规律药物治疗对稳定期慢性阻塞性肺疾病患者的影响

目的研究稳定期规律应用支气管舒张药包括吸入激素,对于重度、极重度慢性阻塞性肺疾病（COPD）患者的肺功能和生活质量的影响。方法对于入选的COPD患者均进行用药指导,建议其规律应用一种或者多种支气管舒张药,反复急性加重者联合吸入糖皮质激素,对于慢性呼吸衰竭者则指导进行家庭氧疗。对患者在出院时、出院1个只、出院4个月时分男13行肺功能检查和生活质量的调查,调查结束后按患者是否规律用药将其分为规律用药组和按需用药组,规律用药组30例,按需用药组31例。分别测量两组患者出院时、出院4个月时肺功能和出院1个月、出院4个月生活质量的变化。两组资料在年龄,性别及出院时1秒钟用力呼气客积（FEV1）值均具有可比性（均P〉0．05）。结果出院4个月时规律用药组的FEV1及生活质量评分分别为（1．051±0．470）L,（20．9±15．0）分,与按需用药组（0．822±0．364）L,（31．2±14．4）分相比差异有统计学意义（均P〈0．05）。结论规律应用支气管舒张药短期内能改善重度或极重度COPD患者的肺功能及提高生活质量。

Effect of regular drug administration in patients with stable COPD

Objective To detect the effect of regular drug therapy including inhaled sterid in patients with severe chronic obstructive pulmonary disease （COPD）. Methods Patients with severe COPD were given a drug instruction according to the guideline. Suggestions for regular use of one or two bronchodilatation drugs including inhaled sterid and long home oxygen therapy were given for the patients with repeatedly acute exacerbation and respiratory failure. Every patient was made the lung function examination and life quality investigation in the day of leaving hospital,one mouth and four mouths after hospital discharge. Then after the survey, the patients were divided into two groups： the regular therapy group（ n =30） and irregular therapy group （drug in need）（ n =31）. The patients of two groups were observed in lung funetion（FEV1 ） and life quality（St. George scores）. The age,gender and FEV1 in the day of leaving hostiptal between the two groups were no statistically significant （all P 〉 0.05）. Results In the four mouths after hospital discharge,FEV1 and St. George scores in the regular therapy group （1.051±0.470） L,（20.9±15.0） scores were statistically different compared to those of the irregular therapy group （0. 822±0. 364） L, （31.0±14.4） scores （all P 〈0.05）. Conclusion Regular brochodilatation drug therapy can improve the lung function and life quality in patients with stable severe COPD.