不同剂量布地奈德雾化吸入和甲强龙静脉滴注治疗慢性阻塞性肺病的疗效对比
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摘要
目的探讨不同剂量布地奈德雾化吸入和甲强龙静脉滴注治疗慢性阻塞性肺病(COPD)的临床疗效和安全性。方法选取300例在本院就诊的COPD患者,随机分为布地奈德低剂量组(雾化吸入,1 mg/次,3次/d)、高剂量组(雾化吸入,2 mg/次,3次/d)和甲强龙组(静脉滴注,40 mg/次,1次/d),临床治疗7 d后比较临床疗效和不良反应发生率。结果布地奈德高剂量组临床疗效显著高于甲强龙组和低剂量组(P <0.01),且不良反应发生率显著低于甲强龙组(χ~2=5.92,P <0.05),不良反应发生率与低剂量组比较无显著差异(χ~2=2.66,P> 0.05)。结论高剂量布地奈德雾化吸入治疗COPD急性发作期的效果显著,且不良反应发生率较低。
Objective To compare the clinical efficacy and safety of different doses of budesonide aerosol inhalation and methylprednisolone intravenous drip in the treatment of chronic obstructive pulmonary disease(COPD). Methods Three hundred patients with COPD were randomly divided into low-dose budesonide group(1 mg,3 times/d,inha/ation),high-dose budesonide group(2 mg,3 times/d,inha/ation)and methylprednisolone group(40 mg/d,intravenous infusion). After 7 d of clinical treatment,the incidence of clinical efficacy and adverse reactions were compared. Result The clinical efficacy of high-dose budesonide group was significantly higher than that of methylprednisolone group and low-dose budesonide group(P<0.01),and the incidence of adverse reactions was significantly lower than that of methylprednisolone group(χ2=5.92,P<0.05). There was no significant difference between the incidence of adverse reactions and that of low-dose group(χ2=2.66,P>0.05). Conclusion High dose of budesonide aerosolized inhalation(2 mg/d,3 times/d)is effective in the treatment of COPD in acute attack,and the incidence of adverse reaction is low.
Objective To compare the clinical efficacy and safety of different doses of budesonide aerosol inhalation and methylprednisolone intravenous drip in the treatment of chronic obstructive pulmonary disease(COPD). Methods Three hundred patients with COPD were randomly divided into low-dose budesonide group(1 mg,3 times/d,inha/ation),high-dose budesonide group(2 mg,3 times/d,inha/ation)and methylprednisolone group(40 mg/d,intravenous infusion). After 7 d of clinical treatment,the incidence of clinical efficacy and adverse reactions were compared. Result The clinical efficacy of high-dose budesonide group was significantly higher than that of methylprednisolone group and low-dose budesonide group(P<0.01),and the incidence of adverse reactions was significantly lower than that of methylprednisolone group(χ2=5.92,P<0.05). There was no significant difference between the incidence of adverse reactions and that of low-dose group(χ2=2.66,P>0.05). Conclusion High dose of budesonide aerosolized inhalation(2 mg/d,3 times/d)is effective in the treatment of COPD in acute attack,and the incidence of adverse reaction is low.
引文
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[5]苏长海,任水明.糖皮质激素在COPD急性加重期的近远期疗效及安全性[J].中国临床药理学杂志,2012,28(4):253-255.
[6]龚建化,何丽,张家洪,等.糖皮质激素不同给药方式治疗慢性阻塞性肺疾病急性加重期患者的临床研究[J].实用医学杂志,2013,29(20):3325-3328.
[7]钟南山.早发现、早诊断和早干预应是我国慢性阻塞性肺疾病防治的主要研究方向[J].中华结核和呼吸杂志,2012,35(4):243-245.
[8]潘东霞,钱一建,王春梅,等.吸烟与室内空气污染的交互作用对慢性阻塞性肺部疾病影响的分析[J].中华流行病学杂志,2016,37(11):1444-1449.
[9]张梅,赵云峰,骆益民,等.肺炎及英国胸科协会改良肺炎评分对慢性阻塞性肺疾病急性加重患者早期病死率的评估价值[J].中华结核和呼吸杂志,2013,36(4):269-273.
[10]慢性阻塞性肺疾病急性加重抗菌治疗论坛专家组.“慢性阻塞性肺疾病诊治指南”中急性加重抗菌治疗的地位[J].中华结核和呼吸杂志,2013,36(9):712-714.
[11]李晓勇,王斌.布地奈德雾化吸入联合暖肺祛瘀汤治疗慢性阻塞性肺疾病(COPD)急性发作期临床研究[J].中华中医药学刊,2016,34(3):690-692.
[12]徐飞,崔文强,吴晓,等.布地奈德与全身性激素治疗COPD急性加重期疗效的Meta分析[J].中国全科医学,2015,18(8):873-880.