不同剂量茶碱联合吸入治疗对重度COPD的疗效研究  

Study on the effect of different doses of theophylline combined with salmeterol-fluticasone on severe COPD patients

作　　者：陈琳 陈慧 孙雪皎[1] 袁焱[1] 刘琼霞[1] CHEN Lin;CHEN Hui;SUN Xuejiao;YUAN Yan;LIU Qiongxia(Department of Respiratory and Critical Care Medicine,Liuzhou People′s Hospital,Liuzhou,Guangxi 545006,China)

机构地区：[1]广西壮族自治区柳州市人民医院呼吸内科,545006

出　　处：《重庆医学》2021年第4期616-620,共5页Chongqing medicine

基　　金：广西壮族自治区自筹经费课题(Z20180273);广西壮族自治区柳州市科技计划项目(2018BJ10507)。

摘　　要：目的探讨不同剂量茶碱联合吸入治疗对重度慢性阻塞性肺疾病(COPD)的疗效。方法将2018年7月至2019年5月该院门诊就诊的60例重度稳定期COPD患者分为小剂量茶碱联合治疗组(20例,吸入沙美特罗替卡松50/500μg+口服茶碱缓释片0.1 g,每日两次)、常规剂量茶碱联合治疗组(20例,吸入沙美特罗替卡松50/500μg+口服茶碱缓释片0.2 g,每日两次)和沙美特罗替卡松组(20例,吸入沙美特罗替卡松50/500μg)。比较治疗前及治疗后1、3、6个月外周血白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)及肺功能、慢性阻塞性肺病自我评估测试(CAT)评分及药物不良反应发生情况。结果各组治疗后1、3、6个月IL-8、TNF-α水平均较治疗前下降,且治疗后3、6个月较治疗后1个月明显下降,差异有统计学意义(P<0.05)。同时,小剂量茶碱联合治疗组和常规剂量茶碱联合治疗组较沙美特罗替卡松组降低更明显,差异有统计学意义(P<0.05)。小剂量茶碱联合治疗组和常规剂量茶碱联合治疗组治疗后3、6个月MEF50%及MEF25%预测值较治疗前升高,且治疗后6个月较治疗后1个月明显升高,差异有统计学意义(P<0.05)。治疗后1、3、6个月各组CAT评分较治疗前降低,且治疗后6个月较治疗后1个月明显降低(P<0.05)。各组不良反应发生率比较,差异无统计学意义(P>0.05)。结论小剂量茶碱联合吸入治疗对重度COPD可能有益。Objective To study the efficacy and safety of different doses of theophylline combined with salmeterol-fluticasone treatment for severe chronic obstructive pulmonary disease(COPD)patients.Methods Recruited 60 patients with severe stable COPD from July 2018 to May 2019,and divided into the low dose theophylline combined treatment group(n=20,theophylline 0.1 g+Salmeterol-fluticasone 50/500μg,twice daily),the conventional dose theophylline combined treatment group(n=20,theophylline 0.2 g+Salmeterol-fluticasone 50/500μg,twice daily)and the salmeterol-fluticasone group(n=20,salmeterol-fluticasone 50/500μg,twice daily).The concentration of interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)in peripheral blood,lung function,chronic obstructive pulmonary disease self-assessment test(CAT)score and the adverse effects before and after the treatment at 1 month,3 months and 6 months were compared.Results The levels of IL-8 and TNF-αin each group decreased at 1,3,and 6 months after treatment compared with those before treatment,while compared with 1 month after treatment,the levels at 3 and 6 months after treatment decreased more,the difference was statistically significant(P<0.05).At the same time,the low dose theophylline combined treatment group and the conventional dose theophylline combined treatment group had a more significant reduction than the salmeterol-fluticasone group,the difference was statistically significant(P<0.05).MEF50%and MEF25%in the low dose theophylline combined treatment group andthe conventional dose theophylline combined treatment group increased at 3 and 6 months after treatment compared with before treatment,while compared with 1 month after treatment,the levels at 6 months after treatment increased more,the difference was statistical significant(P<0.05).CAT score of each group at 1,3,and 6 months after treatment was lower than that before treatment,while compared with 1 month after treatment,the levels at 6 months after treatment decreased more(P<0.05).There was no significant difference in

关 键 词：茶碱 肺疾病 慢性阻塞性 糖皮质激素类 呼吸功能试验 组蛋白脱乙酰基酶2 治疗结果 

分 类 号：R563.3[医药卫生—呼吸系统]