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论著:社区单用或联合应用支气管扩张剂长期治疗稳定期慢性阻塞性肺疾病的临床研究
Long term Treatment of Stable COPD with Single or Associated Bronchodilators in Community
马云霞 苗玉兰 马正义 沈迁 李瑞 马俏玲
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作者单位:宁夏银川市第二人民医院呼吸内科
中文关键字:社区;稳定期;氨茶碱;异丙托溴铵;慢性阻塞性肺疾病
英文关键字:Community;Stable;Aminofilne;Ipratropium bromide;Chronic obstructive pulmonary disease
中文摘要:目的:观察单用或联合应用异丙托溴铵气雾剂、茶碱缓释片长期治疗社区稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)的临床疗效、安全性,评价其对COPD患者运动耐力和生活质量改善的价值。方法:将185例COPD患者随机分为溴铵组、茶碱组及联合组3组。溴铵组吸入异丙托溴铵气雾剂,茶碱组口服茶碱缓释片,联合组合用上述2种药。于治疗前及治疗3个月、6个月检测肺功能、6 min步行试验(6MWT),进行呼吸困难及生活质量评分,记录治疗期间COPD急性发作次数及不良反应。结果:治疗6个月3组肺功能均较前显著改善,6MWD/预计值(%)较前显著增加,呼吸困难较前显著减轻,生活质量评分较前显著降低,与治疗前比较3组均有显著差异(P<0.05)。溴铵组与联合组的疗效比茶碱组显著(P<0.05)。3组治疗6个月期间平均急性发作次数比治疗前显著减少(P<0.05)。溴铵组与联合组急性发作次数显著少于茶碱组(P<0.05)。3组疗程中不良反应发生均较少。 结论:异丙托溴铵气雾剂、茶碱缓释片单用或联合应用长期治疗中重度稳定期COPD,均能改善患者的肺功能和临床症状、增加运动耐力、提高生活质量、减少急性发作次数,且不良反应少。异丙托溴铵效果尤其确切,应用更方便、安全,是稳定期COPD长期治疗较好的选择。
英文摘要:Objective:To observe the clinical curative effect and safety of single or associated ipratropium bromide aerosol and Theo Dur in long term treatment of stable chronic obstructive pulmonary disease(COPD) in community and to evaluate amelioration of exercise tolerance and life quality of COPD patients. Methods: A total of 185 patients with stable COPD were randomly divided into three group: ipratropium bromide group, theocin group and associated group. Ipratropium bromide group breathe in aerosol of ipratropium bromide, theocin group take Theo Dur orally, the associated group was treated with both ipratropium bromide and Theo Dur. All participants had lung function test and 6 minute walk test (6MWT) before treatment and at 3 months, 6 months after treatment. March score of dyspnea and quality of life, acute episode frequency and adverse reaction were recorded during treatment. Results: After 6 months treatment, in all of the three groups, lung function was obviously improved , 6MWD/prediction (%) increased obviously, dyspnea score and quality of life score was obviously improved, Indicators of the three groups have significant difference before and after treatment (P<0.01). During six months the acute episode frequency was obviously decreased compared with before treatment in all of the three groups, and the difference was significant (P<0.05), the ipratropium bromide group and the associated group being more drastically. The incidence of adverse reactions were few in all of the three groups. Conclusions: Ipratropium bromide aerosol, Theo Dur, single or associated in long term treatment of moderate or severe stable COPD, all can improve lung function and clinical symptoms of the patients, increase exercise tolerance, improve quality of life, reduce acute episodes, while the adverse reactions is rare. In particular, ipratropium bromide has exact effect, and was easy to use and more secure, and thus make it a better choice in long term treatment of stable COPD.
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