从小气道病变探讨药物干预早期COPD的临床效果  

Exploring the clinical effects of pharmacological intervention in early COPD from the perspective of small airway lesions

作　　者：黄旺[1] 罗培丰 薛爱丽 江丽慧[1] 张文昌[1] 张素平 HUANG Wang;LUO Peifeng;XUE Aili;JIANG Lihui;ZHANG Wenchang;ZHANG Suping(Department of Respiratory Medicine,the Second Hospital of Longyan City in Fujian Province,Longyan 364000,China)

机构地区：[1]福建省龙岩市第二医院呼吸内科,福建龙岩364000

出　　处：《中国现代医生》2021年第36期41-44,共4页China Modern Doctor

基　　金：福建省龙岩市科技计划项目(2018LYF5017)。

摘　　要：目的从小气道病变角度探讨孟鲁司特、噻托溴铵两药联用干预早期慢性阻塞性肺疾病(COPD)的效果。方法选取2018年6月至2020年1月我院呼吸内科门诊及体检科符合早期COPD的患者120例,按随机数字表法分为研究组和对照组,每组各60例;研究组选用孟鲁司特+噻托溴铵早期干预COPD,对照组服用维生素C,观察两组小气道病变变化情况。结果研究组的总有效率为96.67%,明显高于对照组的18.33%,差异有统计学意义(P<0.05);研究组治疗后的MEF75、MEF50、MEF25、RV/TLC、CAT指标均明显优于治疗前,差异有统计学意义(P<0.01)。结论早期COPD患者选用孟鲁司特+噻托溴铵进行干预,效果显著,胸闷、咳嗽、呼吸困难等自觉症状及肺功能均获明显改善,临床应用价值较高,值得推广。Objective To observe the effect of the combination of montelukast sodium and tiotropium bromide in early chronic obstructive pulmonary disease(COPD)from the perspective of small airway lesions.Methods A total of 120 patients with early COPD in outpatient clinic of the department of respiratory medicine and the department of physical examination from June 2018 to January 2020 were selected and randomly grouped into the study group(n=60)and the control group(n=60).The study group received montelukast sodium+tiotropium bromide for early intervention of COPD,while the control group was treated with oral vitamin C.The changes of small airway lesions in both groups were observed.Results The efficacy of the study group was 96.67%,which was significantly better than 18.33%of the control group,with statistically significant differences(P<0.05).The maximal expiratory flow in 75%vital capacity(MEF75),maximal expiratory flow in 50%vital capacity(MEF50),maximal expiratory flow in 25%vital capacity(MEF25),residual volume/total lung capacity(RV/TLC),COPD Assessment Test(CAT)score of the study group after treatment were sig nificantly better than those before treatment,with statistically significant differences(P<0.01).Conclusion The interven tion of montelukast sodium+tiotropium bromide in early COPD patients is significantly effective in improving chest tightness,cough,dyspnea and other self-conscious symptoms and pulmonary function,and is worthy of application and promotion in clinic.

关 键 词：早期COPD 孟鲁司特 噻托溴铵 肺功能检测 小气道病变 COPD自我问卷评估测试 

分 类 号：R563.9[医药卫生—呼吸系统]