摘要
目的:探讨吸入型糖皮质激素(ICS)联合长效双支气管扩张剂在稳定期尘肺合并COPD患者中的应用效果。方法:选取2019年5月-2020年5月就诊于十堰市太和医院门诊的120例尘肺合并COPD患者,采用随机数字表法将患者分为A组和B组,各60例。A组给予常规治疗+长效β_(2)受体激动剂(LABA)+长效胆碱能受体拮抗剂(LAMA),B组给予常规治疗+ICS+LABA+LAMA。比较两组的肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、第1秒用力呼气容积与用力肺活量比值(FEV_(1)/FVC)],评估患者临床症状(CAT、mMRC),不良反应的发生情况及急性加重的次数。结果:治疗6个月后,两组肺功能指标均优于治疗前,差异均有统计学意义(P<0.05);两组治疗6个月后的肺功能指标比较,差异均无统计学意义(P>0.05)。两组治疗6个月后的CAT和mMRC评分均低于治疗前,且B组均高于A组,差异均有统计学意义(P<0.05)。在不良反应方面,B组肺部感染发生率高于A组,差异有统计学意义(P<0.05)。治疗6个月后,两组急性加重次数相比,差异无统计学意义(P>0.05)。结论:在尘肺合并COPD患者的治疗中,ICS联合LAMA+LABA治疗患者临床症状改善程度不如单用LAMA+LABA,可能会增加肺部感染的发生。
Objective:To investigate the effect of inhaled corticosteroid(ICS)combined with long-acting double bronchodilators in patients with stable pneumoconiosis complicated with COPD.Method:A total of 120 patients with pneumoconiosis complicated with COPD hospitalized in Taihe Hospital of Shiyan City from May 2019 to May 2020 were selected,and they were divided into group A and group B by random number table method,with 60 cases in each group.Group A received conventional treatment+long-actingβ_(2) agonist(LABA)+long-acting muscaring cholinergic receptor antagonist(LAMA),and group B received conventional treatment+ICS+LABA+LAMA.Lung function[forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1)),ratio of forced expiratory volume in one second to forced vital capacity(FEV_(1)/FVC)],clinical symptoms(CAT,mMRC),occurrence of adverse reactions and times of acute exacerbations were evaluated between the two groups.Result:After 6 months of treatment,the lung function indexes of the two groups were better than those before treatment,with statistical significances(P<0.05);while there were no statistical significances in lung function indexes between the two groups after 6 months of treatment(P>0.05).After 6 months of treatment,CAT and mMRC scores in two groups were lower than those before treatment,and group B were higher than those of group A,the differences were statistically significant(P<0.05).In terms of adverse reactions,incidence of pulmonary infection in group B was higher than that in group A,the difference was statistically significant(P<0.05).After 6 months of treatment,there was no significant difference between the two groups in the reduction of acute exacerbations(P>0.05).Conclusion:In the treatment of patients with pneumoconiosis combined with COPD,the clinical symptoms of ICS combined with LAMA+LABA are not as improved as LAMA+LABA alone,which may increase the occurrence of pulmonary infection.
作者
冯莉
赵琪琪
刘玉全
王梅芳
FENG Li;ZHAO Qiqi;LIU Yuquan;WANG Meifang(Postgraduate Training Basement of Jinzhou Medical University,Taihe Hospital of Shiyan City,Hubei University of Medicine,Shiyan 442000,China;不详)
出处
《中国医学创新》
CAS
2022年第20期38-42,共5页
Medical Innovation of China
