糖皮质激素联合特布他林对慢阻肺的治疗作用研究

目的:分析糖皮质激素联合特布他林治疗慢阻肺的临床效果.方法:选取我院2014年6月至2016年6月期间收治的100例慢阻肺患者的临床资料,将其随机分为对照组和观察组,每组50例.对照组采用糖皮质激素,观察组使用糖皮质激素联合特布他林.比较两组治疗总有效率与不良反应发生率.结果:观察组治疗总有效率为96.00%,对照组治疗总有效率为78.00%,差异具有统计学意义(P<0.05);两组均未发生不良反应事件.结论:糖皮质激素联合特布他林治疗慢阻肺的临床效果相对较好,且不会对患者造成其他损害,用药安全有效,值得临床推广.     

评价糖皮质激素与特布他林联合苏黄止咳胶囊对急性加重期慢性阻塞性肺疾病的临床作用

目的:分析、观察糖皮质激素与特布他林联合苏黄止咳胶囊对急性加重期慢性阻塞性肺疾病的临床作用.方法:随机选取2019年9月至2021年4月确诊入住本院呼吸内科的慢性阻塞性肺疾病患者64名,采用随机数字法将所选实验对象分为急重组和胶囊组,每组32例病患.急重组采用糖皮质激素和特布他林共同治疗急性加重期慢性阻塞性肺疾病患者,...     

特布他林联合盐酸氨溴索雾化吸入辅助治疗慢性阻塞性肺疾病急性发作期50例

目的观察特布他林联合氨溴索雾化吸入辅助治疗慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)急性发作期的临床疗效及安全性。方法 2009年3月—2011年12月选择COPD急性发作期患者100例,随机分为对照组和治疗组各50例。对照组给予控制性氧疗、抗感染、解痉、营养支持等常规治疗,治疗组在对照组基础上加用特布他林联合盐酸氨溴索雾化吸入治疗,连续治疗10 d后观察两组疗效。结果对照组痊愈12例,显效15例,有效12例,总有效率78.00%;治疗组痊愈17例,显效25例,有效5例,总有效率94.00%。结论特布他林联合盐酸氨溴索雾化吸入辅助治疗COPD急性发作期疗效满意,值得临床推广。     

布地奈德联合硫酸特布他林治疗慢性阻塞性肺疾病94例疗效观察

<正>慢性阻塞性肺疾病(COPD)是常见病和多发病,可引起心肺功能不全,造成患者生活质量下降,口服用药副作用较多,为缓解临床症状,减少其副作用,我院采用布地奈德联合硫酸特布他林雾化吸入治疗COPD急性发作期患者94例,取得了良好效果。现报告如下。     

探讨治疗老年慢性阻塞性肺疾病患者应用布地奈德及特布他林与氨茶碱联合治疗的临床效果

目的 研究在老年慢性阻塞性肺疾病患者治疗过程中,应用布地奈德、特布他林、氨茶碱联合治疗的效果.方法 选取2019年1至2019年12月我院收治的老年慢性阻塞性肺疾病患者138例,采取随机数字法将其分为对照组(采取布地奈德、特布他林联合治疗)和观察组(予以布地奈德、特布他林、氨茶碱联合治疗),比较两组患者治疗效果、肺功能...     

特布他林与氨溴索联合治疗慢性阻塞性肺病的疗效

目的观察并对比分析特布他林与氨溴索联合应用治疗慢性阻塞性肺病的临床效果,指导用药方法.方法选择2011年6月—2012年6月某院收治的70例慢性阻塞性肺病(COPD)患者作为本次的研究对象,将其随机分为2组,对照组(n=35)患者单纯进行综合疗法,治疗组(n=35)患者在对照组的基础给予特布他林与氨溴索联合应用治疗;对比分析2组患者的临床有效率.结果治疗组患者的临床效果要显著优于对照组患者(P<0.05),具有统计学意义.结论特布他林与氨溴索联合应用治疗慢性阻塞性肺病的疗效确切,建议临床推广.     

糖皮质激素与特布他林治疗COPD的效果观察

目的 观察糖皮质激素与特布他林治疗COPD的效果.方法 2019年10月至2020年10月该院收治的COPD患者84例,按照随机双盲法分为观察组与对照组各42例.两组均予硫酸特布他林雾化液治疗,观察组加用糖皮质激素吸入用异丙托溴铵溶液雾化治疗,两组均持续用药1周,比较疗效、治疗前后肺功能指标及生活质量简表(SF-36)...     

抗生素联合糖皮质激素治疗老年慢性阻塞性肺疾病疗效分析

目的:观察抗生素联合糖皮质激素治疗老年慢性阻塞性肺疾病的疗效.方法:选取我院老年慢性阻塞性肺疾病患者88例(2019年7月至2020年8月),随机分为抗生素治疗的对照组(44例)与联合糖皮质激素治疗的观察组(44例),观察治疗情况.结果:与对照组相比,观察组肺功能改善好,P<0.05;两组不良反应对比,P>0.05.结...     

吸入糖皮质激素治疗稳定期慢性阻塞性肺疾病疗效观察

目的：探讨ICSs布地奈德治疗稳定期慢性阻塞性肺疾病（COPD）的临床疗效。方法：回顾性分析86例稳定期COPD患者的临床资料,将86例患者随机分为观察组44例和对照组42例,对照组给予常规治疗,观察组在常规治疗的基础上加用ICSs布地奈德治疗。结果：观察组急性加重住院人次明显少于对照组,差异有统计学意义（P〈0.05）;两组治疗后各观察指标均较之治疗前改善（P〈0.05）,但观察组改善程度均优于对照组,两组比较差异均有统计学意义（P〈0.05）。结论：ICSs治疗稳定期COPD疗效显著,能够有效延缓肺功能衰退,改善症状和使患者病情急性加重的次数减少,值得临床推广。     

硫酸特布他林雾化吸入联合机械排痰治疗尘肺合并慢性阻塞性肺疾病急性加重期的疗效观察

将我院2014—2016年收治的尘肺合并慢性阻塞性肺疾病急性加重期(AECOPD)的62例患者,随机分为观察组和对照组各31例。对照组采取常规治疗;观察组在常规治疗的基础上加用硫酸特布他林雾化吸入联合机械排痰治疗,10d为一个疗程;比较两组患者的临床症状(咳嗽、咳痰量、喘息)、体征(肺部痰鸣音)、血气分析[动脉血氧分压(PaO_2)、二氧化碳分压(PaCO_2)、动脉血氧饱和度(SaO_2)]、肺功能[第1秒最大呼气容积(FEV1.0)、最高呼气流量(PEF)]等指标变化。结果显示,观察组总有效率高于对照组,且观察组患者PaO_2、PaCO_2、SaO_2、FEV1.0、PEF值明显升高,各项指标优于对照组,差异有统计学意义(P<0.05)。提示硫酸特布他林雾化吸入联合机械排痰治疗尘肺合并AECOPD疗效显著。     

慢性阻塞性肺气肿老年患者应用抗生素与糖皮质激素联合治疗的效果分析

目的观察抗生素联合糖皮质激素治疗老年慢性阻塞性肺气肿患者的临床效果。方法以2008年10月至2012年10月于我院接受治疗的80例老年慢性阻塞性肺气肿患者作为研究对象,随机将其分为两组各40例,观察组给予抗生素联合糖皮质激素治疗,对照组则仅给予抗生素治疗,观察比较两组患者的治疗效果、肺功能及血流动力学的改善情况。结果观察组总有效率明显高于对照组(P<0.05);观察组MVV为(80.51±16.42)L/min,FVC为(86.38±11.87)%,FEV1为(3.17±0.21)L,FEV1%为(55.78±8.91)%,其肺功能指标改善情况均明显优于对照组(P<0.05);观察组Pa O2为(11.33±0.71)k Pa,Sa O2为(90.26±4.51)k Pa,Pa CO2为(5.09±0.31)k Pa,均显著优于对照组(P<0.05)。结论抗生素联合糖皮质激素治疗老年慢性阻塞性肺气肿患者效果显著,可改善患者的肺功能,纠正其呼吸道症状,提高患者的生活质量,有推广价值。     

伐尼克兰联合心理干预戒烟对慢性阻塞性肺疾病的疗效观察

目的评估伐尼克兰联合心理干预措施对轻中度慢性阻塞性肺疾病（COPD）吸烟患者烟草依赖的疗效和安全性。方法选取轻中度COPD烟草依赖的患者108例,随机分为干戒组、伐尼克兰组、伐尼克兰＋心理干预（干预组）三组,对伐尼克兰组及干预组给予口服12周伐尼克兰,干预组并给予戒烟咨询及心理干预,随访至24周,观察戒烟者的戒烟率、肺功能变化、不良反应、戒断症状及复吸率。结果干预组12周和24周持续戒烟率分别为77.8%和75%,伐尼克兰组分别为55.6%和41.7%,干戒组分别为25%和8.3%,三组之间差异有统计学意义（P〈0.05）;不良反应主要为恶心、失眠、头痛等,程度轻微,多为一过性。伐尼克兰组12周戒断症状评分为（1.8±2.3）分,干预组为（1.7±2.1）分,均显著低于干戒组（4.1±1.6）分（P〈0.05）。结论伐尼克兰联合心理干预可大大提高戒烟患者短期和长期的戒烟率,伐尼克兰戒烟安全、有效、耐受性好,对我国COPD烟草依赖的患者具有适用性。     

支气管扩张剂联合吸入性糖皮质激素治疗慢性阻塞性肺病的疗效观察及对生活质量的影响

目的对慢性阻塞性肺病患者给予支气管扩张剂联合吸入性糖皮质激素治疗,并对临床疗效和患者生活质量的影响情况进行观察。方法选取2016年3月—2017年3月医院收治的慢性阻塞性肺病(COPD)患者80例,根据随机数字表法将其分为研究组和对照组。给予对照组支气管扩张剂进行治疗,给予研究组支气管扩张剂联合吸入性糖皮质激素进行治疗。对两组治疗前后肺通气功能、血气分析情况、生活质量评分、临床疗效和不良反应等进行比较分析。结果在各项肺通气功能指标(FEV1、FVC、FEV1/FVC)方面,两组治疗后均较治疗前明显提高,且研究组提高程度显著优于对照组(P<0.05);在血气分析方面,两组治疗后血氧分压(PaO_2)明显提高,动脉二氧化碳分压(PaCO_2)明显降低,且研究组各指标改善程度均显著优于对照组(P<0.05);在生活质量(SF-36)评分方面,研究组得分均较对照组明显提高,差异具有统计学意义(P<0.05);治疗后,研究组治疗总有效率(95.0%)较对照组(75.0%)明显提高,差异具有统计学意义(P<0.05);在不良反应方面,两组发生率间比较差异无统计学意义(P>0.05)。结论对慢性阻塞性肺病患者给予支气管扩张剂联合吸入性糖皮质激素治疗能够取得显著的临床疗效,可使患者肺通气功能、血气状况和生活质量明显改善,且疗效安全可靠,对稳定患者病情具有非常重要的价值,值得临床上进一步推广应用。     

慢性阻塞性肺疾病并发肺结核的影响因素

目的探讨慢性阻塞性肺疾病并发肺结核（COPD-PTB）的危险因素。方法采用以医院为基础的频数匹配病例对照研究方法,收集经确诊的105例COPD-PTB病例和105例对照的各项资料,采用单因素和多因素非条件logistic回归法筛选危险因素。结果单因素logistic回归分析显示,体重、文化程度、婚姻状况、职业、应激事件等15个变量影响COPD-PTB发病;多因素logistic回归分析显示,体重（OR=0.637）、文化程度（OR=0.654）、应激事件（OR=3.554）、结核病接触史（OR=3.187）、吸烟（OR=3.547）、接触粉尘史（OR=2.560）、取暖方式采用柴草土暖（OR=2.649）或者煤炉（OR=2.418）为COPD-PTB发病的重要影响因素。结论体重较轻、文化程度低、有应激事件、结核病接触史、吸烟、接触粉尘、柴草土暖或煤炉取暖等,是COPD-PTB发病的危险因素。     

Disease-Specific Self-Management Programs in Patients with Advanced Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a long-term illness. As the disease progresses, it become more complex and spirals into an abstract complex of interrelated physical, emotional and psychosocial problems. Patients are in a constant process of learning as they endure, manage and adapt to the changing nature of the disease. It has recently been proposed that self management should be a part of the standard care for patients with COPD.This review presents a comprehensive and critical evaluation of the international literature with respect to the benefits of disease-specific self-management programs on health status and the use of health resources in patients with advanced COPD.This review screened all English-language studies indexed in Medline that investigated patient education and self management in patients with COPD, and were published in peer-reviewed journals between 1966 and 2003. Randomized controlled trials of self management in COPD were included in this review if health status or the use of health resources were measured.A best-evidence synthesis was conducted and ten studies were selected for this review. It was found that there was extreme variation between the studies in terms of the content and intensity of self-management programs, continuum of the patient program, follow-up visits, and support provided to patients. Of the ten studies, four reported a significant improvement in health status for patients in the self-management groups compared with usual-care groups. Physician visits (acute) were significantly reduced in the self-management group compared with the usual-care group in two out of four studies in which it was assessed. Self management was also associated with a reduction in emergency room visits in one out of two studies and a reduction in hospital admissions or duration of hospitalization in one out of five studies.The findings of this review reveal new evidence that disease-specific self management can improve patients’ health status and reduce physician visits and hospital use. Self-management programs that are coupled with a supervised exercise-training program would probably be more effective in improving dimensions of health status. Programs combined with communication from a trained health professional could be integrated into standard medical practice and support full population access. However, there are still many unanswered questions that need to be addressed with respect to the specific components of effective education for patients with COPD, methods to adjust self-management programs to suit the needs of individual patients, and long-term maintenance strategies.     

慢性阻塞性肺疾病

文章对基层卫生人员必须掌握的慢性阻塞性肺疾病的诊治等内容进行介绍.     

Patients with Chronic Obstructive Pulmonary Disease

For many years, chronic obstructive pulmonary disease (COPD) has been under-recognized and stigmatized. Misconceptions about this disease have led to under-treatment and under-funding, resulting in an increase in the burden of COPD.In 2005, the National Emphysema/COPD Association published the results of a set of national surveys of patients, primary care physicians, and pulmonologists. The findings of these surveys indicated that activity limitation was prevalent among patients with COPD, and that, although most physicians believed that effective therapy could slow the progression of COPD, their inadequate knowledge and poor adherence to practice guidelines had a negative impact on the care of patients with COPD.Patients with COPD may not be optimally treated by physicians. Greater attention needs to be paid to effective smoking cessation programs and self-management. Many physicians under-prescribe effective therapies, with some patients experiencing the ill effects of long-term systemic corticosteroids.Ambulatory oxygen is an effective therapy for COPD. However, the use of ambulatory oxygen can make daily living and leisure activities difficult for patients, and thus physicians have difficulty convincing patients to initiate this therapy. Attention needs to be paid to finding the right oxygen delivery system for the patient, and to educating patients on the correct use of this therapy, particularly when travelling. Another important issue surrounding oxygen therapy is sleep anxiety and the fear of breathlessness or dying in one’s sleep.COPD exacerbations have a major impact on quality of life; however, most therapies used to treat exacerbations have been designed for the treatment of asthma. Corticosteroids, antibacterials, and bronchodilators are routinely used for the treatment of exacerbations, but physicians often do not follow practice guidelines. Exacerbation management is too often ‘too little, too late.’ Another area of concern for patients is effective use of inhalers; incorrect inhaler technique is too common.It has been established that pulmonary rehabilitation programs should be an integral part of the management of COPD, particularly in patients with moderate or severe disease. Currently, the availability of pulmonary rehabilitation programs in the US is limited, as reimbursement is either inadequate or not available. In addition, many physicians do not refer patients to these programs when they are available.Medical advances notwithstanding, most patients with COPD demand therapies that are more effective, more enabling, and cause fewer adverse effects than current therapies. The challenge for medical science and the pharmaceutical industry is to bring about a qualitative change in therapy for the acute exacerbations of COPD as well as for the perpetual shortness of breath, which has such a devastating effect on quality of life. It is very encouraging that the medical community is beginning to recognize this challenge and is moving towards treating patients with COPD as ‘whole people’ and training them to self-manage at home. The overall success of these efforts is dependent on the recognition of COPD as a national health priority.     

喘乐宁联合布地奈德对慢性阻塞性肺疾病患者肺功能的影响

目的探讨喘乐宁联合布地奈德对慢性阻塞性肺疾病患者肺功能的影响。方法选取我院2015年7月至2016年4月收治的70例慢性阻塞性肺疾病患者,随机分为对照组和观察组,各35例。对照组口服氨茶碱,观察组采用布地奈德联合喘乐宁治疗。对比两组患者治疗前后的肺功能指标及不良反应发生率。结果治疗前,两组患者的肺功能指标比较,差异无统计学意义(P>0.05);治疗后,观察组的肺功能指标均优于对照组,差异有统计学意义(P<0.05)。观察组的不良反应发生率显著低于对照组,差异有统计学意义(P<0.05)。结论喘乐宁联合布地奈德可有效改善慢性阻塞性肺疾病患者的肺功能指标,缓解其临床症状,安全性高,值得临床推广应用。     

The Emerging Chronic Obstructive Pulmonary Disease Epidemic

The incidence and economic impact of chronic obstructive pulmonary disease (COPD) is escalating worldwide and is projected to remain on a positive trajectory for many years to come. At some point in this escalation, COPD may be regarded as a true epidemic. Unfortunately, the incidence among women is escalating more rapidly than in men, reflecting the social anthropology of changing smoking habits. This knowledge, coupled with the fact that the true disease prevalence is under-reported, suggests that we are facing a significant medical and economic crisis. The most preventable risks for COPD continue to be cigarette smoking and exposure to second-hand smoke. This is a particular problem for youth in their formative and critical growth years. Amalgamated with these alarming trends are the decline in air quality, occupational exposure to inhaled pollutants and pro-inflammatory materials, poor nutrition, lack of exercise, and increasing body mass index.There is a lack of patient and family understanding regarding this chronic disease process and its co-morbid conditions. First and foremost, smoking-cessation efforts must be increased, and protection from second-hand smoke needs to be emphasized. Spirometric testing to identify populations at risk and in the early stages of disease should be implemented on a large scale and should trigger implementation of appropriate preventive steps. Disease management processes and strategies used in alliance with educational-, nutritional-, and physical exercise-related interventions may hold the key to altering behavioral patterns of patients and their families. We need to provide patients with simple and definitive interventions that can be self-initiated at the earliest possible time. This may help us to integrate best medical practices early in the disease process. Thus, we can improve bodily function from a systemic perspective, while implementing coordinated disease surveillance and treatment plans for each affected individual. From an economic perspective, financial incentives can be provided by way of shifting costs from disease treatment to disease prevention and health enhancement. When the correct incentives and disease management strategies are embraced, a disease-oriented intervention can ameliorate the devastating impact of COPD on patients and their families while relieving the economic impact of the disease.In summary, numerous stakeholders will need to come together in order to identify and remove barriers for implementation of preventive measures, provide early intervention, modify the disease course, and minimize the economic impact of COPD. Strategies should be developed for populations, as well as individual patients, if we are to adequately address this emerging epidemic.