噻托溴铵联合布地奈德福莫特罗治疗成人重度支气管哮喘的临床观察
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篇名: 噻托溴铵联合布地奈德福莫特罗治疗成人重度支气管哮喘的临床观察
TITLE:
摘要: 目的:观察噻托溴铵联合布地奈德福莫特罗治疗成人重度支气管哮喘的临床疗效及安全性。方法:选取我院2013年3月-2016年3月收治的重度支气管哮喘成年患者共110例,按随机数字表法分为对照组和观察组,各55例。对照组患者给予布地奈德福莫特罗粉吸入剂,每次2吸,bid;观察组患者在对照组基础上加用噻托溴铵粉吸入剂18 μg,qd。两组患者均治疗6个月。比较两组患者的临床疗效,治疗前后的哮喘控制测试表(ACT)评分、呼吸功能指标和哮喘急性发作次数,以及不良反应发生情况。结果:观察组患者的显效率和总有效率分别为54.55%、96.36%,均显著高于对照组的32.73%、78.18%,差异均有统计学意义(P<0.05)。治疗前,两组患者的ACT评分、各呼吸功能指标和哮喘急性发作次数比较,差异均无统计学意义(P>0.05);治疗后,两组患者的ACT评分显著高于治疗前,1秒用力呼气容积(FEV1)、FEV1占用力肺活量的比值和最大呼气流量均显著大于治疗前,最大呼气流量变异率显著低于治疗前,且观察组各指标均显著优于对照组,差异均有统计学意义(P<0.05);治疗后1、3、6个月时,两组患者的哮喘急性发作次数均显著少于治疗前,且观察组发作次数均显著少于同期对照组,差异均有统计学意义(P<0.05)。观察组患者的不良反应发生率为20.00%,与对照组的14.55%比较,差异无统计学意义(P>0.05)。结论:噻托溴铵联合布地奈德福莫特罗治疗成人重度支气管哮喘可有效降低病情严重程度,改善患者呼吸功能,减少哮喘急性发作次数,临床疗效好且安全性较高。
ABSTRACT: OBJECTIVE: To observe clinical efficacy and safety of tiotropium bromide combined with budesonide formoterol in the treatment of severe bronchial asthma in adults. METHODS: A total of 110 adult patients with severe bronchial asthma were selected from our hospital during Mar. 2013-Mar. 2016 were divided into control group and observation group according to random number table, with 55 cases in each group. Control group was given Budesonide formoterol powder for inhalation, 2 inhalations each time, bid; observation group was additionally given Tiotropium bromide powder for inhalation 18 μg,qd, on the basis of control group. Both groups were treated for 6 months. Clinical efficacies as well as ACT scores, respiration function indexes and the times of acute attack of asthma before and after treatment, the occurrence of ADR were compared between 2 groups. RESULTS: The efficiency rate and total response rate of observation group were 54.55% and 96.36%, which were significantly higher than 32.73%, 78.18% in control group, with statistical significance (P<0.05). Before treatment, there was no statistical significance in ACT scores, respiration function indexes or the times of acute attack of asthma between 2 groups (P>0.05). After treatment, ACT scores of 2 groups were significantly higher than before treatment; FEV1, FEV1/FVC and PEF were significantly greater than before treatment, PEFR was significantly lower than before treatment; and the indexes in observation group was significantly better than control group, with statistical significance (P<0.05). 1, 3, 6 months after treatment, the times of acute attack of asthma in 2 groups were significantly less than before treatment, and that in observation group was significantly less than control group, with statistical significance (P<0.05). The incidence of ADR in observation group was 20.00%, and there was no statistical significance compared to 14.55% of control group(P>0.05). CONCLUSIONS: Tiotropium bromide combined with budesonide formoterol in the treatment of severe bronchial asthma in adults can effectively relieve the severity of disease, improve respiration function, reduce the times of acute attack of asthma, and have good therapeutic efficacy and safety.
期刊: 2017年第28卷第23期
作者: 韩忠,李华,王齐,陈家亮
AUTHORS: HAN Zhong,LI Hua,WANG Qi,CHEN Jialiang
关键字: 噻托溴铵;布地奈德福莫特罗;重度支气管哮喘;胆碱能受体拮抗剂
KEYWORDS: Tiotropium bromide; Budesonide formoterol; Severe bronchial asthma; Cholinergic receptor antagonist
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