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目的分析支气管哮喘合并慢性阻塞性肺疾病的临床治疗方法。方法 84例支气管哮喘合并慢性阻塞性肺疾病患者,根据随机抽签分为观察组和对照组,各42例。对照组实施常规治疗,观察组在对照组基础上采用噻托溴铵联合沙美特罗替卡松粉吸入剂(舒利迭)治疗。比较两组患者哮喘控制情况、肺功能改善情况、生活质量情况、病情急性加重发作情况及不良反应发生情况。结果治疗后1周、12个月,观察组患者哮喘控制测试评分表(ACT)评分、第1秒钟用力呼气量(FEV1)增加量均高于对照组,呼气峰值流速增加量(△PEF)低于对照组,差异具有统计学意义(P<0.05);治疗后12个月,观察组患者第1秒钟用力呼气量占预计值百分比(FEV1%预计值)(83.9±6.4)%、生活质量评分(92.8±5.6)分均高于对照组的(75.7±5.2)%、(74.6±7.9)分,急性加重发作次数少于对照组,急性加重发作间隔时间长于对照组,差异均具有统计学意义(P<0.05);观察组治疗后不良反应发生率为4.76%,与对照组的2.38%比较差异无统计学意义(P>0.05)。结论噻托溴铵联合舒利迭治疗支气管哮喘合并慢性阻塞性肺疾病效果明显,值得临床应用。
Objective To analyze the clinical treatment of bronchial asthma with chronic obstructive pulmonary disease. Methods Eighty-four patients with bronchial asthma and chronic obstructive pulmonary disease were randomly divided into observation group and control group, 42 cases in each group. The control group was given conventional treatment. The observation group was treated with tiotropium combined with salmeterol and fluticasone powder inhaler (seretide) on the basis of the control group. Compare the two groups of patients with asthma control, pulmonary function improvement, quality of life, acute exacerbations and adverse reactions. Results The scores of asthma control test (ACT), FEV1 of the observation group were higher than those of the control group at 1 week and 12 months after treatment (P <0.05), and the increase of peak expiratory flow rate (△ PEF) was lower than the control group (P <0.05). At 12 months after treatment, the forced expiratory volume in one second of the observation group as a percentage of the predicted value (FEV1% predicted) (83.9 ± 6.4) %, And quality of life score (92.8 ± 5.6) were higher than that of the control group (75.7 ± 5.2)% and (74.6 ± 7.9) respectively. The number of acute exacerbation seizures was less than that of the control group. The acute exacerbation seizure interval was longer than that of the control group. (P <0.05). The incidence of adverse reactions in the observation group after treatment was 4.76%, which was not significantly different from the control group (2.38%) (P> 0.05). Conclusion Tiotropium combined with seretide treatment of bronchial asthma with chronic obstructive pulmonary disease effect is obvious, worthy of clinical application.