本文選題：穩(wěn)定期copd　切入點(diǎn)：噻托溴銨　出處：《廣東藥學(xué)院》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：背景：慢性阻塞性肺疾�。–OPD)是一種可以預(yù)防、可以治療并伴有顯著肺外效應(yīng)的疾病，是一種具有氣流受限特征的肺部疾病，氣流受限不完全可逆，呈進(jìn)行性發(fā)展。COPD的控制包括藥物治療和日常的功能鍛煉。支氣管舒張劑伴或者不伴吸入性糖皮質(zhì)激素用于重度COPD患者穩(wěn)定期的維持治療被證明為有效的治療方案。目的：評估噻托溴銨吸入、沙美特羅/氟替卡松吸入以及口服茶堿三種療法對穩(wěn)定期重度COPD患者的肺功能、生活質(zhì)量、氣道炎癥因子的影響并觀察藥物的不良反應(yīng)。 方法：在4個(gè)星期的篩選期治療后，符合條件的137個(gè)患者按1:1:1隨機(jī)分配為三組,分別接受口服緩釋茶堿片0.2BID、沙美特羅/氟替卡松50ug/250ug吸入BID或者噻托溴銨18ug QD吸入治療。在試驗(yàn)的開始、第4、12、24周分別完成肺功能測定、6分鐘步行實(shí)驗(yàn)、呼吸困難問卷、BODE指數(shù)、心電圖以及痰細(xì)胞計(jì)數(shù)、痰VEGF和LTB4的測定。 結(jié)果：在3組穩(wěn)定期重度COPD患者中，茶堿組、沙美特羅/氟替卡松組以及噻托溴銨組分別有40、40、42個(gè)患者最終完成試驗(yàn)，三組患者的肺功能、6分鐘步行實(shí)驗(yàn)、呼吸困難問卷、BODE指數(shù)都有所改善，，結(jié)果有統(tǒng)計(jì)學(xué)差異，吸入噻托溴銨組及沙美特羅/氟替卡松組的改善比茶堿組更顯著，除了6分鐘步行實(shí)驗(yàn)外，噻托溴銨組和沙美特羅/氟替卡松組兩組之間其他檢測無統(tǒng)計(jì)學(xué)差異。三組治療方案都能減輕患者痰VEGF以及LTB4的含量，噻托溴銨對于痰VEGF的降低更顯著。 結(jié)論：噻托溴銨組、沙美特羅/氟替卡松組和茶堿組對于重度穩(wěn)定期COPD患者均有較好的療效，噻托溴銨組、沙美特羅/氟替卡松組相對于茶堿組療效更顯著，噻托溴銨組可能對于氣道重塑有潛在的影響。
[Abstract]:Background: chronic obstructive pulmonary disease (COPD) is a preventable and can be treated with significant extrapulmonary effects of the disease, a lung disease characterized by airflow limitation, irreversible airflow limitation, a control for the development of.COPD include drug treatment and daily bronchodilator functional exercise. With or without inhaled corticosteroids as maintenance therapy for patients with severe COPD in stable phase were proved to be effective treatment. Objective: To evaluate the effect of tiotropium bromide inhalation, Shah Mette Lo / fluticasone inhalation and oral theophylline three therapy on severe stable lung function, quality of life in patients with COPD, adverse effect of airway inflammatory factors were observed.
Methods: during the screening period after 4 weeks of treatment, 137 eligible patients with 1:1:1 were randomly assigned into three groups, respectively received oral theophylline 0.2BID Shah Mette Lo / fluticasone inhalation of 50ug/250ug BID or 18ug QD tiotropium bromide inhalation therapy. At the start of the test, the 4,12,24 weeks were completed pulmonary function determination of 6 minute walk test, Dyspnea Questionnaire, BODE index, electrocardiogram and sputum cell counts, determination of sputum VEGF and LTB4.
Results: in 3 groups of patients with severe COPD in stable phase, theophylline group, Shah Mette Lo / fluticasone group and tiotropium group respectively 40,40,42 patients completed the final test, the pulmonary function of three groups of patients, 6 minutes walk test, Dyspnea Questionnaire, BODE index has improved, the results were statistically significant difference, inhalation the tiotropium group and Shah Mette Lo / fluticasone group better than theophylline group is more significant, in addition to the 6 minute walk test, the tiotropium group and Shah Mette Lo / fluticasone group between the two groups had no significant difference. Other treatment group three patients with phlegm can reduce VEGF and LTB4 content, Sai tiotropium bromide for reducing phlegm VEGF more significantly.
Conclusion: the tiotropium group, Shah Mette Lo / fluticasone group and theophylline group for severe COPD patients had good curative effect, the tiotropium group, Shah Mette Lo / fluticasone group compared with the more significant effect of theophylline group, the tiotropium group may have potential effects on airway remodeling.

【學(xué)位授予單位】：廣東藥學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R563.9

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 霍建民;陳晶瑩;孔英君;石玉枝;;慢性阻塞性肺疾病患者肺組織中血管內(nèi)皮生長因子和誘生型一氧化氮合酶的表達(dá)及吸煙的影響[J];中華結(jié)核和呼吸雜志;2007年08期

2 ;慢性阻塞性肺疾病診治指南(2007年修訂版)[J];中華內(nèi)科雜志;2007年03期

本文編號：1599444