比索洛尔联合噻托溴铵治疗慢性阻塞性肺疾病稳定期患者40例疗效观察

目的探讨比索洛尔联合噻托溴铵治疗慢性阻塞性肺疾病(COPD)稳定期患者的疗效及安全性。方法COPD稳定期患者80例随机分为噻托溴铵组(对照组)和比索洛尔联合噻托溴铵组(观察组)各40例。对照组在常规治疗基础上给予噻托溴铵粉吸入剂,观察组在对照组治疗基础上给予小剂量比索洛尔片口服,根据患者情况适当调整剂量,疗程均为12周;并对2组患者治疗前后总有效率、肺功能、COPD评估测试问卷(CAT)评分及急性加重情况进行比较。结果观察组完成试验34例,对照组完成36例。治疗后对照组和观察组总有效率分别为80.56%(29/36)和97.06%(33/34),差异有统计学意义(P<0.05),治疗前对照组和观察组FEV_1、FEV_1%、FEV_1/FVC、CAT评分分别为(1.58±0.57)L、(41.73±5.74)%、(56.73±4.74)%、(23.9±4.8)分和(1.56±0.63)L、(42.26±5.13)%、(57.33±3.95)%、(24.2±4.3)分,2组比较差异无统计学意义(P均>0.05);治疗后对照组和观察组FEV、FEV,%、FEV/FVC、CAT评分分别为(1.89±0.33)I、(49.23±3.53)%、(59.83±5.53)%、(16.3±3.7)分和(2.02±0.31)L、(53.53±4.34)%、(63.46±6.17)%、(13.6±3.3)分,急性加重分别为l1例次(30.6%)和4例次(11.8%),2组比较差异均有统计学意义(P均<0.05);且观察组改善均较对照组明显(P均<0.05)。结论比索洛尔联合噻托溴铵较单纯使用噻托溴铵更能改善COPD稳定期患者的肺功能和生活质量;稳定期急性加重次数明显降低,而相关的不良反应并未明显增加。

Effect of bisoprolol combined with tiotropium in treatment of 40 cases with stable chronic obstructive pulmonary disease

Objective To investigate bisoprolol combined tiotropium bromide in the treatment of chronic obstructive puhnonary disease （COPD） and stable curative effect and safety of patients. Methods Patients with stable COPD （80 cases） were randmnly divided into tiotropium group （control group） and bisoprolol with tiotropium group （observation group） with 40 cases in each group. The control group on the basis of conventional therapy, given tiotropium bromide powder tot inhalation, the ohservation group was treated with small dose of bisoprolol tablets, according to the conditions of patients adjust the dose, duration of treatment was 12 weeks; cmnpared to the total efficiency, and the 2 groups before and after treatment,COPD as- sessment test（CAT） score and puhnonary function of acute exacerbation the situation. Results Observation group completed the trial in 34 cases, 36 cases in the control group completed the trial. After treatment, the observation group and the control group~ total effective rate was 80.56% （29/36） and 97.06% （33/34）, the difference was statistically significant （ P 〈 0.05 ）. Before treatment, the control group and the observation group FEVI, FEV, % , FEVI/FVC, CAT scores were （ 1. 58± 0.57）L,（41.73±5.74）%,（56.73±4.74）%,（23.9±4.8） points and （1.56±0.63）L,（42.26±5.13）%,（57.33± 3.95） % , （24.2 ± 4.3） points, no significant difterences between the 2 groups （ all P 〉 0.05 ）. After treatment, the observation group and the control group＇s FEV1 FEV1% , FEV1/ FVC, CAT scores were （ 1.89±0.33） L, （49.23 ±3.53）% , 459.83 ±5.53）% ,（16.3 ±3.7） points and （2.02 ±0.31）L,（53.53 ±4.34）% ,（63.46 ±6.17）% ,（13.6 ±3.3）pnint~, acute exacerbation were found in 11 patients （30.6%） and 4 patients（ 11.8% ） respectively, compared with before treatment, the difference between the 2 groups were statistically significant （ P 〈 0.05 ） ; and the observation group were improved signifi- cantly compared with the control group, the difference was statistically significant （P 〈 0.05 ）. Conclusion Bisoprolol com-bined with tiotropium than the simple use of tiotropium bromide can improve the patients with stable COPD pulmonary function and quality of life;fewer acute exacerbation period of stability, and associated with adverse reactions did not significantly increase.