孟鲁司特联合复方异丙托溴铵及布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期的疗效研究

目的观察孟鲁司特联合复方异丙托溴铵及布地奈德雾化吸入治疗慢性阻塞性肺疾病(COPD)急性加重期的临床疗效。方法选择我科2013年1—10月收治的COPD急性加重期患者84例,采用随机数字表法将所有患者分为对照组和治疗组,每组42例。对照组患者采用吸氧、抗感染、止咳化痰、维持水电解质平衡等综合治疗,治疗组患者在对照组基础上加用孟鲁司特10 mg口服,1次/晚;雾化吸入复方异丙托溴铵2.5 ml和布地奈德混悬液2 ml,2次/d,连用1周。观察两组患者临床疗效及肺功能改善情况。结果治疗组患者总有效率为95.24%(40/42),高于对照组的80.95%(34/42)(P0.01)。治疗组患者治疗前后第1秒用力呼气容积(FEV1)占预计值百分比(FEV1%)、用力肺活量(FVC)、FEV1/FVC、最大呼气流量(PEF)、残气量(RV)、RV/肺总量(TLC)差值均大于对照组(P0.05)。结论孟鲁司特联合复方异丙托溴铵及布地奈德雾化吸入能明显提高COPD急性加重期患者的临床疗效,改善患者肺功能。

Clinical Efficacy of Montelukast Combined with Ipratropium Bromide and Budesonide Aerosol Inhalation on Acute Exac-erbation of Chronic Obstructive Pulmonary Disease

Objective To observe the clinical efficacy of Montelukast combined with Ipratropium bromide and Budes-onide aerosol inhalation on acute exacerbation of chronic obstructive pulmonary disease（ COPD）. Methods A total of 84 inpa-tients with acute exacerbation of COPD in our department were selected from January to October 2013,and they were divided into treatment group（n=42）and control groups（n=42）according to random number table. Both groups received comprehensive treatment,including oxygen inhalation,antibiotics,facilitating expectoration,suppressing cough and maintaining balance of water and electrolyte. Treatment group were additionally treated with Montelukast 10 mg,1 time per night,Ipratropium bromide 2. 5 ml and Budesonide suspension aerosols 2. 0 ml,twice a day,the treatment lasted for 1 week. The clinical efficacy and lung function changes in both groups were observed. Results The effective rate of treatment group was 95. 24%（40/42）,was sig-nificantly higher than that of control group of 80. 95%（34/42）（P﹤0. 01）. The differentials of FEV1%,FVC,FEV1/FVC, PEF,RV and RV/TLC before and after treatment were significantly higher of treatment group than those of control group（ P﹤0. 05）. Conclusion Montelukast combined with Ipratropium bromide and Budesonide aerosol inhalation can improve the clinical efficacy in COPD patients with acute exacerbation,and improve the lung function.