CAJ | 학술논문

目的观察老年重度慢性阻塞性肺疾病(COPD)患者通过特殊装置(都保)吸入糖皮质激素的疗效.方法 76例老年重度COPD急性加重期患者(男53例,女23例),分别按照随机数字表法分为试验组(38例)和对照组(38例).治疗期10 d,试验组吸入布地奈德粉吸入剂2吸(0.2 mg),每日2次；对照组氧化雾化吸入布地奈德混悬液1 mg,每日2次,观察患者喘息症状变化.随访期3个月,试验组吸入布地奈德粉吸入剂1吸(0.1 mg),每日2次治疗,对照组停止雾化吸入药物,观察两组患者喘息症状、6 min步行距离、急性加重次数.并观察患者不良反应的发生.对试验数据进行意向性分析和符合方案数据分析.结果治疗结束两组患者喘息症状均有显著改善(F值分别为8.746、7.952；P均＜0.05),但两组间治疗第1、5、10天喘息症状评分比较差异均无统计学意义(P均＞0.05).但试验组患者不良反应发生率明显低于对照组,差异有统计学意义(x2=11.372,P＜0.01),且治疗费用明显低于对照组,差异亦有统计学意义(t=4.573,P＜0.01).随访期开始(第0周)两组急性加重频率、喘息症状、呼气峰流量、6 min步行距离比较差异均无统计学意义(P均＞0.05).12周随访期结束时,试验组患者急性加重次数明显低于对照组(aF组内=9.343,aF组间=16.343,aF交互=20.017;P均＜0.05),喘息症状较对照组明显减轻(bF组内=8.537,bF组间=11.453,bF交互=13.071；P均＜0.05),呼气峰流量较对照组明显改善(cF组内=9.015,cF组间=12.426,cF交互=14.852;P均＜0.05),6min步行距离较对照组明显增加(dF组内=12.263,dF组间=21.371,d F交互=24.651；P均＜0.05),差异均有统计学意义.结论老年重度COPD患者通过特殊装置(都保)吸入糖皮质激素,不仅有效控制急性加重期喘息症状,而且减少稳定期急性加重次数,提高运动耐量,疗效明显,安全性及耐受性良好.
목적 관찰노년중도만성조새성폐질병(COPD)환자통과특수장치(도보)흡입당피질격소적료효.방법 76례노년중도COPD급성가중기환자(남53례,녀23례),분별안조수궤수자표법분위시험조(38례)화대조조(38례).치료기10 d,시험조흡입포지내덕분흡입제2흡(0.2 mg),매일2차；대조조양화무화흡입포지내덕혼현액1 mg,매일2차,관찰환자천식증상변화.수방기3개월,시험조흡입포지내덕분흡입제1흡(0.1 mg),매일2차치료,대조조정지무화흡입약물,관찰량조환자천식증상、6 min보행거리、급성가중차수.병관찰환자불량반응적발생.대시험수거진행의향성분석화부합방안수거분석.결과 치료결속량조환자천식증상균유현저개선(F치분별위8.746、7.952；P균＜0.05),단량조간치료제1、5、10천천식증상평분비교차이균무통계학의의(P균＞0.05).단시험조환자불량반응발생솔명현저우대조조,차이유통계학의의(x2=11.372,P＜0.01),차치료비용명현저우대조조,차이역유통계학의의(t=4.573,P＜0.01).수방기개시(제0주)량조급성가중빈솔、천식증상、호기봉류량、6 min보행거리비교차이균무통계학의의(P균＞0.05).12주수방기결속시,시험조환자급성가중차수명현저우대조조(aF조내=9.343,aF조간=16.343,aF교호=20.017;P균＜0.05),천식증상교대조조명현감경(bF조내=8.537,bF조간=11.453,bF교호=13.071；P균＜0.05),호기봉류량교대조조명현개선(cF조내=9.015,cF조간=12.426,cF교호=14.852;P균＜0.05),6min보행거리교대조조명현증가(dF조내=12.263,dF조간=21.371,d F교호=24.651；P균＜0.05),차이균유통계학의의.결론 노년중도COPD환자통과특수장치(도보)흡입당피질격소,불부유효공제급성가중기천식증상,이차감소은정기급성가중차수,제고운동내량,료효명현,안전성급내수성량호.
Objective To investigate the curative effects of old age severe chronic obstructive pulmonary disease (COPD) patients inhaled Glucocorticoids with the special devices (Turbuhaler).Methods Seventy-six cases of elderly patients with severe acute exacerbation of COPD patients (53 males,23 females) were divided into experimental group(n =38) and control group(n =38),respectively,according to the random number table.In 10 days of therapy,patients of experimental group inhaled budesonide powder of inhalation 0.2 mg twice daily;Control group inhaled oxygen atomization budesonide suspension 1mg twice daily.The changes of panting symptom were observed.Three months followed-up,the test team inhaled budesonide powder of inhalation 1 mg twice daily,control group stopped inhaling drugs,all patients of panting symptom were observed,also were six-minutes walking distance,the frequency of acute exacerbation and adverse reaction.Intent and compliance program data analysis were performed of the experimental data.Results At the end of the stage of therapy,panting symptom of two group patients were all improved (F =8.746,7.952 respectively,P ＜ 0.05) ; Wheezing score between the two groups 1,5,10 days of treatment differences were not statistically significant(P ＞ 0.05).But the incidence rate of adverse reaction in experimental group was significantly lower than that of control group(x2 =11.372,P ＜0.01),and the treatment costs of test team was significantly lower than that of control group(t =4.573,P ＜ 0.01).At the start of the follow-up period (week 0),two groups of acute exacerbation frequency,wheezing,peak expiratory flow and 6 minutes walking distance had no significant difference(P ＞ 0.05).When follow-up period was at tne end of 12 weeks.The test group of patients with acute exacerbation frequency was significantly lower than the control group(aF within grouP =9.343,aF between groups =16.343,the aF interaction =20.017 ; P ＜ 0.05),wheezing in the control group was significantly mitigate (bF within group =8.537,b F between groups =11.453,bF interaction =13.071 ; P ＜ 0.05),and peak expiratory flow rate than the control group improved significantly (cF within group =9.015,cF between groups =12.426,cF interaction =14.852 ;P ＜ 0.05),6 min walking distance increased significantly compared with the control group (d F within group =12.263,d F between groups =21.371,d F interactive =24.651 ; P ＜ 0.05),the differences were statistically significant.Conclusion Elderly patients with moderate to severe COPD inhaled Glucocorticoids,with the special devices(Turbuhaler),not only in acute exacerbation stage the panting symptom was controlled; but also in stable phase the frequency of acute exacerbation was decreased,and the exercise tolerance was improved.Curative effect is obvious withsafety and well-tolerated.