡特罗片剂治疗2周.记录患儿的哮喘症状评分、喘鸣发作次数和短效β2受体激动剂的用量,并记录不良反应发生情况.结果 贴剂组治疗后哮喘日间症状评分[治疗1周后为(2.2±0.9)分/周、治疗2周后为(0.9 ±0.5)分/周]明显低于对照组[治疗1周后为(3.4 ±1.1)分/周、治疗2周后为(1.3±0.6)分/周],差异均有统计学意义(P均<0.05);贴剂组治疗1周后哮喘夜间症状评分[(1.8±0.7)分/周],明显低于对照组[(3.3 ±0.9)分/周],差异有统计学意义(P<0.05);贴荆组治疗期间喘鸣发作次数为(2.3±1.2)次,对照组为(3.6±1.3)次,2组比较差异有统计学意义(t=4.09,P<0.05);贴剂组的β2受体激动剂用量为(2.6 ±0.9)喷/周,对照组为(3.7 ±0.8)喷/周,差异有统计学意义(t=5.07,P<0.05);贴剂组不良反应发生率(3.12%)明显低于对照组(23.33%),2组比较差异有统计学意义(X2=3.89,P<0.05).结论 妥洛特罗贴剂是一种安全、有效的轻中度婴幼儿支气管哮喘治疗药物.     

妥洛特罗贴剂佐治小儿急性支气管肺炎48例临床分析

目的:观察妥洛特罗贴片佐治小儿急性支气管肺炎的临床疗效。方法:将2012年1月到2013年10月收治的急性支气管肺炎患儿90例随机分为对照组和研究组各45例,对照组采用抗感染、化痰止咳等常规治疗,研究组在对照组常规治疗的基础上,每晚加妥洛特罗贴片贴于患儿背部脊柱旁并固定,每日更换1次,背部垫小毛巾以吸汗,连续治疗10 d为1个疗程,疗程结束后比较两组疗效。结果:研究组的临床症状、体征消失时间均明显少于对照组(P0.05),研究组的总有效率97.8%显著高于对照组的77.8%(P0.05)。结论:妥洛特罗贴片辅助治疗小儿支气管肺炎的疗效显著,不良反应少,且使用方便,建议临床推广应用。     

妥洛特罗贴剂治疗轻中度婴幼儿支气管哮喘临床观察

Objective To evaluate the therapeutic effect of tulobuterol tape on mild or moderate bronchial asthma in children less than three years old . Methods Sixty-two children with mild or moderate asthma were randomized to receive either tulobuterol tape(treatment group) or procaterol hydrochloride tablet(control group) on the basis of inhaled fluticasone propionate for 2 weeks. Symptom scores of asthma, frequencies of episode of wheeze, doses of inhaled ventolin as rescue drug and the incidence of adverse reactions were recorded. Results In the treatment group,the symptom scores during daytime in the treatment group were (2. 2 ±0. 9)/week and (0. 9 ±0. 5)/week after 1 and 2 weeks of treatment, respectively, which were significantly lower than that in the control group(3.4 ± 1. 1)/week and (1. 3 ± 0. 6)/week after 1 and 2 weeks of treatment, respectively) (P < 0. 05). The symptom scores during night in the treatment group was significantly lower than that in the control group after one week of treatment (1. 8 ± 0. 7) /week v. s. (3. 3 ± 0. 9) /week, P < 0. 05). The frequencies of episode of wheeze was significantly different between the two groups (2. 3 ±1.2 and 3. 6 ± 1.3 in the treatment and control groups, respectively (P < 0.05) .The doses of inhaled ventolin in the treatment group (2. 6 ±0.9 spray/week) was significantly lower than that in the control group (3.7 ± 0. 8) spray/week) (P < 0. 05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group (3. 12% v. s. 23. 33% ,x2 = 3. 89,P<0.05). Conclusions Tulobuterol tape is a safe and effective medication for the treatment of mild or moderate bronchial asthma in children less than three years old.     

妥洛特罗贴剂治疗轻中度婴幼儿支气管哮喘临床观察

Objective To evaluate the therapeutic effect of tulobuterol tape on mild or moderate bronchial asthma in children less than three years old . Methods Sixty-two children with mild or moderate asthma were randomized to receive either tulobuterol tape(treatment group) or procaterol hydrochloride tablet(control group) on the basis of inhaled fluticasone propionate for 2 weeks. Symptom scores of asthma, frequencies of episode of wheeze, doses of inhaled ventolin as rescue drug and the incidence of adverse reactions were recorded. Results In the treatment group,the symptom scores during daytime in the treatment group were (2. 2 ±0. 9)/week and (0. 9 ±0. 5)/week after 1 and 2 weeks of treatment, respectively, which were significantly lower than that in the control group(3.4 ± 1. 1)/week and (1. 3 ± 0. 6)/week after 1 and 2 weeks of treatment, respectively) (P < 0. 05). The symptom scores during night in the treatment group was significantly lower than that in the control group after one week of treatment (1. 8 ± 0. 7) /week v. s. (3. 3 ± 0. 9) /week, P < 0. 05). The frequencies of episode of wheeze was significantly different between the two groups (2. 3 ±1.2 and 3. 6 ± 1.3 in the treatment and control groups, respectively (P < 0.05) .The doses of inhaled ventolin in the treatment group (2. 6 ±0.9 spray/week) was significantly lower than that in the control group (3.7 ± 0. 8) spray/week) (P < 0. 05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group (3. 12% v. s. 23. 33% ,x2 = 3. 89,P<0.05). Conclusions Tulobuterol tape is a safe and effective medication for the treatment of mild or moderate bronchial asthma in children less than three years old.     

Efficacy of traditional Chinese exercise (Baduanjin) on patients with stable COPD: A systematic review and meta-analysis

BackgroundCOPD is a prevalent and intractable chronic airway disease. At present, COPD is one of the diseases with the highest morbidity and mortality in the world; and causes a significant economic burden to patients and society. As a traditional exercise, the Baduanjin exercise has been inherited in China for hundreds of years. However, the treatment effects of Baduanjin exercise are controversial. This systematic review was designed to evaluate the efficacy of Baduanjin exercise in patients with stable chronic obstructive pulmonary disease.MethodsPublished articles were searched in nine English and Chinese databases from inception to December, 2022. Two investigators conducted study selection and data extraction independently. Review Manager software 5.4 were implemented for data synthesis and analysis. Quality assessment for each study was based on the modified PEDro scale.ResultsThis review included 41 studies with 3835 participants with stable COPD. Compared with the control group, the pooled data of Baduanjin exercise group showed significant improvements in the following outcomes (mean difference, 95 % confidence interval): FVC (0.29, 0.25–0.33), FEV1 (0.27, 0.22–0.33), FEV1% (5.38, 4.38–6.39), FEV1/FVC (5.16, 4.48–5.84), 6MWD (38.57, 35.63–41.51), CAT (−2.30, −2.89 to −1.70), mMRC (−0.57, −0.66 to −0.48), SGRQ (−8.80, −12.75 to −4.86), HAMA (−7.39, −8.77 to −6.01), HAMD (−7.80, −9.24 to −6.37), SF-36 (8.63, 6.31–10.95).ConclusionsBaduanjin exercise may have the potential to enhance lung function, exercise capacity, health status, mental status, and quality of life for patients with stable COPD.Ethic and disseminationThis study is a systematic review and it does not involve harming the rights of participants. Ethical approval will not be required for this study. The research results may be published in a peer-reviewed journal.     

社区干预对稳定期嗜烟慢性阻塞性肺疾病老年患者戒烟后肺功能的影响

目的 探讨社区干预对稳定期嗜烟慢性阻塞性肺疾病(COPD)老年患者戒烟后肺功能的影响,以提高戒烟率,促进疾病康复.方法 选取自2008年7月～2010年12月在呼吸内科住院的稳定期嗜烟COPD老年男性患者60例,建立戒烟健康档案.观察组30例,接受全程的戒烟指导及定期随访,为期半年,每2周访视1次,每次30 min;对照组30例,接受一般院内戒烟护理指导.比较两组患者6个月后的肺功能变化情况.结果 观察组和对照组患者干预前后肺功能比较,两者存在显著性差异,P＜0.05.结论 全程综合性社区戒烟干预措施可以有效促进稳定期嗜烟COPD老年患者的肺功能改善.     

家庭肺康复联合移动医疗应用程序在稳定期COPD患者中的应用效果研究

【】目的：探讨家庭肺康复联合移动医疗应用程序对慢性阻塞性肺疾病(COPD)患者肺康复的效果。方法：便利抽样法选取2016年5月至2017年8月在上海同济大学附属同济医院门诊就诊的91名稳定期COPD患者为研究对象,按随机数字表法分为对照组(43人)和试验组(48人)。对照组给予常规家庭肺康复训练,试验组给予常规家庭肺康复训练和COPD管家应用程序进行干预。评价两组患者出院时、出院后3个月的肺功能、6 min步行试验距离和生活质量。结果：出院后3个月,试验组患者的肺功能与对照组相比无统计学差异(P > 0.05);6 min步行距离和生活质量评分均优于对照组(P < 0.05)。结论：家庭肺康复联合COPD管家应用程序有助于提高COPD患者的身体活动能力,改善其生活质量,值得在COPD患者中推广应用。     

补充维生素D对慢性阻塞性肺疾病患者血清25（OH）D和FEVl的影响

目的观察慢性阻塞性肺疾病（COPD）患者补充维生素D后血清25一羟基维生素D[25（OH）D]和1秒用力呼气容积（FEVl）的变化,评价维生素D的辅助治疗价值。方法稳定期重度COPD患者72例,随机分成观察组和对照组,前组在吸入性激素治疗基础上辅助阿法骨化三醇干预,后组采用常规吸入性激素治疗。分别在治疗前和治疗3个月后,通过酶联免疫吸附法（ELISA）检测血清25（OH）D水平,Medisoft肺功能仪测定FEVl。结果阿法骨化三醇干预3个月后,观察组血清25（OH）D水平和FEVl较对照组有明显改善（P〈0．01）。结论补充维生素D可以改善COPD患者的肺功能,对呼吸器官有保护作用。     

呼吸肌功能训练对COPD患者肺功能的影响

目的:探讨慢性阻塞性肺疾病(COPD)康复期患者呼吸肌功能锻练对其临床症状及肺功能的影响。方法:对COPD康复期患者,应用缩唇呼吸、深呼吸、呼吸操等呼吸肌功能锻炼方法锻炼,时间8．2±3．8个月,观察患者缺氧、呼吸疲劳改善情况,并行肺功能检查。结果:COPD康复期患者经呼吸肌锻炼后缺氧状况、呼吸疲劳状况及肺功能检测指标均有明显改善(P<0．05)。结论:呼吸肌功能锻炼对COPD患者康复期有改善肺功能、减少每年住院次数、提高生活质量的作用。     

舒利迭对稳定期中重度慢性阻塞性肺疾病患者临床疗效观察

目的观察舒利迭对稳定期中重度慢性阻塞性肺疾病（COPD）的疗效。方法将76例经住院治疗处于稳定期中重度COPD患者,随机分为治疗组和对照组。对照组给予常规治疗,治疗组在此基础上给予吸入舒利迭。记录治疗前和治疗后的肺功能、血气分析,临床症状评分等指标。结果治疗组的总有效率显著高于对照组,两组疗效比较差异有显著性（P〈0.01）,吸入舒利迭无明显的毒副作用。结论应用舒利迭治疗稳定期中重度COPD,能显著改善动脉血气指标、肺功能和临床症状,使用安全,值得在临床上推广。     

慢性阻塞性肺疾病稳定期患者康复训练的疗效观察

目的探讨慢性阻塞性肺疾病（COPD）稳定期患者康复训练的疗效。方法80例COPD稳定期患者,随机分为治疗组和对照组各40例,对照组患者给予常规治疗,治疗组加用康复训练,在治疗前后分别对患者的血气分析、肺功能检测结果进行比较。结果治疗后治疗组血气分析及肺功能与治疗前比较有明显提高,与对照组相应指标比较,差异有统计学意义（均为P〈0．05）。结论COPD稳定期患者应用康复训练,可明显提高患者的康复效果。     

舒利迭吸入治疗稳定期慢性阻塞性肺疾病70例

目的观察舒利迭吸入治疗慢性阻塞性肺疾病(COPD)稳定期患者的疗效。方法将70例处于稳定期的中、重度COPD患者,随机分为治疗组和对照组。两组均给予常规治疗,在此基础上,治疗组给予吸入舒利迭(50/250),每次1吸,每天2次;对照组给予缓释茶碱片,每次0.1 g,每天2次,比较两组治疗前、后肺功能及临床症状积分变化。结果治疗后治疗组肺功能指标、临床症状积分改善情况均明显优于对照组(P0.05)。结论对于稳定期COPD患者,舒利迭能减轻临床症状,明显改善肺功能,提高生活质量。     

温补肺肾法对慢性阻塞性肺疾病稳定期患者肺功能及免疫功能的影响

目的观察温补肺肾法对慢性阻塞性肺疾病稳定期患者肺功能及免疫功能的影响。方法选取COPD稳定期患者76例,随机分为治疗组与对照组。对照组予西医常规治疗,治疗组加用温补肺肾方药治疗。比较2组治疗前后疗效、中医症状评分、肺功能、免疫功能的变化。结果 2组治疗后中医症状评分、肺功能有所改善,FEV_1和FEV_1/FVC均有提高;免疫功能水平增强,CD_3~+、CD_4~+、CD_8~+、CD_4~+/CD_8~+及Ig G、Ig M水平较治疗前提升,且治疗组各项指标改善程度好于对照组。结论温补肺肾方药可明显改善慢性阻塞性肺疾病稳定期患者临床症状、肺功能及免疫水平。     

吸入舒利迭治疗稳定期中度慢性阻塞性肺疾病2年的临床分析

目的 观察长期使用舒利迭治疗稳定期中度慢性阻塞性肺疾病(COPD)的疗效.方法 稳定期中度COPD患者64例随机平分为试验组和对照组.对照组给予常规治疗,试验组在常规治疗的基础上吸入舒利迭(50/250 μg),观察2年.在治疗前、治疗24个月后测定肺功能,评价肺功能改善情况;并进行临床症状和体征评分、COPD急性加重次数及发作时间监测.结果 试验组治疗前后肺功能各项指标比较差异均有统计学意义(P均＜0.01),而对照组治疗前后肺功能各项指标比较差异均无统计学意义(P均＞0.05);在治疗24个月后两组临床症状和体征评分[(2.1±0.4)分与(4.4±0.3)分,t =2.365)、COPD急性发生率(29％与47％,x2=3.547)和发作时间[(5.0±1.2)d与(10.0±1.6)d,t=2.149]比较,差异均有统计学意义(P均＜0.01).结论 舒利迭能改善稳定期中度COPD患者的肺功能,减少急性发作次数,有一定的临床价值.