沙美特罗/丙酸氟替卡松联合缩唇呼吸治疗尘肺病合并慢性阻塞性肺疾病效果研究  

Effect of salmeterol/fluticasone propionate combined with lip shrinkage respiration on the treatment of pneumoconiosis complicated COPD

作　　者：刘英姿[1,2] 王凤玲[2] 王东升[1] 王春兰[1] 杨冠英[1] 徐勇[1] 

机构地区：[1]大庆市人民医院,黑龙江大庆163000 [2]佳木斯大学第一附属医院,佳木斯154003

出　　处：《中国职业医学》2016年第2期148-151,共4页China Occupational Medicine

基　　金：黑龙江省卫生厅科技计划项目(2013111)

摘　　要：目的观察沙美特罗/丙酸氟替卡松联合缩唇呼吸治疗尘肺病合并慢性阻塞性肺疾病(COPD)患者的效果。方法采用简单随机数字表法,将98例处于病情稳定期的尘肺病合并COPD患者分为药物治疗组(33例,仅予吸入沙美特罗/丙酸氟替卡松50μg/500μg,2次/d)、缩唇呼吸组(34例,仅予腹式呼吸及缩唇呼吸训练,15 min/次,3次/d)和联合治疗组(31例,同时予上述2种治疗),治疗前和治疗6个月后检查患者肺功能、6 min步行距离和血氧饱和度(Sa O2),采用改良版《英国医学研究委员会呼吸问卷》(m MRC)评价患者呼吸困难程度。结果与治疗前比较,3组患者治疗6个月的用力肺活量占预计值百分比(FVC%)、第1秒用力呼出容积占预计值的百分比(FEV1%)、最大通气量(MVV)、6 min步行距离、m MRC问卷分级和Sa O2均改善(P<0.05)。治疗后,与舒利迭组和缩唇呼吸组比较,联合治疗组患者FVC%、FEV1%、MVV、6 min步行距离和Sa O2均升高(P<0.05),m MRC问卷分级下降(P<0.05)。结论沙美特罗/丙酸氟替卡松联合缩唇呼吸治疗对尘肺合并COPD患者治疗效果优于单一治疗方法的应用。Objective To observe the effects of combined treatment using salmeterol / fluticasone propionate and lip shrinkage respiration on the treatment of patients with pneumoconiosis complicated with chronic obstructive pulmonary disease（ COPD）. Methods By random number table method,98 patients with stable pneumoconiosis complicated with COPD were divided into 3 groups： drug treatment group（ 33 cases） was treated only with inhalation of salmeterol /fluticasone propionate（ 50 μg /500 μg）,twice a day; lip shrinkage respiration group（ 34 cases） was treated with abdominal breathing and lip shrinkage respiration training,three times daily for 15 min per session; combined treatment group（ 31 cases） was treated with both the above treatments. Before and after 6 months of treatment,the lung function,the 6-minute walk distance and the oxygen saturation（ Sa O2） were detected. The modified Medical Research Council（ m MRC） Respiratory Questionnaire was used to evaluate the degree of dyspnea. Results After 6 months of treatment,the forced vital capacity percentage（ FVC%）,percentage of forced expiratory volume in one second（ FEV1%）,maximum ventilatory volume（ MVV）,6-minute walking distance,m MRC degree and the Sa O2 improved in the patients of these 3groups compared with those before treatment（ P〈0. 05）. Compared with the drug treatment group or lip shrinkage respiration group after treatment,the FVC%,FEV1%,MVV,6-minute walking distance and the Sa O2 in the combined treatment group were higher（ P〈0. 05）,and the m MRC degree was lower（ P〈0. 05）. Conclusion Salmeterol /fluticasone propionate combined with lip shrinkage respiration treatment had better therapeutic effect than single treatment in treating patients with pneumoconiosis combined with COPD.

关 键 词：尘肺病 慢性阻塞性肺疾病 沙美特罗/丙酸氟替卡松 缩唇呼吸 小气道功能 联合治疗 

分 类 号：R135.2[医药卫生—劳动卫生]