噻托溴铵在重度慢性阻塞性肺疾病治疗中的依从性及疗效评价

钟淑萍+黎艳聪

[摘要] 目的 研究分析噻托溴铵治疗重度慢性阻塞性肺疾病的临床疗效及依从性。方法 选取我院在2016年5～11月收治的72例重度慢性阻塞性肺疾病的患者为研究对象，随机等分为对照组和实验组，对照组在常规吸氧、止咳、平喘等常规治疗的基础上联合使用异丙托溴铵，实验组在常规治疗的基础上联合使用噻托溴铵，两组均治疗12周，比较治疗前后两组患者肺功能改善情况、临床治疗效果、治疗依从性。结果 两组患者治疗前肺功能指标FEV1、FEV1/FVC无明显差异（P>0.05），治疗后两组患者肺功能指标均有明显改善，而实验组明显优于对照组（P<0.05）；实验组治疗总有效率97.22%明显高于对照组77.78%（P<0.05）；两组患者治疗依从性差异无统计学差异（P>0.05）。结论 支气管扩张药物噻托溴铵治疗重度慢性阻塞性肺疾病可以显著改善患者的肺功能，疗效显著，治疗依从性高，值得推广应用。

[关键词] 噻托溴铵；重度慢性阻塞性肺疾病；临床疗效；依从性

[中图分类号] R563.9 [文献标识码] A [文章编号] 2095-0616（2017）08-222-03

[Abstract] Objective To study and analyze the clinical effect of tiotropium bromide in the treatment of severe chronic obstructive pulmonary disease and its compliance. Methods 72 patients with severe chronic obstructive pulmonary disease cured in our hospital from May 2016 to November 2016 were selected as the study objects. And they were randomly divided into control group and experimental group. Patients in control group were treated with ipratropium bromide on the basis of conventional oxygen inhalation， cough， asthma and other conventional treatment， and patients in experimental group were treated with Tiotropium bromide on the basis of routine treatment. All the patients were treated for 12 weeks. Before and after treatment， pulmonary function improvement， clinical treatment effect， treatment compliance of the two groups were compared. Results There was no significant difference in FEV1 and FEV1/FVC between the two groups before treatment（P>0.05）. After treatment， pulmonary function indicators of the two groups were significantly improved， while the experimental group was significantly better than the control group（P<0.05）. The total effective rate of the experimental group was 97.22%， which was higher than that of the control group with 77.78%（P<0.05）. There was no significant difference in treatment compliance between the two groups（P>0.05）. Conclusion Tiotropium bromide（Bronchodilator drugs） in the treatment of severe chronic obstructive pulmonary disease can significantly improve the patients lung function. The curative effect is obvious， and the treatment complianc is high. It is worthy of promotion and application.

[Key words] Tiotropium bromide； Severe chronic obstructive pulmonary disease； Clinical curative effect； Compliance

慢性阻塞性肺疾病（chronic obstructive pulmonarydisease，COPD）是一種基于有害颗粒及气体侵入肺部导致的炎症反应而产生的持续性进行性加重气流受限性的慢性疾病。由于气流受限进行性加重，患者活动能力也在逐步降低，严重时可引起肺功能不全导致死亡，对人们的日常生活及生命安全造成严重影响[1]。导致慢性阻塞性肺疾病患者气流受限的机制主要是胆碱能神经张力异常增高所致，临床上可使用抗胆碱能药物进行治疗[2]。对于重度慢性阻塞性肺疾病患者建议使用长效的支气管扩张剂配合相应的常规治疗，选取何种长效支气管扩张剂治疗重度慢性阻塞性肺疾病是目前临床上争论较多的问题。有……