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目的观察噻托溴铵联合小剂量阿奇霉素对稳定期慢性阻塞性肺疾病(COPD)的疗效和安全性。方法选取已经确诊的120例COPD患者,采取随机对照的研究方法,分为对照组、噻托溴铵组、阿奇霉素组及联合组,每组30例。对照组给予常规治疗;噻托溴铵组给予噻托溴铵吸入剂18μg,每晚睡前吸入;阿奇霉素组给予阿奇霉素片250 mg,隔日1次口服;联合组给予噻托溴铵吸入和阿奇霉素口服,用法用量同噻托溴铵组和阿奇霉素组;疗程均为1年。观察治疗前和治疗后患者的肺功能、运动耐量、生活质量、COPD急性加重次数。结果对照组:肺功能、运动耐量、生活质量明显改善,COPD急性加重次数等各项观察指标治疗前后无明显变化;噻托溴铵、阿奇霉素及联合组:各项观察指标较治疗前明显改善(P<0.05),联合组各项观察指标优于噻托溴铵和阿奇霉素组(P<0.05)。结论噻托溴铵联合小剂量阿奇霉素能够更好改善稳定期COPD患者的肺功能、生活质量,使患者运动耐量增加,临床疗效提高,安全性好,优于单药治疗。
Objective To observe the efficacy and safety of tiotropium plus low-dose azithromycin in patients with stable chronic obstructive pulmonary disease (COPD). Methods A total of 120 patients with COPD were selected and randomly divided into control group, tiotropium group, azithromycin group and combination group, with 30 cases in each group. The control group was given routine treatment; tiotropium group was given tiotropium bromide inhalation 18μg, inhaled every night before going to bed; azithromycin group given azithromycin tablets 250 mg orally every other day; combination group was given tiotropium bromide and azithromycin oral , Usage and dosage with tiotropium group and azithromycin group; treatment for 1 year. Observe the pulmonary function, exercise tolerance, quality of life and acute exacerbation of COPD before and after treatment. Results In the control group, there were no significant changes in the indexes of lung function, exercise tolerance, quality of life, acute exacerbations of COPD and other indexes before and after treatment. Tiotropium bromide, azithromycin and combination group showed significant improvement P <0.05). The observation group was superior to tiotropium and azithromycin in the combination group (P <0.05). Conclusions Tiotropium combined with low-dose azithromycin can improve lung function and quality of life in patients with stable COPD, increase patient’s exercise tolerance, improve clinical efficacy and safety, and is superior to monotherapy.