维生素D联合异丙托溴铵治疗支气管哮喘患者的临床疗效分析
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摘要
目的:研究维生素D联合异丙托溴铵治疗支气管哮喘患者的临床疗效。方法:选择2015年1月～2017年12月在我院进行诊治的81例支气管哮喘患者并将其随机分为两组。对照组雾化吸入异丙托溴铵,观察组在对照组的基础上联合口服维生素D。比较两组的喘憋症状消失时间、咳嗽缓解时间、肺部哮鸣音消失时间和肺部湿啰音消失时间,治疗前后的最大呼气峰流速(peak expiratory flow rate,PEF)变异率和哮喘控制测试(asthma control test,ACT)评分值。结果:观察组治疗有效率为90.00%(36/40),较对照组[78.05%(32/41)]显著升高(P<0.05);观察组的喘憋症状消失时间、咳嗽缓解时间、肺部哮鸣音消失时间和肺部湿啰音消失时间均明显短于对照组(P<0.05)。治疗前,两组PEF变异率和ACT评分值比较差异无统计学意义(P>0.05);治疗后,两组PEF变异率均较治疗前显著降低(P<0.05),ACT评分值均较治疗前显著升高(P<0.05),且观察组PEF变异率显著低于对照组(P<0.05),而ACT评分值明显高于对照组(P<0.05)。结论:与单用雾化吸入异丙托溴铵相比,维生素D联合雾化吸入异丙托溴铵治疗支气管哮喘的临床疗效更优,且可以有效缩短患者的症状消失时间。
Objective: To study the clinical efficacy of vitamin D combined with ipratropium bromide in the treatment of bronchial asthma. Methods: 81 cases of bronchial asthma diagnosed and treated in our hospital from January 2015 to December 2017 were randomly divided into two groups. The control group was inhaled ipratropium bromide, and the observation group was given oral vitamin D on the basis of control group. The disappearance time of asthma symptoms, the time of cough remission, the time of disappearance of lung wheezing sound, and the loss of lung rale, the maximum peak expiratory flow rate(PEF) and the asthma control test(ACT) score before and after treatment were compared between the two groups. Results: The effective rate of observation group was 90%(36/40), which was significantly higher than that of the control group([78.05%(32/41)]. The time of disappearance of asthmatic symptoms, the time of cough remission, the disappearance time of lung wheezing sound and the loss of lung wet rale were significantly shorter in the observation group than those in the control group(P<0.05). Before treatment, there was no significant difference in the PEF and ACT scores between the two groups(P>0.05). After treatment, the PEF variations of both groups were significantly lower than those before the treatment(P<0.05), and the ACT score was significantly higher than that before the treatment(P<0.05), and the PEF variation rate in the observation group was significantly lower than that in the control group(P<0.05), while the ACT score was significantly higher than that of the control group(P<0.05). Conclusion: Compared with the inhalation of ipratropium bromide alone, vitamin D combined with ipratropium bromide was more effective in the treatment of bronchial asthma, and it could effectively promote the disappearance of symptoms.
Objective: To study the clinical efficacy of vitamin D combined with ipratropium bromide in the treatment of bronchial asthma. Methods: 81 cases of bronchial asthma diagnosed and treated in our hospital from January 2015 to December 2017 were randomly divided into two groups. The control group was inhaled ipratropium bromide, and the observation group was given oral vitamin D on the basis of control group. The disappearance time of asthma symptoms, the time of cough remission, the time of disappearance of lung wheezing sound, and the loss of lung rale, the maximum peak expiratory flow rate(PEF) and the asthma control test(ACT) score before and after treatment were compared between the two groups. Results: The effective rate of observation group was 90%(36/40), which was significantly higher than that of the control group([78.05%(32/41)]. The time of disappearance of asthmatic symptoms, the time of cough remission, the disappearance time of lung wheezing sound and the loss of lung wet rale were significantly shorter in the observation group than those in the control group(P<0.05). Before treatment, there was no significant difference in the PEF and ACT scores between the two groups(P>0.05). After treatment, the PEF variations of both groups were significantly lower than those before the treatment(P<0.05), and the ACT score was significantly higher than that before the treatment(P<0.05), and the PEF variation rate in the observation group was significantly lower than that in the control group(P<0.05), while the ACT score was significantly higher than that of the control group(P<0.05). Conclusion: Compared with the inhalation of ipratropium bromide alone, vitamin D combined with ipratropium bromide was more effective in the treatment of bronchial asthma, and it could effectively promote the disappearance of symptoms.
引文
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[17]Gupta A,Gupta L K,Rehan H S,et al.Response to inhaled corticosteroids on serum CD28,quality of life,and peak expiratory flow rate in bronchial asthma[J].Allergy&Asthma Proceedings,2017,38(2):13-18
[18]Gupta S,Malhotra V,Tripathi Y,et al.Respiratory functions in textile mill workers:Role of peak expiratory flow rate[J].Asian Journal of Pharmaceutical&Clinical Research,2017,10(4):306
[19]Hossain D,Khanum S,Kawser C A,et al.Relationship of Obesity and Peak Expiratory Flow Rate(PEFR)amongst 8-15 Years Old School Children[J].Bangladesh J child health,2017,39(2):77
[20]Hosseini S R,Imani F,Shayanpour G,et al.The effect of nephrostomy tract infiltration of ketamine on postoperative pain and peak expiratory flow rate in patients undergoing tubeless percutaneous nephrolithotomy:a prospective randomized clinical trial[J].Urolithiasis,2017,45(6):1-5
[21]Kola M,Hac覦o lu D,Erd觟l H,et al.Bilateral acute angle closure developing due to use of ipratropium bromide and salbutamol[J].International Ophthalmology,2017,38(1):385-388
[22]Hung Y H,Huang H L,Chen W C,et al.Argininosuccinate lyase interacts with cyclin A2 in cytoplasm and modulates growth of liver tumor cells[J].Oncology Reports,2017,37(2):969-978
[23]Indinnimeo L,Chiappini E,Miraglia M D G.Guideline on management of the acute asthma attack in children by Italian Society of Pediatrics[J].Italian Journal of Pediatrics,2018,44(1):46
[24]Navanandan N,Federico M,Mistry R D.Positive Expiratory Pressure for the Treatment of Acute Asthma Exacerbations:A Randomized Controlled Trial[J].Journal of Pediatrics,2017,185(2):149-154
[25]Baraluma B E,Efrati O,Kaufmann H,et al.A Controlled Trial of Inhaled Bronchodilators in Familial Dysautonomia[J].Lung,2017,196(3):1-9
[26]Lin X,Fan Y,Wang X,et al.Correlation Between Tumor Necrosis Factor-魴±and Interleukin-1魴2 in Exhaled Breath Con densate and Pulmonary Function[J].American Journal of the Medical Sciences,2017,354(4):388-394
[27]Akhter L S,Monkman J L,Vang G,et al.Improving Asthma Control through Asthma Action Plans:A Quality Improvement Project at a Midwest Community Clinic[J].Journal of Community Health Nursing,2017,34(3):136-146
[28]Turan O,Turan P A,Mirici A.Parameters affecting inhalation therapy adherence in elderly patients with chronic obstructive lung disease and asthma[J].Geriatrics&Gerontology International,2017,17(6):999-1005
[29]Yan Y,Bao H P,Li C L,et al.Wentong decoction cures allergic bronchial asthma by regulating the apoptosis imbalance of EOS[J].Chinese Medicine,2018,13(1):21
[30]Geng G,Du Y,Dai J,et al.KIF3A knockdown sensitizes bronchial epithelia to apoptosis and aggravates airway inflammation in asthma[J].Biomedicine&Pharmacotherapy,2018,97:1349-1355
[2]Talwar D.A Drug Utilization Surveillance Study to Assess the Clinical Impact of Digital Dose Counter p MDIs on Bronchial Asthma:DUSSAnalyses;DUSS-Digital p MDI Utilization Surveillance Study[J].Chest,2017,152(4):A22
[3]Despotovic M,Stoimenov T J,Stankovic I,et al.Vitamin D receptor gene polymorphisms in Serbian patients with bronchial asthma:a case-control study[J].Journal of Cellular Biochemistry,2017,118(11):3986-3992
[4]Hisada T,Aokisaito H,Koga Y.Are specialized pro-resolving mediators promising therapeutic agents for severe bronchial asthma?[J]Journal of Thoracic Disease,2017,9(11):4266-4269
[5]Yoshida M,Kaneko Y,Ishimatsu A,et al.Effects of tiotropium on lung function in current smokers and never smokers with bronchial asthma[J].Pulmonary Pharmacology&Therapeutics,2017,42(suppl59):7-12
[6]Yan Y,Bao H P,Li C L,et al.Wentong decoction cures aller gic bronchial asthma by regulating the apoptosis imbalance of EOS[J].Chinese Medicine,2018,13(1):21
[7]Jiang X G,Yang X D,Lv Z,et al.Elevated serum levels of TNF-α,IL-8,and ECP can be involved in the development and progression of bronchial asthma[J].Journal of Asthma,2017,55(2):[Epub ahead of print]
[8]Liccardi G,Calzetta L,Barrile A,et al.Is the risk of developing atopic sensitization and bronchial asthma in animal laboratory workers preventable in well-defined susceptible individuals?[J].Journal of Occupational Health,2017,59(3):310-311
[9]Zhang J,Bai Y,Gao P,et al.P1.03-011 Clinical Characters of 19Bronchial Asthmatic Patients with Lung Cancer[J].Journal of Thoracic Oncology,2017,12(1):S548-S549
[10]T.Ka erová,M.Kuzma,P.Kaíer.Molecular diagnosis of bronchial asthma based on the content of cysteinyl leukotrienes and lipoxines in exhaled breath condensate[J].Chemicke Listy,2017,111(1):50-55
[11]Valeromoreno S,Pérezmarín M,Montoyacastilla I,et al.Emotional distress in family caregivers of adolescents with bronchial asthma:analysis of its predictors[J].Archivos Argentinos De Pediatria,2018,116(2):e234-e240
[12]Schauerte G,Weber A.Transition issues in bronchial asthmaGhosts?[J].Allergologie,2017,40(9):372-379
[13]Tikhonova I V,Kosyakova N I,Grinevich A A,et al.Accelerated reactivity of blood granulocytes in patients with atopic bronchial asthma out of exacerbation[J].Immunobiology,2017,223(1):8-17
[14]Chen W Q,Xie Z Z,Wang X,et al.Influences of PON1 on Airway Inflammation and Remodeling in Bronchial Asthma[J].Journal of Cellular Biochemistry,2017,119(1):793-805
[15]Akhter L S,Monkman J L,Vang G,et al.Improving Asthma Control through Asthma Action Plans:A Quality Improvement Project at a Midwest Community Clinic[J].Journal of Community Health Nursing,2017,34(3):136-146
[16]Cai Y,Cao J,Kan R,et al.A Multi-center Study on Improvement in Life Quality of Pediatric Patients with Asthma via Continuous Care[J].Iranian Journal of Public Health,2017,46(11):1521-1527
[17]Gupta A,Gupta L K,Rehan H S,et al.Response to inhaled corticosteroids on serum CD28,quality of life,and peak expiratory flow rate in bronchial asthma[J].Allergy&Asthma Proceedings,2017,38(2):13-18
[18]Gupta S,Malhotra V,Tripathi Y,et al.Respiratory functions in textile mill workers:Role of peak expiratory flow rate[J].Asian Journal of Pharmaceutical&Clinical Research,2017,10(4):306
[19]Hossain D,Khanum S,Kawser C A,et al.Relationship of Obesity and Peak Expiratory Flow Rate(PEFR)amongst 8-15 Years Old School Children[J].Bangladesh J child health,2017,39(2):77
[20]Hosseini S R,Imani F,Shayanpour G,et al.The effect of nephrostomy tract infiltration of ketamine on postoperative pain and peak expiratory flow rate in patients undergoing tubeless percutaneous nephrolithotomy:a prospective randomized clinical trial[J].Urolithiasis,2017,45(6):1-5
[21]Kola M,Hac覦o lu D,Erd觟l H,et al.Bilateral acute angle closure developing due to use of ipratropium bromide and salbutamol[J].International Ophthalmology,2017,38(1):385-388
[22]Hung Y H,Huang H L,Chen W C,et al.Argininosuccinate lyase interacts with cyclin A2 in cytoplasm and modulates growth of liver tumor cells[J].Oncology Reports,2017,37(2):969-978
[23]Indinnimeo L,Chiappini E,Miraglia M D G.Guideline on management of the acute asthma attack in children by Italian Society of Pediatrics[J].Italian Journal of Pediatrics,2018,44(1):46
[24]Navanandan N,Federico M,Mistry R D.Positive Expiratory Pressure for the Treatment of Acute Asthma Exacerbations:A Randomized Controlled Trial[J].Journal of Pediatrics,2017,185(2):149-154
[25]Baraluma B E,Efrati O,Kaufmann H,et al.A Controlled Trial of Inhaled Bronchodilators in Familial Dysautonomia[J].Lung,2017,196(3):1-9
[26]Lin X,Fan Y,Wang X,et al.Correlation Between Tumor Necrosis Factor-魴±and Interleukin-1魴2 in Exhaled Breath Con densate and Pulmonary Function[J].American Journal of the Medical Sciences,2017,354(4):388-394
[27]Akhter L S,Monkman J L,Vang G,et al.Improving Asthma Control through Asthma Action Plans:A Quality Improvement Project at a Midwest Community Clinic[J].Journal of Community Health Nursing,2017,34(3):136-146
[28]Turan O,Turan P A,Mirici A.Parameters affecting inhalation therapy adherence in elderly patients with chronic obstructive lung disease and asthma[J].Geriatrics&Gerontology International,2017,17(6):999-1005
[29]Yan Y,Bao H P,Li C L,et al.Wentong decoction cures allergic bronchial asthma by regulating the apoptosis imbalance of EOS[J].Chinese Medicine,2018,13(1):21
[30]Geng G,Du Y,Dai J,et al.KIF3A knockdown sensitizes bronchial epithelia to apoptosis and aggravates airway inflammation in asthma[J].Biomedicine&Pharmacotherapy,2018,97:1349-1355