盐酸氨溴索注射液联合雾化吸入治疗急性加重期慢阻肺临床研究

目的观察盐酸氨溴索注射液静脉输注联合布地奈德混悬液、异丙托溴胺溶液雾化吸入在慢性阻塞性肺疾病急性加重期患者的临床疗效。方法收集我院2008年1月-2012年8月120例慢性阻塞性肺疾病急性加重期住院患者，随机分为2组：试验组在基础治疗原则上加入盐酸氨溴索注射液（沐舒坦）30mg静脉输注、布地奈德混悬液（普米克令舒）2mg与异丙托溴胺溶液（爱全乐）雾化吸入治疗，氧流量6—8L／min，持续20～30min，2杉日，7d为一疗程，共60例患者。对照组常规治疗，包括静脉应用抗生素、解痉平喘、持续低流量吸氧（1—2L／min）、祛痰等。共60例。治疗前后比较两组患者临床症状变化、临床体征变化、动脉血气分析、最大呼气流速的变化等因素，评价三联药物对COPD患者急性加重期的临床疗效。结果两组患者经过治疗后，临床症状如咳痰、肺部哆音、咳嗽、气促等评分。动脉血气分析、最大呼气流速等均较治疗前有显著性改善，具有明显统计学差异（P〈0．05）。经过治疗后实验组临床症状（咳痰、咳嗽、肺部哆音、气促）评分、最大呼气流速、动脉血气分析均对照组有显著性改善，具有明显统计学差异（P〈0．05）。结论盐酸氨溴索注射液静脉输注联合布地奈德混悬液、异丙托溴胺溶液雾化吸入能显著改善COPD患者急性加重期的临床疗效。

THE CLINICAL RESEARCH ON COMBINING INHALATION AND INTRAVEOUS INJECTION OF AMBROXOL ON ACUTE EXACERBATION OF COPD

Objective To observe the clinical effects of inhaling budesonide, ipratropium bromide and intravenous injection of ambroxol for the treatment of AECOPD. Methods Enrolled data of 120 patients with AECOPD in our hospital from January 2008 to August 2012. All patients were treated with continuous inhalation of 6-8L/min oxygen, antispasmodic, anti - infection, and other treatment. They were randomly divided into 2 groups according to the order of admission ： Experi- ment group ： 60 patients received conventional medical therapy plus inhalation of budesonide, ipratropium bromide and intra- venous injection of ambroxol. Control group ： 60 patients received conventional medical therapy but did not inhalate bodes- onide, ipratropium bromide and intravenous injection of arnbroxol. Before and after treatment, compare the patients in two groups with clinical symptomes, signs, blood gas analysis of artery, MEFR, ete, to evaluate the effect of triple drug on AE- COPD. Results Clinical effect： after treatment, the clinical symptoms, MEFR were significantly improved in both two groups（p 〈 0. 05 ）. Compared to the control group, the treatment group was significantly better after treatment （p 〈 0. 05 ）. Conclusion Inhalation of budesonide, ipratropium bromide and intravenous injection of ambroxol can improve the clinical effects on acute exacerbation of COPD significantly.