三联药物雾化吸入对重症哮喘患者的临床疗效及安全性观察  

Efficacy and security of triple aerosol inhalation of pulmicort respules,ventolin and ipratropine in treatment of severe acute asthma exacerbations

作　　者：王佩芳[1] 

机构地区：[1]慈溪市人民医院呼吸内科,浙江省慈溪315300

出　　处：《中国基层医药》2017年第11期1719-1723,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨布地奈德、硫酸沙丁胺醇雾化溶液和异丙托溴铵溶液三联药物雾化吸入对重症哮喘患者的临床疗效及安全性.方法 选取78例成人重症哮喘患者,采用随机数字表法将患者随机分为研究组和对照组,各39例.对照组患者接受静脉滴注甲泼尼龙的常规治疗,研究组在上述基础上接受布地奈德、硫酸沙丁胺醇雾化溶液和异丙托溴铵溶液三联药物雾化吸入治疗.观察并比较两组患者的临床疗效、甲泼尼龙使用量和使用时间、哮喘症状评分、哮喘症状消失的时间以及不良反应发生率.结果 研究组治疗有效率为97.44%（38/39）,高于对照组的82.05%（32/39）,研究组临床疗效优于对照组（x2=5.014,P＜0.05）;研究组甲泼尼龙使用量及使用时间均低于对照组（t=-6.410、-3.993,均P＜0.05）;治疗后,两组患者日间及夜间哮喘评分均低于治疗前（均P＜0.05）;治疗后,研究组在同一天的日间及夜间哮喘评分均低于对照组（均P＜0.05）;研究组患者气促、胸闷、喘息、肺内肠鸣音消失的时间均短于对照组（t=-4.709、-2.929、-5.253、-4.082,均P＜0.05）;研究组不良反应发生率为12.8%（5/39）,对照组为15.4%（6/39）,两组间差异无统计学意义（x2=0.106,P＞0.05）.结论 在静脉用药的基础上联合布地奈德、硫酸沙丁胺醇雾化溶液和异丙托溴铵溶液三联药物雾化吸入治疗重症哮喘患者,能减低静脉使用甲泼尼龙的用量,可有效减轻患者的哮喘症状,疗效显著,临床价值较高,值得推广应用.Objective To investigate the clinical efficacy and safety of intravenous inhalation of pumicillin,ventolin and ipratropine in the treatment of severe acute asthma exacerbations in adults.Methods 78 adult patients with severe asthma were randomly divided into research group and control group by the method of random number table.The patients in the control group received routine treatment,it was intravenous infusion of methylprednisolone.On the basis of the above, the research group received intravenous inhalation of pumicil.The clinical efficacy,methylprednisolone use and use of time,asthma symptoms score,the disappearance of asthma symptoms and the incidence of adverse reactions of the two groups were observed and compared.Results The effective rate of the research group was 97.44% （38/39）,which was higher than 82.05% （32/39） of the control group （x2=5.014,P〈0.05）.The amount and time of use of methylprednisolone in the study group were lower than those in the control group（t=-6.410,-3.993,all P〈0.05）.After treatment,the daily and nocturnal asthma scores of the two groups were lower than those before treatment （all P〈0.05）.After treatment,daily and nocturnal asthma scores in the same day of the research group were lower than the control group （all P〈0.05）.The time of disappearance of shortness of breath,chest tightness,wheezing and intrapulmonary bowel sounds were shorter in the research group than those in the control group（t=-4.709,-2.929,-5.253,-4.082,all P〈0.05）.The incidence of adverse reactions in the study group was 12.8%（5/39）,which in the control group was 15.4%（6/39）,the differences was no statistically significant（x2=0.106,P〉0.05）.Conclusion On the basis of intravenous medication,combined with pumicillin,ventolin and ipratropine triple inhalation in the treatment of severe asthma patients,can reduce the intravenous use of methylprednisolone,it was effective in patients with asthma symptoms,the clinical efficacy is significant,the clinical value is high

关 键 词：哮喘 布地奈德 硫酸沙丁胺醇雾化溶液 异丙托溴铵溶液 

分 类 号：R562.25[医药卫生—呼吸系统]