噻托溴铵联合N-乙酰半胱氨酸及呼吸训练治疗稳定期中度慢阻肺的临床观察  

Clinical observation of tiotropium combined with N-acetylcysteine and breathing exercises? in the treatment of moderate chronic obstructive pulmonary disease at stable stage

作　　者：樊有[1] 顾晓燕[2] 蒋德升[1] 王毓薇[1] 沈素娥[2] 张建涛[2] 侯玉昆[2] 于天培 

机构地区：[1]解放军第四五四医院呼吸科,江苏南京210002 [2]解放军第四五四医院康复科,江苏南京210002

出　　处：《临床肺科杂志》2016年第3期498-501,共4页Journal of Clinical Pulmonary Medicine

基　　金：全军医学科技青年培育项目(No 14QNP040)

摘　　要：目的探讨噻托溴铵联合N-乙酰半胱氨酸(N-acetylcysteine,NAC)及呼吸训练对稳定期中度慢性阻塞性肺病(简称慢阻肺)患者的临床治疗效果。方法筛选稳定期中度慢阻肺患者,随机分为噻托溴铵治疗组、噻托溴铵+NAC治疗组和噻托溴铵+NAC+呼吸训练治疗组,各33例。在治疗前、治疗后6个月评定临床症状、改良英国MRC呼吸困难指数(m MRC)、6分钟步行距离(6-minute walk distance,6MWD)及肺功能。结果各组患者治疗前临床症状评分、m MRC评分、6MWD及1秒用力呼气容积(FEV_1)占预计值百分比(FEV_1%)、FEV_1/用力肺活量(forced vital capacity,FVC)比较均无显著差异(P>0.05)。治疗6个月后,患者的临床症状及m MRC评分下降,FEV_1%、FEV_1/FVC及6MWD均增加(P<0.05),而噻托溴铵+NAC+呼吸训练治疗组临床症状及mMRC评分、FEV_1%、6MWD的改善效果均优于同期对照组(P<0.05)。结论噻托溴铵联合NAC和呼吸训练治疗对改善慢阻肺患者的临床症状、增加运动耐力有显著疗效。Objective To explore the clinical effect of tiotropium combined with N-acetylcysteine and breathing exercises in the treatment of chronic obstructive pulmonary disease （COPD） at stable stage. Methods COPD patients were randomly divided into three groups： the tiotropium treatment group （the group A）, the tiotropium＋ breathing exercises group （ the group B）, and the tiotropium ＋ NAC ＋ breathing exercises treatment group （ the group C ）, 33 cases in every group. Their clinical symptoms, modified medical research council dyspnea scale （mMRC）, lung function and six-minute walking distance （6MWD） were determined before and after treatment. Results There was no significant differences in clinical symptoms, mMRC, 6MWD and FEV1/FVC among the three groups before treatment （P 〉 0. 05 ）. After six months follow-up, the obvious improvements of clinical symptoms, mMRC, FEV1 , FEV, FVC and 6MWD were observed in the three groups （P 〈 0. 05 ）, and the improvement was more pronounced in the group C than in the rest two groups （P 〈 0. 05）. Conclusion Tiotropium combined with NAC and breathing exercises can relieve clinical symptoms and increase the exercise endurance？ of COPD patients, which could be contribute to improve the quality of life.

关 键 词：噻托溴铵 N-乙酰半胱氨酸 呼吸训练 慢性阻塞性肺病 

分 类 号：R563.9[医药卫生—呼吸系统]