噻托溴铵辅助治疗哮喘-慢阻肺重叠综合征的可行性及对血清TNF-α、IL-6的影响  

The Efficacy of Tiotropium Bromide in the Treatment of Asthma-chronic Obstructive Pulmonary Overlap Syndrome and Its Effect on Serum TNF-α and ⅠL-6

作　　者：缪卓峰 郭伟洪[1] 林宇鹏[1] MIAO Zhuofeng;GUO Weihong;LIN Yupeng(Zhongshan People’s Hospital,Zhongshan 528400,China)

机构地区：[1]广东省中山市人民医院,广东中山528400

出　　处：《中国医学创新》2018年第35期6-10,共5页Medical Innovation of China

基　　金：中山市医学科研项目(2014A1FC090)

摘　　要：目的:探讨噻托溴铵与异丙托溴铵辅助治疗哮喘-慢阻肺重叠综合征(ACOS)的效果差异及对血清TNF-α、IL-6的影响。方法:选取本院2015年2月-2017年11月收治的哮喘-慢阻肺重叠综合征患者80例,按照随机数字表法分为噻托溴铵组和异丙托溴铵组,各40例。噻托溴铵组在给予相应基础治疗的同时给予噻托溴铵治疗,异丙托溴铵组在相同基础治疗上给予异丙托溴铵治疗。连续治疗8周后,观察两组患者的治疗总有效率,治疗前后的肺功能、哮喘控制测试评分(ACT评分)、慢性阻塞性肺病评估测试(CAT评分)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL-6)的变化,观察两组患者不良反应发生率。结果:连续治疗8周后,噻托溴铵组治疗总有效率为92.50%,显著高于异丙托溴铵组的72.50%,差异有统计学意义(P<0.01);两组患者的FEV1、FVC、FEV1/FVC(%)以及ACT评分较治疗前均明显增加,且噻托溴铵组较异丙托溴铵组增加更为明显,差异均有统计学意义(P<0.01);两组患者的CAT评分、hs-CRP、TNF-α、IL-6较治疗前均明显降低,且噻托溴铵组较异丙托溴铵组降低更为明显,差异均有统计学意义(P<0.01);两组患者不良反应发生率对比,差异无统计学意义(P>0.05)。结论:噻托溴铵辅助治疗哮喘-慢阻肺重叠综合征能够显著提高治疗总有效率,改善肺功能,并能显著降低炎症因子,安全性较好,值得推广应用。Objective:To explore the efficacy of Tiotropium Bromide and Ipratropium Bromide in the adjuvant treatment of ACOS and its effect on serum TNF-α and IL-6.Method:80 patients with ACOS in our hospital from February 2015 to November 2017 were selected,they were randomly divided into Tiotropium Bromide group and Ipratropium Bromide group,according to the random number table method,40 cases in each group.The Tiotropium Bromide group was given Tiotropium Bromide after basic treatment,while the Ipratropium Bromide group was given Ipratropium Bromide on the same basal treatment.8 weeks later,the efficiency of two groups,the pulmonary function,ACT score,CAT score,hs-CRP,TNF-α,IL-6 and the incidence of adverse reactions were observed between the two groups.Result:8 weeks later,the effective rate of Tiotropium Bromide group was 92.50%,significantly higher than 72.50% of the Ipratropium Bromide group,the difference was statistically significant(P<0.01).The FEV1,FVC,FEV1/FVC(%) and ACT scores of two groups were significantly higher than those before treatment,and the Tiotropium Bromide group was more obvious than those in Ipratropium Bromide group,the differences were statistically significant(P<0.01).The CAT score,hs-CRP,TNF-α and IL-6 of the two groups were significantly lower than those before treatment,and the Tiotropium Bromide group were more obvious than those in Ipratropium Bromide group,the differences were statistically significant(P<0.01).There was no difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion:Tiotropium Bromide adjuvant treatment of ACOS can significantly improve the treatment efficiency,improve lung function,and can significantly reduce inflammatory factors, and has good safety,it is worthy of clinical application.

关 键 词：哮喘-慢阻肺重叠综合征 噻托溴铵 异丙托溴铵 肺功能 ACT评分 CAT评分 

分 类 号：R563.9[医药卫生—呼吸系统] R562.25[医药卫生—内科学]