异丙托溴铵联合特布他林对慢阻肺急性加重期患者的疗效探讨

摘要/Abstract

摘要： 目的探讨与分析异丙托溴铵联合特布他林对慢阻肺急性加重期患者的疗效。方法选择2020年1月~2022年1月在无锡市康复医院诊治的慢阻肺急性加重期患者88例作为研究对象,根据1∶1随机数表法原则把患者分为联合组与传统组,各44例。对照组给予异丙托溴铵治疗,联合组在对照组治疗的基础上给予特布他林治疗,两组都治疗观察3个月,观察两组患者的治疗效果。结果联合组治疗总有效率高于对照组,但差异无统计学意义（P>0.05）。联合组治疗期间的震颤、胃部不适、心悸等不良反应发生率与对照组相比,差异无统计学意义（P>0.05）。两组治疗后的第一秒呼出量（FEV1）占预计值百分比、FEV1/用力肺活量（FVC）都明显高于治疗前（P<0.05）,联合组与对照组相比也明显升高（P<0.05）。两组治疗后的动脉二氧化碳分压（PaCO2）明显低于治疗前（P<0.05）,血氧饱和度（SpO2）明显高于治疗前（P<0.05）,治疗后联合组PaCO2低于对照组,SpO2高于对照组,差异有统计学意义（P<0.05）。两组治疗后的角色、躯体、情绪、认知和社会等生活质量评分均显著升高（P<0.05）,且联合组治疗后的角色、躯体、认知和社会等生活质量评分都显著高于对照组（P<0.05）。结论异丙托溴铵联合特布他林在慢阻肺急性加重期患者的应用能提高患者的生活质量,能促进提高治疗效果,改善患者的肺功能,且不会增加不良反应的发生,还可促进恢复患者的血气状况。

关键词: 慢性阻塞性肺疾病, 急性加重期, 异丙托溴铵, 特布他林, 肺功能, 血气状况, 不良反应, 生活质量

Abstract: Objective To explore and analysis the efficacy of ipratropium bromide combined with terbutaline in patients with acute exacerbation of chronic obstructive pulmonary disease. Methods From January 2020 to January 2022, 88 cases of patients with acute exacerbation of chronic obstructive pulmonary disease who were diagnosed and treated in our hospital were selected as the research subjects. Accorded to therandom number table of 1:1, the patients were divided into the combined group and the control group with 44 cases in each group. The control group were given ipratropium bromide treatment, and the combined group were given terbutaline treatment on the basis of the treatment of the control group. Both groups were treated for 3 months, and the therapeutic effect of the patients were observed. Results The total effective rates of the combined group was higher than the control group, and the difference was not statistically significant (P>0.05). The incidence rates of adverse reactions such as tremor, stomach discomfort, and palpitations during treatment in the combined group were not significantly different from those in the control group (P>0.05). After treatment, the percentage of exhaled volume in 1 second (FEV1) to the predicted value and FEV1/forced vital capacity (FVC) in the two groups were significantly higher than those before treatment (P<0.05), and the combined group were also significantly higher than the control group (P<0.05). The arterial partial pressure of carbon dioxide (PaCO2) in the two group after treatment were significantly lower than that before treatment (P<0.05), and blood oxygen saturation (SpO2) was significantly higher than that before treatment (P<0.05). And after treatment, the PaCO2 in the combined group was significantly lower than the control group (P<0.05), the SpO2 was significantly higher than the control group (P<0.05). The quality of life scores of role, body, emotion, cognition and society in the two groups after treatment were significantly increased (P<0.05), and the scores of quality of life such as role, body, cognition and society after treatment in the combined group were significantly higher than the control group (P<0.05). Conclusion The application of ipratropium bromide combined with terbutaline in patients with acute exacerbation of chronic obstructive pulmonary disease can improve the quality of life of patients, improve the pulmonary function of patients, and promote the improvement of treatment effect without increasing the occurrence of adverse reactions. It also promotes recovery of the patient's blood gas status.

Key words: ipratropium bromide, terbutaline, acute exacerbation of chronic obstructive pulmonary disease, pulmonary function, blood gas status, adverse reactions, quality of life

中图分类号:

R452

左国璋. 异丙托溴铵联合特布他林对慢阻肺急性加重期患者的疗效探讨[J]. 中华养生保健, 2022, 40(24): 62-66.

ZUO Guo-zhang. Efficacy of Ipratropium Bromide Combined with Terbutaline in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(24): 62-66.

参考文献

[1] 伏琼,彭敏,汤素琴,等.乙酰半胱氨酸联合特布他林雾化液治疗COPD的临床疗效及其对血清炎性因子的影响[J].川北医学院学报,2021,36(8):1033-1036.
[2] 高硕,高建荣,颜刚林.安徽巢湖市60岁以上人群慢性阻塞性肺疾病流行特征及危险因素分析[J].公共卫生与预防医学,2022,33(1):136-140.
[3] 张黎,蒋艳秋,黄燕,等.慢性阻塞性肺疾病肺部侵袭性真菌感染危险因素及细胞因子基因多态性[J].中华医院感染学杂志,2021, 31(13):1930-1935.
[4] 徐琳琳,周瑞清,郑法德,等.糖皮质激素联合特布他林雾化吸入治疗慢性阻塞性肺疾病急性加重患者的临床疗效及其对肺功能的影响[J].实用心脑肺血管病杂志,2021,29(7):18-23.
[5] 彭宁,寿志南,陈敏.莫西沙星联合特布他林对慢性阻塞性肺疾病患者临床疗效及FEV1、FVC、FEV1/FVC的影响[J].吉林医学,2021, 42(8):1842-1845.
[6] 徐琴. 特布他林联合异丙托溴铵雾化吸入治疗对老年慢性阻塞性肺疾病患者肺通气功能及动脉血气指标的影响[J].吉林医学,2021,42(11):2716-2718.
[7] 王宁,栗娜,韩巧玲,等.布地奈德福莫特罗联合噻托溴铵治疗哮喘-慢性阻塞性肺疾病重叠的临床研究[J].中国综合临床,2021,37(1): 39-45.
[8] 李浩,曾惠雪,汪铁柱.糖皮质激素联合特布他林治疗COPD急性加重期的疗效[J].上海医药,2021,42(21):40-42.
[9] 邵宝琴,肖辉.布地奈德+特布他林对慢阻肺的临床效果及血气指标的影响[J].江西医药,2021,56(11):1997-1999.
[10] Duan Y, Zhou H, Chen J.The effects of the atomization inhalation of budesonide, salbutamol, and ipratropium bromide on the T-lymphocyte subset and inflammatory cytokine levels in children with asthmatic pneumonia[J]. Am J Transl Res,2021,13(9):10517-10526.
[11] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中国医学前沿杂志(电子版),2014,6(2):67-80.
[12] Schuh S, Freedman S B, Zemek R, et al.Association Between Intravenous Magnesium Therapy in the Emergency Department and Subsequent Hospitalization Among Pediatric Patients With Refractory Acute Asthma: Secondary Analysis of a Randomized Clinical Trial[J]. JAMA Netw Open, 2021, 4(7):e2117542.
[13] 俞昌赫,甘甜,宋红磊.N-乙酰半胱氨酸联合硫酸特布他林片辅助常规治疗老年COPD并呼吸衰竭对功能康复及β2-MG、CHE血清水平的影响[J].中国老年学杂志,2022,42(6):1385-1389.
[14] 贾金虎,常彩虹,高玉林.不同剂量布地奈德福莫特罗用于高风险慢性阻塞性肺疾病急性加重期患者的疗效对比研究[J].中国基层医药,2021,28(5):660-665.
[15] 薛世民,高晓嵘,叶瑜,等.特布他林联合羧甲司坦片治疗慢性阻塞性肺疾病的疗效及对血清MMP-9、MMP-12、TIMP-1的影响[J].现代生物医学进展,2020,20(3):532-535,514.
[16] 邱绍伟. 异丙托溴铵联合特布他林雾化吸入辅助治疗慢性阻塞性肺疾病急性加重期的疗效分析[J].吉林医学,2020,41(3):625-626.
[17] 李锋,何成,付蓉.福多司坦对老年慢性阻塞性肺疾病急性加重期肺功能及呼出气一氧化氮的影响[J].上海医药,2020,41(16):19-21.
[18] 唐晓霞,翁军,韩静.特布他林联合多索茶碱对慢性阻塞性肺疾病患者的疗效及患者呼吸动力学的影响[J].中国医院药学杂志,2020, 40(15):1659-1662.
[19] 陈苗,张洁,陈思,等.痰热清治疗慢性阻塞性肺疾病合并肺部感染的疗效[J].中华医院感染学杂志,2021,31(10):1466-1469.
[20] 黄程辉,陈东成,梁兰芳,等.布地奈德联合特布他林雾化吸入治疗对COPD患者肺功能和血清学变化的影响[J].黑龙江医药,2021, 34(4):847-849.