噻托溴銨聯合肺康復治療輕中度支氣管擴張癥的療效_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

蔡仁萍 , 潘倩倩 , 孫培欣 , 時海洋 ,  呂紅霞

山東第一醫科大學附屬萊鋼醫院呼吸科（山東濟南 250000）;

Corresponding?author：

呂紅霞, Email: lhx761006@sina.com

Keywords：

噻托溴銨; 支氣管擴張癥; 支氣管擴張嚴重程度指數; 肺康復

DOI：

10.7507/1671-6205.201904009

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目的探討噻托溴銨聯合肺康復治療輕中度穩定期支氣管擴張癥的有效性。方法納入 2017 年 9 月至 12 月就診于山東第一醫科大學附屬萊鋼醫院呼吸科支氣管擴張嚴重程度指數（BSI）評分為輕中度的穩定期支氣管擴張癥患者 90 例，隨機分為常規治療組、噻托溴銨組和聯合治療組，各 30 例。規律治療 1 年后，比較三組患者改良呼吸困難指數（mMRC）評分、BSI 評分和肺通氣功能檢查的變化。結果治療后常規治療組 mMRC 為（2.00±1.08）分，BSI 評分為（4.40±0.89）分，明顯高于聯合治療組［（1.37±0.49）分、（2.37±1.13）分］和噻托溴銨組［（1.47±0.57）分、（3.40±1.16）分］，差異均有統計學意義（均 P<0.05）。常規治療組第 1 秒用力呼氣容積占預計值百分比（FEV₁%pred）為（71.70±6.46）%，用力肺活量占預計值百分比（FVC%pred）為（63.80±6.67）%，FEV₁/FVC 為（74.00±5.47）%，明顯低于噻托溴銨組［（74.97±5.33）%、（70.83±8.41）%、（79.47±4.90）%］和聯合治療組［（78.53±4.75）%、（74.23±5.19）%、（81.70±5.80）%］，差異均有統計學意義（均 P<0.05）。聯合治療組 FEV₁%pred 明顯高于噻托溴銨組，而 BSI 評分明顯低于噻托溴銨組，差異有統計學意義（P<0.05）。結論噻托溴銨粉吸入劑聯合肺康復治療能減輕支氣管擴張癥患者的呼吸困難，提高肺通氣功能，改善預后。

Citation： 蔡仁萍, 潘倩倩, 孫培欣, 時海洋, 呂紅霞. 噻托溴銨聯合肺康復治療輕中度支氣管擴張癥的療效. Chinese Journal of Respiratory and Critical Care Medicine, 2020, 19(4): 403-406. doi: 10.7507/1671-6205.201904009 Copy

1.	周玉民, 王辰, 姚婉貞, 等. 我國7省市40歲及以上居民支氣管擴張癥的患病情況及危險因素調查. 中華內科雜志, 2013, 52(5): 379-382.
2.	梅靜靜, 王煥勤, 劉媛華, 等. LABA/LAMA和LABA/ICS治療COPD穩定期的安全性及有效性薈萃分析. 國際呼吸雜志, 2018, 38(14): 1041-1048.
3.	Spruit MA, Singh SJ, Garvey C, et al. ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med, 2013, 188(8): e13-64.
4.	Corhay JL, Dang DN, Van CH, et al. Pulmonary rehabilitation and COPD: providing patients a good environment for optimizing therapy. Int J Chron Obstruct Pulmon Dis, 2014, 9: 27-39.
5.	張靜, 尚茜, 馬利軍, 等. 肺康復治療中重度穩定期慢性阻塞性肺疾病患者的療效觀察. 中國呼吸與危重監護雜志, 2019, 18(4): 314-317.
6.	Chalmers JD, Goeminne P, Aliberti S, et al. The bronchiectasis severity index. An international derivation and validation study. Am J Respir Crit Care Med, 2014, 189(5): 576-585.
7.	成人支氣管擴張癥診治專家共識編寫組. 成人支氣管擴張癥診治專家共識. 中華結核和呼吸雜志, 2012, 35(7): 485-492.
8.	Pothirat C, Chaiwong W, Phetsuk N. Efficacy of a simple and inexpensive exercise training program for advanced chronic obstructive pulmonary disease patients in community hospitals. J Thorac Dis, 2015, 7(4): 637-643.
9.	劉振剛. 吸入沙美特羅替卡松治療支氣管擴張合并氣流受限患者的前瞻性\隨機對照研究[D]. 山東: 山東大學醫學院, 2012.
10.	Martinez-Garcia MA, Soler-Cataluna JJ, Catalan-Serra P, et al. Clinical efficacy and safety of budesonide-formoterol in non-cystic fibrosis bronchiectasis. Chest, 2012, 141(2): 461-468.
11.	Wei P, Yang JW, Lu HW, et al. Combined inhaled corticosteroid and long-acting β2-adrenergic agonist therapy for noncystic fibrosis bronchiectasis with airflow limitation: an observational study. Medicine, 2016, 95(42): e5116.
12.	徐海玲. 噻托溴銨治療中重度穩定期慢性阻塞性肺疾病的療效與安全性分析. 國際醫藥衛生導報, 2016, 22(17): 2672-2675.
13.	Beeh KM, Derom E, Echave-Sustaeta J, et al. The lung function profile of once-daily tiotropium and olodaterol via Respimat^? is superior to that of twice-daily salmeterol and fluticasone propionate via Accuhaler^? (ENERGITO^? study). Int J Chronic Obstruct Pulm Dis, 2016, 11: 193-205.
14.	蘇曉波, 王立茵, 吳斌, 等. 噻托溴銨粉吸入劑對支氣管擴張穩定期患者的臨床效果及安全性研究. 當代醫學, 2016, 22(30): 134-134.
15.	廖曉斌, 戴志輝, 楊勇瓊. 噻托溴銨在支氣管擴張伴阻塞性通氣障礙患者中應用價值探討. 臨床肺科雜志, 2015, 20(4): 743-744, 748.
16.	Jaong HJ, Lee H, Carriere KC, et al. Effects of long-term bronchodilators in bronchiectasis patients with airflow limitation based on bronchodilator response at baseline. Int J Chron Obstruct Pulmon Dis, 2016, 11: 2757-2764.
17.	Gloeckl R, Schneeberger T, Jarosch I, et al. Pulmonary rehabilitation and exercise training in chronic obstructive pulmonary disease. Dtsch Arztebl Int, 2018, 115(8): 117-123.
18.	周敏, 趙建平. 現代肺康復常用方法. 中國實用內科雜志, 2018, 38(5): 410-413.

1. 周玉民, 王辰, 姚婉貞, 等. 我國7省市40歲及以上居民支氣管擴張癥的患病情況及危險因素調查. 中華內科雜志, 2013, 52(5): 379-382.
2. 梅靜靜, 王煥勤, 劉媛華, 等. LABA/LAMA和LABA/ICS治療COPD穩定期的安全性及有效性薈萃分析. 國際呼吸雜志, 2018, 38(14): 1041-1048.
3. Spruit MA, Singh SJ, Garvey C, et al. ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med, 2013, 188(8): e13-64.
4. Corhay JL, Dang DN, Van CH, et al. Pulmonary rehabilitation and COPD: providing patients a good environment for optimizing therapy. Int J Chron Obstruct Pulmon Dis, 2014, 9: 27-39.
5. 張靜, 尚茜, 馬利軍, 等. 肺康復治療中重度穩定期慢性阻塞性肺疾病患者的療效觀察. 中國呼吸與危重監護雜志, 2019, 18(4): 314-317.
6. Chalmers JD, Goeminne P, Aliberti S, et al. The bronchiectasis severity index. An international derivation and validation study. Am J Respir Crit Care Med, 2014, 189(5): 576-585.
7. 成人支氣管擴張癥診治專家共識編寫組. 成人支氣管擴張癥診治專家共識. 中華結核和呼吸雜志, 2012, 35(7): 485-492.
8. Pothirat C, Chaiwong W, Phetsuk N. Efficacy of a simple and inexpensive exercise training program for advanced chronic obstructive pulmonary disease patients in community hospitals. J Thorac Dis, 2015, 7(4): 637-643.
9. 劉振剛. 吸入沙美特羅替卡松治療支氣管擴張合并氣流受限患者的前瞻性\隨機對照研究[D]. 山東: 山東大學醫學院, 2012.
10. Martinez-Garcia MA, Soler-Cataluna JJ, Catalan-Serra P, et al. Clinical efficacy and safety of budesonide-formoterol in non-cystic fibrosis bronchiectasis. Chest, 2012, 141(2): 461-468.
11. Wei P, Yang JW, Lu HW, et al. Combined inhaled corticosteroid and long-acting β2-adrenergic agonist therapy for noncystic fibrosis bronchiectasis with airflow limitation: an observational study. Medicine, 2016, 95(42): e5116.
12. 徐海玲. 噻托溴銨治療中重度穩定期慢性阻塞性肺疾病的療效與安全性分析. 國際醫藥衛生導報, 2016, 22(17): 2672-2675.
13. Beeh KM, Derom E, Echave-Sustaeta J, et al. The lung function profile of once-daily tiotropium and olodaterol via Respimat^? is superior to that of twice-daily salmeterol and fluticasone propionate via Accuhaler^? (ENERGITO^? study). Int J Chronic Obstruct Pulm Dis, 2016, 11: 193-205.
14. 蘇曉波, 王立茵, 吳斌, 等. 噻托溴銨粉吸入劑對支氣管擴張穩定期患者的臨床效果及安全性研究. 當代醫學, 2016, 22(30): 134-134.
15. 廖曉斌, 戴志輝, 楊勇瓊. 噻托溴銨在支氣管擴張伴阻塞性通氣障礙患者中應用價值探討. 臨床肺科雜志, 2015, 20(4): 743-744, 748.
16. Jaong HJ, Lee H, Carriere KC, et al. Effects of long-term bronchodilators in bronchiectasis patients with airflow limitation based on bronchodilator response at baseline. Int J Chron Obstruct Pulmon Dis, 2016, 11: 2757-2764.
17. Gloeckl R, Schneeberger T, Jarosch I, et al. Pulmonary rehabilitation and exercise training in chronic obstructive pulmonary disease. Dtsch Arztebl Int, 2018, 115(8): 117-123.
18. 周敏, 趙建平. 現代肺康復常用方法. 中國實用內科雜志, 2018, 38(5): 410-413.

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