刘瑛
LIU Ying

• 1:成都市龙泉驿区第一人民医院呼吸科

摘要(Abstract)：

目的:探讨吸入糖皮质激素治疗稳定期慢性阻塞性肺病的临床疗效。方法:将98例稳定期慢性阻塞性肺病患者按数字表法随机分为两组,对照组进行氧疗、祛痰以及按需吸入沙丁胺醇等常规治疗,观察组患者在对照组治疗的基础上吸入布地奈德(一种非卤素糖皮质激素)气雾剂进行治疗,比较两组患者治疗前后肺功能、呼吸困难评分、临床症状评分、生活质量评分、临床总有效率和不良反应发生率。结果:治疗后观察组的肺功能以及呼吸困难评分、临床症状评分、生活质量评分的改善情况明显优于对照组;观察组总有效率为93.88%,明显高于对照组的75.51%,差异均具有统计学意义(χ2=9.87,P<0.05),而不良反应率分别为18.37%、16.33%,差异无统计学意义(χ2=3.12,P>0.05)。结论:吸入糖皮质激素治疗稳定期慢性阻塞性肺病的疗效优于常规治疗,可改善患者临床症状,提高生活质量,不良反应少。
Objective: To explore the curative efficacy of corticosteroid inhalation in treating stable chronic obstructive pulmonary disease( COPD). Methods: A total of 98 patients with stable COPD were randomly divided into two groups by using digital table method. The control group was given conventional treatment such as oxygen therapy,expectorant and inhalation salbutamol based on demand. Observation group was given budesonide aerosol inhalation in addition to the treatment of control group. Pulmonary function and dyspnea scores,clinical symptom scores,life quality scores,total effective rate and adverse reaction incidence of the two groups were observed and compared before and after treatment. Results: After treatment,the improvement of lung function,dyspnea scores,clinical symptom scores and life quality scores was more obvious than that of control group. The total effective rate of observation group( 93. 88%) was significantly higher than that of control group( 75. 51%),the difference was statistically significant( χ2= 9. 87,P < 0. 05). Adverse reaction rates of observation group and control group were 18. 37% and 16. 33% respectively,the difference was not statistically significant( χ2= 3. 12,P > 0. 05). Conclusions: The curative efficacy of corticosteroid inhalation in treating stable COPD is better than that of conventional treatment. Corticosteroid inhalation can improve the clinical symptoms and life quality and cause less adverse reaction.

关键词(KeyWords)： 糖皮质激素类;肺疾病,慢性阻塞性;吸入法;疗效;不良反应
glucocorticoids;pulmonary disease,chronic obstructive;inhalation;curative efficacy;adverse reaction

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 刘瑛
LIU Ying

DOI: 10.19367/j.cnki.1000-2707.2014.02.021

参考文献(References)：

• [1]刘鹏珍,乔丽霞,姚翠玲.吸入糖皮质激素治疗稳定期COPD的疗效观察[J].临床肺科杂志,2010(4):537-538.
• [2]段炼.吸入糖皮质激素治疗稳定期COPD疗效研究[J].华西医学,2009(6):1435-1437.
• [3]蔡显斌,田明庆.吸入型糖皮质激素治疗COPD疗效观察[J].现代中西医结合杂志,2010(34):4420-4421.
• [4]Zhang C,Cai S,Chen P,et a1.Inhibition of TNF-a reduces alveolar septal cell apotosis in passive smoking rats[J].Chin Med J,2008(12):597-601.
• [5]Dat NR,Eandi M,Pradelli L,et a1.Cost-effectiveness and health care budget impact in Italy of inhaled corticosteruids and bronehodi-lators for severe and very severe COPD patients[J].Int J Chron Obstruct Pulmon Dis,2007(2):169-176.
• [6]Claes GL,Asa E,Klas S,et a1.Cost effectiveness of budesonide/for moterol in a single inhaler for COPD compared with each monocom-ponent used alone[J].Pharmaeoeeonomics,2005(4):365-375.
• [7]赵可辉,刘翠红,王瑁.长期联合吸入糖皮质激素及长效受体激动剂对慢性阻塞性肺疾病患者肺功能的影响[J].临床荟萃,2010(14):1267-1269.
• [8]中华医学会呼吸病学分会慢性阻塞性肺疾病组.《慢性阻塞性肺疾病诊治指南》[J].中华结核与呼吸杂志,2007(30):8-17.
• [9]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2007年修订版)[J].中华结核和呼吸杂志,2009(12):126-127.
• [10]钱朝霞,何艳,方陈,等.不同剂量布地奈德雾化吸入和泼尼松龙静脉用药治疗AECOPD的对比研究[J].临床肺科杂志,2010(4):488.
• [11]刘丽,罗如滢,蒋胜华,等.糖皮质激素对慢性阻塞性肺疾病急性期的疗效观察[J].南华大学学报:医学版,2008(1):67-70.
• [12]宋立华.吸入糖皮质激素治疗稳定期慢性阻塞性肺疾病的临床疗效观察[J].中国保健营养,2012(16):13-18.
• [13]薛金凤.雾化吸入布地奈德混悬液治疗AECOPD疗效分析[J].临床肺科杂志,2011(8):23-28.
• [14]顾剑玲,王婷,马薇.布地奈德治疗慢性阻塞性肺疾病急性加重临床疗效观察[J].医学综述,2011(8):212-234.
• [15]林凡峰,林凡源,张效艳.沙丁胺醇联合布地奈德雾化吸入对慢性阻塞性肺疾病急性发作的疗效分析[J].临床合理用药杂志,2011(3):29-32.

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