布地格福吸入气雾剂联合茶碱治疗慢性阻塞性肺疾病稳定期的临床研究

目的 探讨布地格福吸入气雾剂联合茶碱治疗慢性阻塞性肺疾病（COPD）稳定期的临床效果。方法 选取2020年1月—2021年3月天津市第五中心医院收治的96例COPD稳定期患者，随机分为对照组（48例）和治疗组（48例）。对照组口服茶碱缓释片，1片/次，2次/d。治疗组在对照组基础上经口吸入布地格福吸入气雾剂，2揿/次，2次/d。两组患者连续治疗12周。观察两组患者临床疗效，比较治疗前后两组患者6 min步行距离（6MWD）、自我评估测试（CAT）问卷、St George’s呼吸问卷（SGRQ）评分、肺功能参数第1秒用力呼气容积（FEV1）、FEV1与用力肺活量（FVC）比值（FEV1/FVC）、一氧化碳弥散量（DLCO）占预计值百分数、FEV1占预计值百分数和残气容积（RV）与肺总量（TLC）比值（RV/TLC）及呼出气一氧化氮（FeNO）浓度、外周血辅助性T细胞（Th）1与Th2比值（Th1/Th2）、血清基质金属蛋白酶-9（MMP-9）和白细胞介素-18（IL-18）水平。结果 治疗后，治疗组总有效率为95.8%，显著高于对照组的83.3%（P<0.05）。治疗后，两组6MWD均较治疗前显著增加（P<0.05），CAT问卷和SGRQ评分显著降低（P<0.05），且治疗组的6MWD和CAT问卷、SGRQ评分比对照组改善更显著（P<0.05）。治疗后，两组FEV1、FEV1/FVC、DLCO占预计值百分数及FEV1占预计值百分数均较治疗前显著升高（P<0.05），RV/TLC显著降低（P<0.05），且治疗组肺功能明显好于对照组（P<0.05）。治疗后，两组FeNO、外周血Th1/Th2及血清MMP-9、IL-18水平均显著下降（P<0.05），且治疗组降低更明显（P<0.05）。结论 布地格福吸入气雾剂联合茶碱治疗COPD稳定期整体效果显著，能安全有效地改善患者症状、生活质量及肺功能，具有一定临床推广应用价值。

Clinical study on Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol combined with theophylline in treatment of chronic obstructive pulmonary disease in stable phase

Objective To investigate the clinical effect of Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol combined with theophylline in treatment of chronic obstructive pulmonary disease in stable phase. Methods Patients (96 cases) with chronic obstructive pulmonary disease in stable phase in Tianjin Fifth Central Hospital from January 2020 to March 2021 were randomly divided into control (48 cases) and treatment (48 cases) groups. Patients in the control group were po administered with Theophylline Sustained-release Tablets, 1 tablet/time, twice daily. Patients in the treatment group were oral inhalation administered with Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol, 2 press/time, twice daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluation was evaluated, the 6MWD and CAT questionnaires and SGRQ scores, pulmonary function parameters of FEV1, FEV1/FVC, percentage of DLCO in estimated value, percentage of FEV1 in estimated value and RV/TLC, and FeNO concentration, peripheral blood Th1/Th2 and serum MMP-9 and IL-18 levels in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 95.8%, which was significantly higher than that of the control group (83.3%) (P<0.05). After treatment, 6MWD in two groups were significantly increased, CAT questionnaire and SGRQ scores were significantly decreased, and 6MWD, CAT questionnaire and SGRQ scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the FEV1, FEV1/FVC, percentage of DLCO in estimated value, percentage of FEV1 in estimated value of two groups were significantly higher than those before treatment, while RV/TLC were significantly decreased (P<0.05), and the pulmonary function of the treatment group was significantly better than that of the control group (P<0.05). After treatment, the concentration of FeNO, the level of Th1/Th2 in peripheral blood and the level of MMP-9 and IL-18 in serum were significantly decreased in two groups (P<0.05), especially in the treatment group (P<0.05) .Conclusion The overall effect of Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol combined with theophylline in treatment of chronic obstructive pulmonary disease in stable phase is remarkable, and it can safely and effectively improve patients'' symptoms, quality of life and pulmonary function, which has a certain clinical application value.