慢性阻塞性肺疾病患者经能倍乐配合间隔器给药后的临床效果研究
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摘要
目的研究慢性阻塞性肺疾病(COPD)的老年患者使用能倍乐配合间隔器吸入药物的临床效果。方法收集2016年10月-2018年10月期间在苏州科技城医院就诊的慢性阻塞性肺疾病患者77例,随机分为两组,实验组(n=40)用能倍乐配合间隔器进行治疗,对照组(n=37)用能倍乐装置吸入治疗。吸入药物均为噻托溴铵。检测并对比分析两组一般特征、肺功能指标、血气分析指标、临床疗效等。结果两组患者经治疗后FEV1、FVC和FEV1/FVC均有升高,差异均具有统计学差异(P<0.05)。两组间比较,实验组的FEV1、FVC和FEV1/FVC治疗前后差值大于对照组,差异有统计学意义(P<0.05)。两组患者治疗前p H值、PaO2和PaCO2无明显差别(P>0.05),经治疗后p H无明显差别(P>0.05)。两组经治疗后PaO2均升高、PaCO2均降低,差异均具有统计学差异(P<0.05)。两组间比较,治疗后实验组的PaO2大于对照组,PaCO2小于对照组,差异有统计学意义(P<0.05)。实验组患者临床治疗效果总有效率明显大于对照组,差异具有统计学意义(P<0.05)。结论慢性阻塞性肺病患者经能倍乐配合间隔器吸入噻托溴铵能更好的改善肺功能指标、血气指标,获得更好的临床效果分析,提示合并使用间隔器治疗慢阻肺可以获得更好的临床疗效,给临床治疗提供一定指导意义。
Objective To investigate the clinical effect of elderly patients with chronic obstructive pulmonary disease( COPD) who were treated with Respimat combined with spacer. Methods A total of 77 patients with COPD were collected from Suzhou science and technology town hospital in Otc. 2016 to Otc. 2018,and randomly divided into two groups. The experimental group( n = 40) are treated with Respimat combined with spacer and the control group( n = 37) are without spacer. Inhaled drugs are tiotropium bromide. The general characteristics,pulmonary function indexes,blood gas analysis indexes and clinical efficacy of the two groups were detected and compared. Results After treatment,FEV1,FVC and FEV1/FVC increased in both groups,and the difference was statistically significant( P<0.05).Compared between the two groups,the difference of FEV1,FVC and FEV1/FVC before and after treatment in the experimental group was greater than that in the control group,and the difference was statistically significant( P < 0. 05). There was no significant difference in p H,PaO2 and PaCO2 between the two groups before treatment( P>0.05),and no significant difference in p H after treatment( P>0.05).After treatment,PaO2 increased and PaCO2 decreased in both groups,and the difference was statistically significant( P<0.05).After treatment,PaO2 in the experimental group was larger than that in the control group and PaCO2 in the control group was smaller than that in the control group,and the difference was statistically significant( P<0.05).The total effective rate of clinical treatment in the experimental group was significantly higher than that in the control group,and the difference was statistically significant( P< 0.05). Conclusion Patients with chronic obstructive pulmonary disease can better improve pulmonary function indexes and blood and gas indexes by inhaling tiotropium bromide through Respimat combined with spacer,and obtain better clinical effect analysis,suggesting that the use of spacer combined with the treatment of Respimat can obtain better clinical efficacy,providing certain guiding significance for clinical treatment.
Objective To investigate the clinical effect of elderly patients with chronic obstructive pulmonary disease( COPD) who were treated with Respimat combined with spacer. Methods A total of 77 patients with COPD were collected from Suzhou science and technology town hospital in Otc. 2016 to Otc. 2018,and randomly divided into two groups. The experimental group( n = 40) are treated with Respimat combined with spacer and the control group( n = 37) are without spacer. Inhaled drugs are tiotropium bromide. The general characteristics,pulmonary function indexes,blood gas analysis indexes and clinical efficacy of the two groups were detected and compared. Results After treatment,FEV1,FVC and FEV1/FVC increased in both groups,and the difference was statistically significant( P<0.05).Compared between the two groups,the difference of FEV1,FVC and FEV1/FVC before and after treatment in the experimental group was greater than that in the control group,and the difference was statistically significant( P < 0. 05). There was no significant difference in p H,PaO2 and PaCO2 between the two groups before treatment( P>0.05),and no significant difference in p H after treatment( P>0.05).After treatment,PaO2 increased and PaCO2 decreased in both groups,and the difference was statistically significant( P<0.05).After treatment,PaO2 in the experimental group was larger than that in the control group and PaCO2 in the control group was smaller than that in the control group,and the difference was statistically significant( P<0.05).The total effective rate of clinical treatment in the experimental group was significantly higher than that in the control group,and the difference was statistically significant( P< 0.05). Conclusion Patients with chronic obstructive pulmonary disease can better improve pulmonary function indexes and blood and gas indexes by inhaling tiotropium bromide through Respimat combined with spacer,and obtain better clinical effect analysis,suggesting that the use of spacer combined with the treatment of Respimat can obtain better clinical efficacy,providing certain guiding significance for clinical treatment.
引文
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[10]FERGUSON GT,DALBY RN.Clinical implications of the tiotropium/olodaterol inhaler for patients with chronic obstructive pulmonary disease[J].Postgrad Med,2018,130(6):515.
[11]马宝义,马福清,秦英.临夏地区慢性阻塞性肺疾病影响因素及防治措施研究[J].国外医学(医学地理分册),2018(4):296.
[12]MELANI A S.Olodaterol for the treatment of chronic obstructive pulmonary disease:a narrative review[J].Expert Opin Pharmacother,2018,19(14):1603.
[13]李雪平,古辉,杜燕芳,等.思力华能倍乐治疗慢性阻塞性肺疾病的临床效果观察[J].中国医药科学,2017(18):40.
[2]杨博,姜宏英,曹洪丽.肺功能训练仪对预防稳定期慢性阻塞性肺疾病的意义[J].解放军预防医学杂志,2018(4):496.
[3]NI H,MOE S,SOE Z,et al.Combined aclidinium bromide and long-acting beta2-agonist for chronic obstructive pulmonary disease(COPD)[J].Cochrane Database Syst Rev,2018,12:D11594.
[4]LANE D C,STEMKOWSKI S,STANFORD R H,et al.Initiation of Triple Therapy with Multiple Inhalers in Chronic Obstructive Pulmonary Disease:An Analysis of Treatment Patterns from a U.S.Retrospective Database Study[J].JManag Care Spec Pharm,2018,24(11):1165.
[5]赵晓霞,郭义娟,秦玉玲.COPD急性加重期和稳定期睡眠质量及其与肺功能相关性探究[J].解放军预防医学杂志,2017(5):457.
[6]殷晓娜,宋卫东.慢性阻塞性肺疾病评估测试方法的比较研究[J].临床肺科杂志,2017(4):645.
[7]OLIVEIRA M,PIZZICHINI E,DA CC,et al.Evaluation of the preference,satisfaction and correct use of Breezhaler((R))and Respimat((R))inhalers in patients with chronic obstructive pulmonary disease-INHALATORstudy[J].Respir Med,2018,144:61.
[8]张玮,陆波,吴秀凤,等.慢性阻塞性肺疾病病人吸入器的选择[J].药学服务与研究,2017(6):477.
[9]段生和.武威市慢性阻塞性肺疾病流行病学调查及相关因素分析[J].国外医学(医学地理分册),2017(1):32.
[10]FERGUSON GT,DALBY RN.Clinical implications of the tiotropium/olodaterol inhaler for patients with chronic obstructive pulmonary disease[J].Postgrad Med,2018,130(6):515.
[11]马宝义,马福清,秦英.临夏地区慢性阻塞性肺疾病影响因素及防治措施研究[J].国外医学(医学地理分册),2018(4):296.
[12]MELANI A S.Olodaterol for the treatment of chronic obstructive pulmonary disease:a narrative review[J].Expert Opin Pharmacother,2018,19(14):1603.
[13]李雪平,古辉,杜燕芳,等.思力华能倍乐治疗慢性阻塞性肺疾病的临床效果观察[J].中国医药科学,2017(18):40.