噻托溴铵、布地奈德、特布他林吸入治疗AECOPD的临床观察

目的观察噻托溴铵联合布地奈德、特布他林治疗AECOPD的疗效。方法将128例年龄50~80岁中重度AECOPD患者随机分为噻托溴铵组(40例),布地奈德+特布他林组(40例)和联合治疗组(48例)。噻托溴铵组给予噻托溴铵干粉剂(18μg,1次/d)吸入,布地奈德+特布他林组给予雾化吸入布地奈德4mL+特布他林4mL Bid,联合组给予噻托溴铵干粉剂(18μg,1次/d)吸入,布地奈德,特布他林各4mL Bid吸入治疗。疗程14d。观察三组患者用药前后肺功能指标,血气分析及呼吸困难评分变化。结果三组患者用药后与用药前比较呼吸困难评分下降有显著性意义(P<0.01),FEV1、FEV1%及FEV1/FVC上升有显著性意义(P<0.01),噻托溴铵组与布地奈德+特布他林组比较无显著性差异(P>0.05),联合治疗组与噻托溴铵组和布地奈德+特布他林组比较有显著性差异(P<0.05)。结论噻托溴铵联合布地奈德+特布他林治疗AECOPD疗效确切。

Clinical Observation of Tiotropium Bromide, Budesonide and Terbutaline Inhalation in the Treatment of AECOPD

Objective To observe the therapeutic effect of tiotropium bromide and budesonide, terbutaline in the treatment of patients with AECOPD. Methods 128 patients aged from 50 to 80 years old with moderate to severe AECOPD were randomly divided into tiotropium bromide group （40cases）, budesonide and terbutaline group （40 cases）, tiotropium bromide combined with budesonide and terbutaline group （48 cases）. Tiotropiuin bromide group were given tiotropium bromide dry powder （181xg） inhalation once a day, Budesonide and terbutaline group were given Budesonide 4mL＋terbutaline 4mL inhalation therapy twice a day, combined treatment group were treated with tiotropium bromide dry powder （18~tg） inhalation once a day and budesonide 4mL＋ terbutaline 4mL inhalation therapy twice a day. The course of treatment is 14 days. Three groups were observed before and after treatment in patients with pulmonary function, blood gas analysis and dyspnea score changes. Results The three groups of patients after treatment compared with pretreatment of dyspnea score decreased significantly （P〈0.05）, FEV1, FEV1% and FEV1/FVC increased significantly （P〈0.01）, blood gas analysis improved significantly （P〈0.01）, tiotropium bromide group had no difference compared with budesonide and terbutaline group （P〉0.05）, combined treatment group and tiotropium bromide and budesonide and terbutaline group difference was significant difference （P〈0.05）. Conclusion Tiotropium bromide combined with budesonide and terbutaline has good effect in the treatment of AECOPD.