730例慢性阻塞性肺病患者治療現(xiàn)狀的調查
發(fā)布時間：2018-11-20 12:56
【摘要】：目的：通過730例COPD穩(wěn)定期患者的臨床癥狀、急性加重病史、肺功能和藥物治療進行調查及綜合評估，分析A、B、C、D四類臨床特征患者的治療現(xiàn)狀與2011版GOLD推薦選用藥物的差距。 方法：2010年11月至2011年10月對到山西省22家大中型醫(yī)院就診的COPD穩(wěn)定期患者進行問卷調查。調查內容包括患者的一般情況、COPD評估測試(CAT)、過去的急性加重病史、穩(wěn)定期用藥情況、肺功能結果。根據(jù)2011年《慢性阻塞性肺疾病全球防治創(chuàng)議》GOLD（GlobalInitiativeforChronicObstructiveLungDisease）新的修訂版的分類方法分為A、B、C、D四類不同臨床特征的患者群，比較這四類患者治療情況和GOLD推薦的治療方案的差異。采用的是描述統(tǒng)計方法進行統(tǒng)計學分析。 結果：1、共收調查問卷760份，有效問卷730份。2、730例COPD患者年齡在42～91歲之間，平均年齡65.58±9.64歲，其中男性占80.14%（585/730），女性占19.86%（145/730），男女比例4.03:1。3、A、B、C、D四類患者分別占5.07%（37/730）、41.78%（305/730）、4.93%（36/730）、48.22%（352/730）。4、使用藥物情況與2011版GOLD推薦的首選藥物符合率分別為：A類13.51%（5/37）、B類5.25%（16/305）、C類8.33%（3/36）、D類9.09%（32/352）。5、平常使用藥物控制癥狀的患者占98.2%（717/730），其中遵醫(yī)囑用藥的患者占35.62%，按需使用藥物的患者占44.79%。6、其中在使用藥物中氨茶堿治療者占首位63.61%（456/717），其次是使用祛痰劑30.68%（220/717），使用短效β2受體激動劑占23.85%（171/717），使用抗生素分別占19.94%（143/717），使用糖皮質激素患者占18.13%（130/717），，使用抗膽堿能受體占8.93%（64/717）、吸入型糖皮質激素聯(lián)合β2受體激動劑（9.76%，70/717）。 結論：COPD患者多見于老年人，穩(wěn)定期COPD患者實際用藥與GOLD有較大差異，藥物治療欠規(guī)范，聯(lián)合吸入糖皮質激素和長效β2受體激動劑、單獨吸入激素以及抗膽堿能受體相當?shù)�。癥狀驅動式、間斷、按需治療患者多。需加強對患者的健康宣教及穩(wěn)定期患者規(guī)范化治療。
[Abstract]:Objective: to investigate and evaluate the clinical symptoms, acute exacerbation history, pulmonary function and drug therapy of 730 patients with stable COPD. The current treatment status of D-4 patients with clinical characteristics is different from that recommended by GOLD version 2011. Methods: from November 2010 to October 2011, a questionnaire survey was conducted among the stable COPD patients in 22 large and medium hospitals in Shanxi Province. The survey included general information of patients, COPD assessment of (CAT), 's past history of acute exacerbation, stable use of drugs, and pulmonary function results. According to the new revised classification of the 2011 Global Initiative for the Prevention and treatment of chronic obstructive Pulmonary Disease (GOLD (GlobalInitiativeforChronicObstructiveLungDisease), there are four groups of patients with different clinical characteristics. To compare the differences between the four groups of patients and the treatment regimen recommended by GOLD. A descriptive statistical method was used for statistical analysis. Results: 1. There were 730 valid questionnaires and 730 valid questionnaires. The average age of 2730 COPD patients was 65.58 鹵9.64 years old. The male was 80.14% (585 / 730), the female was 19.86% (145 / 730), the average age was 65.58 鹵9.64 years old. The ratio of men to women was 4.03: 1.3% (3.03%), 4.93% (36 / 730), 48.22% (352,730), respectively, in 5.07% (37 / 730), 41.78% (305 / 730), 4.93% (36 / 730), 48.22% (352 / 730). The coincident rates of drug use with those recommended by GOLD 2011 were 13.51% (5.25%) for A / 37), B (8.33% for 16 / 305), C) and 9.09% (32 / 352) for 3 / 36), D, respectively. 98.2% of patients (717 / 730) used drugs to control their symptoms, of which 35.62 were prescribed by doctors and 44.79.6. Among them, aminophylline treatment accounted for 63.61% (456 / 717), followed by expectorant 30.68% (220 / 717), short-term 尾 _ 2 agonist 23.85% (171 / 717), aminophylline treatment accounted for 63.61% (456 / 717), followed by expectorant 30.68% (220 / 717). Antibiotics accounted for 19.94% (143 / 717), glucocorticoids 18.13% (130 / 717), anticholinergic receptors 8.93% (64 / 717), and glucocorticoids 18.13% (130 / 717), respectively. Inhaled glucocorticoids combined with 尾 2 receptor agonists (9.76% 70 / 717). Conclusion: COPD patients are more commonly seen in the elderly. The actual drug use in stable COPD patients is different from that in GOLD patients, and the drug treatment is not standardized. The combination of inhaling glucocorticoid and long-acting 尾 _ 2 agonist, inhaling hormone alone and anticholinergic receptor is quite low. Symptom-driven, intermittent, on-demand treatment of more patients. Health education and standardized treatment should be strengthened.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R563.9
本文編號：2344974
[Abstract]:Objective: to investigate and evaluate the clinical symptoms, acute exacerbation history, pulmonary function and drug therapy of 730 patients with stable COPD. The current treatment status of D-4 patients with clinical characteristics is different from that recommended by GOLD version 2011. Methods: from November 2010 to October 2011, a questionnaire survey was conducted among the stable COPD patients in 22 large and medium hospitals in Shanxi Province. The survey included general information of patients, COPD assessment of (CAT), 's past history of acute exacerbation, stable use of drugs, and pulmonary function results. According to the new revised classification of the 2011 Global Initiative for the Prevention and treatment of chronic obstructive Pulmonary Disease (GOLD (GlobalInitiativeforChronicObstructiveLungDisease), there are four groups of patients with different clinical characteristics. To compare the differences between the four groups of patients and the treatment regimen recommended by GOLD. A descriptive statistical method was used for statistical analysis. Results: 1. There were 730 valid questionnaires and 730 valid questionnaires. The average age of 2730 COPD patients was 65.58 鹵9.64 years old. The male was 80.14% (585 / 730), the female was 19.86% (145 / 730), the average age was 65.58 鹵9.64 years old. The ratio of men to women was 4.03: 1.3% (3.03%), 4.93% (36 / 730), 48.22% (352,730), respectively, in 5.07% (37 / 730), 41.78% (305 / 730), 4.93% (36 / 730), 48.22% (352 / 730). The coincident rates of drug use with those recommended by GOLD 2011 were 13.51% (5.25%) for A / 37), B (8.33% for 16 / 305), C) and 9.09% (32 / 352) for 3 / 36), D, respectively. 98.2% of patients (717 / 730) used drugs to control their symptoms, of which 35.62 were prescribed by doctors and 44.79.6. Among them, aminophylline treatment accounted for 63.61% (456 / 717), followed by expectorant 30.68% (220 / 717), short-term 尾 _ 2 agonist 23.85% (171 / 717), aminophylline treatment accounted for 63.61% (456 / 717), followed by expectorant 30.68% (220 / 717). Antibiotics accounted for 19.94% (143 / 717), glucocorticoids 18.13% (130 / 717), anticholinergic receptors 8.93% (64 / 717), and glucocorticoids 18.13% (130 / 717), respectively. Inhaled glucocorticoids combined with 尾 2 receptor agonists (9.76% 70 / 717). Conclusion: COPD patients are more commonly seen in the elderly. The actual drug use in stable COPD patients is different from that in GOLD patients, and the drug treatment is not standardized. The combination of inhaling glucocorticoid and long-acting 尾 _ 2 agonist, inhaling hormone alone and anticholinergic receptor is quite low. Symptom-driven, intermittent, on-demand treatment of more patients. Health education and standardized treatment should be strengthened.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R563.9
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