CAJ | 학술논문

目的：探讨布地奈德联合异丙托溴铵治疗慢性阻塞性肺疾病急性发作临床疗效，并观察治疗过程中的不良反应，分析其治疗的安全性，为临床治疗提供依据。方法选择慢性阻塞性肺疾病急性加重期患者160例，根据入院编号随机分为对照组 A、B、C 和观察组四组，各40例，对照组 A 应用泼尼松等常规治疗，对照组 B 应用氨茶碱等常规治疗；对照组 C 应用泼尼松、氨茶碱等常规治疗，对照组均予以0．9％氯化钠注射液作为安慰剂雾化吸入；观察组在对照组基础上应用布地奈德联合异丙托溴铵治疗。观察各组治疗效果、检测治疗前后血液二氧化碳分压（PaO2）、血氧分压（PaCO2）、一秒钟用力呼气量（FEV1）、一秒钟用力呼气量（FEV1）和一秒钟用力呼气量占用力肺活量 FVC 的比值（FEV1／FVC），并观察患者不良反应，评价其安全性。结果观察组总有效率为95．00％（38／40），高于对照组 A、B、C，差异有统计学意义（χ2＝9．68、9．70、9．91，均 P ＜0．05）；观察组治疗后 PaO2（76．89±0．63）mmHg，高于对照组 A、B、C 治疗后，且各组治疗后均高于治疗前，差异均有统计学意义（t ＝10．48、13．72、12．83，均 P ＜0．05）；观察组治疗后 PaCO2（50．06±0．60）mmHg，低于对照组 A、B、C 治疗后，且各组治疗后均低于治疗前，差异均有统计学意义（t ＝11．72、12．69、10．74，均 P ＜0．05）；观察组治疗后 FEV1和 FEV1／FVC 分别为（2．19±0．29）L 和（69．27±4．59）％，均高于对照组 A、B、C 治疗后，且各组治疗后均高于治疗前，差异均有统计学意义（t ＝12．68、13．10、12．41、9．89、10．63、11．29，均 P ＜0．05）；各组患者不良反应比较，差异无统计学意义（χ2＝1．38，P ＞0．05）。结论布地奈德联合异丙托溴铵治疗慢性阻塞性肺疾病急性发作患者具有较好的临床疗效，能够显著提高患者肺功能，缩短好转时间，并具有较高的安全性，值得临床推广应用。目的：探討佈地奈德聯閤異丙託溴銨治療慢性阻塞性肺疾病急性髮作臨床療效，併觀察治療過程中的不良反應，分析其治療的安全性，為臨床治療提供依據。方法選擇慢性阻塞性肺疾病急性加重期患者160例，根據入院編號隨機分為對照組 A、B、C 和觀察組四組，各40例，對照組 A 應用潑尼鬆等常規治療，對照組 B 應用氨茶堿等常規治療；對照組 C 應用潑尼鬆、氨茶堿等常規治療，對照組均予以0．9％氯化鈉註射液作為安慰劑霧化吸入；觀察組在對照組基礎上應用佈地奈德聯閤異丙託溴銨治療。觀察各組治療效果、檢測治療前後血液二氧化碳分壓（PaO2）、血氧分壓（PaCO2）、一秒鐘用力呼氣量（FEV1）、一秒鐘用力呼氣量（FEV1）和一秒鐘用力呼氣量佔用力肺活量 FVC 的比值（FEV1／FVC），併觀察患者不良反應，評價其安全性。結果觀察組總有效率為95．00％（38／40），高于對照組 A、B、C，差異有統計學意義（χ2＝9．68、9．70、9．91，均 P ＜0．05）；觀察組治療後 PaO2（76．89±0．63）mmHg，高于對照組 A、B、C 治療後，且各組治療後均高于治療前，差異均有統計學意義（t ＝10．48、13．72、12．83，均 P ＜0．05）；觀察組治療後 PaCO2（50．06±0．60）mmHg，低于對照組 A、B、C 治療後，且各組治療後均低于治療前，差異均有統計學意義（t ＝11．72、12．69、10．74，均 P ＜0．05）；觀察組治療後 FEV1和 FEV1／FVC 分彆為（2．19±0．29）L 和（69．27±4．59）％，均高于對照組 A、B、C 治療後，且各組治療後均高于治療前，差異均有統計學意義（t ＝12．68、13．10、12．41、9．89、10．63、11．29，均 P ＜0．05）；各組患者不良反應比較，差異無統計學意義（χ2＝1．38，P ＞0．05）。結論佈地奈德聯閤異丙託溴銨治療慢性阻塞性肺疾病急性髮作患者具有較好的臨床療效，能夠顯著提高患者肺功能，縮短好轉時間，併具有較高的安全性，值得臨床推廣應用。
목적：탐토포지내덕연합이병탁추안치료만성조새성폐질병급성발작림상료효，병관찰치료과정중적불량반응，분석기치료적안전성，위림상치료제공의거。방법선택만성조새성폐질병급성가중기환자160례，근거입원편호수궤분위대조조 A、B、C 화관찰조사조，각40례，대조조 A 응용발니송등상규치료，대조조 B 응용안다감등상규치료；대조조 C 응용발니송、안다감등상규치료，대조조균여이0．9％록화납주사액작위안위제무화흡입；관찰조재대조조기출상응용포지내덕연합이병탁추안치료。관찰각조치료효과、검측치료전후혈액이양화탄분압（PaO2）、혈양분압（PaCO2）、일초종용력호기량（FEV1）、일초종용력호기량（FEV1）화일초종용력호기량점용력폐활량 FVC 적비치（FEV1／FVC），병관찰환자불량반응，평개기안전성。결과관찰조총유효솔위95．00％（38／40），고우대조조 A、B、C，차이유통계학의의（χ2＝9．68、9．70、9．91，균 P ＜0．05）；관찰조치료후 PaO2（76．89±0．63）mmHg，고우대조조 A、B、C 치료후，차각조치료후균고우치료전，차이균유통계학의의（t ＝10．48、13．72、12．83，균 P ＜0．05）；관찰조치료후 PaCO2（50．06±0．60）mmHg，저우대조조 A、B、C 치료후，차각조치료후균저우치료전，차이균유통계학의의（t ＝11．72、12．69、10．74，균 P ＜0．05）；관찰조치료후 FEV1화 FEV1／FVC 분별위（2．19±0．29）L 화（69．27±4．59）％，균고우대조조 A、B、C 치료후，차각조치료후균고우치료전，차이균유통계학의의（t ＝12．68、13．10、12．41、9．89、10．63、11．29，균 P ＜0．05）；각조환자불량반응비교，차이무통계학의의（χ2＝1．38，P ＞0．05）。결론포지내덕연합이병탁추안치료만성조새성폐질병급성발작환자구유교호적림상료효，능구현저제고환자폐공능，축단호전시간，병구유교고적안전성，치득림상추엄응용。
Objective To explore the effect of budesonide combined with ipratropium bromide in the treat-ment of acute exacerbations of chronic obstructive pulmonary disease,and observe the adverse reactions during treat-ment.To analyze the treatment of safety and to provide the basis for clinical treatment.Methods 160 cases of acute exacerbations of chronic obstructive pulmonary disease were selected,they were randomly divided into the control group A,B,C and the observation group,with 40 cases in each group.The control group A was treated with prednisone and other conventional,control group B was treated with aminophylline and other conventional treatment,the control group C application included prednisone,aminophylline and other conventional treatment,all the control group were treated with 0.9% sodium chloride solution inhaled as a placebo spray.And the observation group application of budesonide was combined with ipratropium bromide based on the routine treatment.Mainly the effect of treatment was observed,and the blood carbon dioxide partial pressure (PaO2 ),partial pressure of oxygen (PaCO2 ),forced expiratory volume in one second (FEV1 ),forced expiratory volume in one second (FEV1 )and forced expiratory volume in one second to forced vital capacity ratio of FVC (FEV1 /FVC)before and after treatment were detected.And the adverse reactions were observed to evaluate its safety.Results The total effective rate of the observation group was 95.00%(38 /40),which were higher than the control group A,B and C,the differences were statistically significant (χ2 =9.68,9.70,9.91,all P <0.05).The PaO2 level of the observation group after treatment was (76.89 ±0.63)mmHg, which were higher than that of the control group after treatment (73.66 ±0.47)mmHg,and that of two groups after treatment were higher than those before treatment,the differences were statistically significant (t =10.48,13.72,12.83,all P <0.05).The PaCO2 of the observation group after treatment was (50.06 ±0.60)mmHg,which were lower than that of the control group A,B and C after the treatment,each group after treatment was lower than that before treatment,the differences were statistically significant (t =11.72,12.69,10.74,all P <0.05 ).FEV1 and FEV1 /FVC of the observation group after treatment were (2.19 ±0.29)L and (69.27 ±0.59)%,which were higher than those of the control group A,B and C after treatment,and each groupafter treatment was higher than that before treatment,the differences were statistically significant (t =12.68,13.10,12.41,9.89,10.63,11.29,all P <0.05). Comparison of adverse reactions in each group,the difference was not statistically significant (χ2 =1.38,P >0.05). Conclusion It has good clinical curative effect on budesonide combined with ipratropium bromide for the treatment of acute exacerbations of chronic obstructive pulmonary disease patients,which can significantly improve the pulmona-ry function of patients,shorten recovery time,and has high security.It is worthy of clinical application.