运动锻炼配合噻托溴铵、沙美特罗/替卡松联合吸入治疗慢性阻塞性肺疾病稳定期疗效分析

目的 观察运动锻炼配合噻托溴铵、沙美特罗/替卡松吸入对慢性阻塞性肺疾病(COPD)稳定期的疗效.方法 将COPD稳定期Ⅲ～Ⅳ级患者60例依据随机数字表法分为对照组(药物)和试验组(药物+锻炼),对照组联合吸入噻托溴铵粉雾剂及沙美特罗/替卡松干粉剂,试验组在药物治疗同时配合运动锻炼(缩唇呼吸和踏阶梯运动),疗程均为8周;治疗前后以第1秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1%)、FEV1/用力肺活量(FVC)、MRC评分、日常生活活动能力(ADL)评分、6min步行距离(6MWD)等指标评价疗效.结果 试验组、对照组治疗前后组内各指标比较差异均有统计学意义(P<0.01);治疗后试验组、对照组FEV1(1.41±0.25)L比(1.28±0.23)L]、FEV1%(53.76±11.17)%比(46.27±8.85)%]、FEV1/FVC(62.12±10.78)%比(55.76±8.57)%]、MRC评分(1.56±1.16)分比(2.29±1.13)分]、ADL评分(5.51±0.18)分比(4.47±0.13)分]、6MWD(342.7±19.7)m比(280.6±17.8)m]比较差异有统计学意义(p<0.05).结论 配合运动锻炼能显著改进噻托溴铵、沙美特罗/替卡松联合吸入对COPD稳定期患者的疗效.

Therapeutic effects of exercise combined with tiotropium bromide and salmeterol/fluticasone inhaling on stable chronic obstructive pulmonary disease

Objective To observe the therapeutic effects of exercise combined with tiotropium bromide and salmeterol/fluticasone inhaling on stable chronic obstructive pulmonary diseases (COPD).Methods Sixty COPD patients with pulmonary function Ⅲ-Ⅳ grade were randomly allocated into experiment group and control group (30 cases in each group).The patients in experiment group were treated with inhaled tiotropium bromide and salmeterol/fluticasone combined with excise,while the patients in control group were treated only with inhaled tiotropium bromide and salmeterol/ fluticasone.Respiratory training with shrinkage lip respiration and steps training was given to the patients in experiment group for 8 weeks.Main outcome measures included forced expiratory volume in one second (FEV1),FEV1,in the anticipation value (FEV1%),FEV1/forced vital capacity (FVC),Medical Research Council (MRC) score,activities of daily living (ADL) score and 6-minute walking distance (6MWD).Results MRC score in control group and experiment group was both lower than that of pre-treatment (P < 0.01).ADL score,6MWD and pulmonary functional parameters in both groups were improved than those of pre-treatment (P< 0.01).FEV1,FEV1%,FEV1/FVC,MRC score,ADL score and 6MWD were (1.41 ±0.25) L,(53.76 ±11.17)%,(62.12 ±10.78)%,(1.56 ± 1.16) scores,(5.51 ±0.18) scores and (342.7 ± 19.7) m after treatment in experimentgroup,and (1.28 ± 0.23) L,(46.27 ±8.85)%,(55.76 ±8.57)%,(2.29 ±1.13)scores,(4.47 ±0.13)scores and (280.6 ± 17.8)m after treatment in control group.There were significant differences between two groups (P<0.05).Conclusion Tiotropium bromide,salmeterol/ fluticasone inhaling can improve life quality and pulmonary functional parameters in patients with stable COPD,while exercise combined with that can significantly enhance the therapeutic effects.