噻托溴铵粉吸入剂联合痰热清注射液对ACOS老年患者的治疗效果

目的研究噻托溴铵粉吸入剂联合痰热清注射液对哮喘-慢性阻塞性肺部疾病重叠综合征(ACOS)老年患者的治疗效果。方法选取2015年10月至2018年4月我院收治的120例ACOS老年患者作为研究对象,按照随机抽签法将其分为对照组和观察组,各60例。对照组给予噻托溴铵粉吸入剂治疗,观察组给予噻托溴铵粉吸入剂+痰热清注射液治疗。比较两组治疗效果、治疗前、后哮喘症状(ACT)评分、COPD症状(CAT)评分、肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV_1)、FEV_1/FVC、吸气分数(IC/TLC)、一氧化碳弥散量(DLCO)、残气量与肺总量比值(RV/TLC)]、免疫功能(外周血Th1、Th2、Th1/Th2)指标水平及不良反应发生情况。结果观察组治疗总有效率为93.33%,显著高于对照组的76.67%(P<0.05);治疗4周后,两组ACT评分均升高,CAT评分均降低,且观察组优于对照组(P<0.05);治疗4周后,两组FVC、FEV_1、FEV_1/FVC、IC/TLC、DLCO均升高,RV/TLC降低,且观察组优于对照组(P<0.05);治疗4周后,两组外周血Th1、Th2、Th1/Th2水平均升高,且观察组均高于对照组(P<0.05);观察组不良反应总发生率为11.67%,高于对照组的10.00%,但差异无统计学意义(P>0.05)。结论噻托溴铵粉吸入剂与痰热清注射液联合应用于ACOS老年患者中疗效显著,可明显减轻临床症状,改善肺功能及免疫功能,且不会加药物不良反应,值得临床推广。

Therapeatic effect of tiotropium bromide powder inhalation combined with Tanreqing injection on elderly patients with ACOS

Objective To study the the therapeutic effect of tiotropium bromide powder inhalation combined with Tanreqing injection on elderly patients with asthma-chronic obstructive pulmonary disease overlap syndrome(ACOS).Methods A total of 120 elderly patients with ACOS admitted in our hospital from October 2015 to April 2018 were selected as the research objects. The patients were divided into control group and observation group according to random drawing method, with 60 cases in each group. The control group was treated with tiotropium bromide powder inhalation, while the observation group was treated with tiotropium bromide powder inhalation and Tanreqing injection. The treatment effects,asthma symptoms score(ACT), COPD symptom score(CAT), lung function [forced vital capacity(FVC), forced expiratory volume in 1 second(FEV1), FEV1/FVC, inspiratory fraction(IC/TLC), carbon monoxide diffusion capacity(DLCO), residual gas volume to lung volume ratio(RV/TLC)], levels of immune function(Th1, Th2, Th1/Th2 of peripheral blood) and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the observation group was93.33%, which was higher than 76.67% of the control group(P <0.05). After 4 weeks of treatment, ACT scores in both groups increased and CAT scores decreased, and those in the observation group were better than the control group(P<0.05).After 4 weeks of treatment, the FVC, FEV1, FEV1/FVC, IC/TLC and DLCO in both groups increased, the RV/TLC decreased, and those in the observation group were better than the control group(P<0.05). After 4 weeks of treatment, the levels of Th1, Th2 and Th1/Th2 in peripheral blood of the two groups increased, and those in the observation group were higher than the control group(P<0.05). The incidence of adverse reactions in the observation group was 11.67%, which was higher than 10.00% in the control group, but there was no significant difference(P>0.05). Conclusion The combination of tiotropium bromide powder inhalation and Tanreqing injection in elderly patients with ACOS has remarkable curative effect.It can obviously relieve clinical symptoms, improve pulmonary function and immune function, and will not increase the adverse drug reactions, which is worthy of clinical promotion.