霧化吸入氨溴索排痰效果的臨床觀察
發(fā)布時間：2019-03-10 19:55
【摘要】：研究背景： 超說明書用藥,即“藥品未注冊用法(unlabeled uses)",是指藥品使用的適應(yīng)證、給藥方法或劑量不在藥品監(jiān)督管理部門批準(zhǔn)的說明書之內(nèi)的用法。雖然已有著作中介紹氨溴索氣霧劑及氨溴索霧化吸入,并出現(xiàn)諸多氨溴索霧化吸入的相關(guān)文獻(xiàn)報道,但多為國內(nèi)小樣本調(diào)查,可信度不高,且目前臨床應(yīng)用的氨溴索注射液說明書(2008年修訂版)中仍未提及氨溴索霧化吸入這一用法,因此該用法尚屬超說明書用藥,需進(jìn)一步尋找相關(guān)循證醫(yī)學(xué)依據(jù)。 目的： 氨溴索注射液靜脈滴注為臨床常用祛痰方法,本文采用生理鹽水、3%氯化鈉、氨溴索注射液霧化吸入三種方法分別對三組患者進(jìn)行誘導(dǎo)排痰,通過相關(guān)指標(biāo)的比較進(jìn)而觀察氨溴索注射液30mg霧化吸入的祛痰效果。 資料和方法： 1.研究對象：收集2013年11月至2014年1月期間在山東省立醫(yī)院東院呼吸內(nèi)科住院治療的咳嗽咳痰且能夠耐受霧化吸入的慢性阻塞性肺病急性加重(AECOPD)患者30例,隨機(jī)分為三組,A組(生理鹽水組)10例,B組(3%氯化鈉溶液組)9例,C組(氨溴索組)11例。 2.霧化吸入方法：本試驗采取氧驅(qū)動霧化,給予A組患者：生理鹽水(NS)8ml霧化吸入一天兩次(bid)；B組患者：NS6ml+10%NaCl2ml霧化吸入bid；C組患者：NS4ml+氨溴索4ml霧化吸入bid。每次霧化吸入時間均為15min左右。 3.痰標(biāo)本的收集：收集每位入組患者霧化吸入前一天(d0)和霧化后三天(d1、d2、d3)每天的痰液,標(biāo)本收集當(dāng)日早上7點(diǎn)至次日早上7點(diǎn)的24小時痰。 4.觀測指標(biāo)：觀察并記錄三組患者d1、d2、d3痰液量、干/濕重、粘度,進(jìn)行平行比較以觀察不同誘導(dǎo)方法對痰液性質(zhì)影響的差異。分別將三組患者每位患者d0、d1的痰液量進(jìn)行比較觀察誘導(dǎo)排痰效果。 5.統(tǒng)計分析：將收集所得原始數(shù)據(jù)以Excel形式分天保存,應(yīng)用統(tǒng)計軟件SPSS20.0進(jìn)行數(shù)據(jù)統(tǒng)計,采用SPSS中單因素方差分析、fisher精確檢驗及獨(dú)立樣本的非參數(shù)檢驗進(jìn)行統(tǒng)計學(xué)分析,P0.05表示差異具有統(tǒng)計學(xué)意義。 結(jié)果： 1.痰液量：C組患者每日痰量多于A組、B組(P均0.05,差異明顯,具有統(tǒng)計學(xué)意義)。 2.粘度：C組每日痰液粘度低于A組、B組(P0.05)。 3.痰液干重/濕重：C組每日痰液干/濕重低于A組、B組(P0.05)。 4.不良反應(yīng)：B組患者霧化過程中存在明顯口腔咸味感,其他組未訴特殊不適。 結(jié)論： 1.生理鹽水、3%氯化鈉溶液、氨溴索霧化吸入均有利于患者痰液排出； 2.氨溴索霧化吸入的排痰效果優(yōu)于生理鹽水、3%氯化鈉溶液組。
[Abstract]:Background: ultra-prescriptive drug use, that is, "unregistered drug usage (unlabeled uses)", refers to the indication of drug use, the use of drug delivery methods or doses that are not in the instructions approved by the drug regulatory department. Although some books have introduced the aerosol of ambroxol and the atomization inhalation of ambroxol, and there are many related literature reports of the atomization inhalation of ambroxol, most of them are small sample investigation in China, and the reliability is not high. The current clinical application of ambroxol injection manual (revised 2008 edition) still does not mention the use of ambroxol atomization inhalation, so the use of ambroxol is still ultra-prescriptive, it is necessary to look for evidence-based medicine. Objective: intravenous infusion of ambroxol injection is a common clinical expectorant method. In this paper, normal saline, 3% sodium chloride and aerosol inhalation of ambroxol injection were used to induce expectoration in three groups of patients, respectively. The expectorant effect of 30mg atomization inhalation of ambroxol injection was observed by comparing the relative indexes. Information and methods: 1. Participants: from November 2013 to January 2014, 30 patients with acute exacerbation of (AECOPD) with chronic obstructive pulmonary disease (COPD) who were hospitalized in the Department of Respiratory Medicine, Eastern Hospital of Shandong Provincial Hospital, were randomly divided into three groups. There were 10 cases in group A (saline group), 9 cases in group B (3% sodium chloride solution group) and 11 cases in group C (ambroxol group). 2. Atomization inhalation method: in this experiment, oxygen-driven atomization was given to patients in group A: normal saline (NS) 8ml atomized inhalation twice a day in (bid); B group; NS6ml 10%NaCl2ml atomization inhalation in bid;C group; NS4ml ambroxol 4ml atomization inhalation in bid. group Each atomization inhalation time is about 15min. 3. Collection of sputum specimens: the sputum was collected one day before atomization inhalation (day 0) and three days after atomization (day 1, day 2, day 3). The sputum samples were collected from 7: 00 a.m. to 7: 00 a.m. on the same day and 24-hour sputum from 7: 00 a.m. to 7: 00 a.m. on the following day (day 1, day 2, day 3). 4. Observation indexes: the sputum volume, dry / wet weight and viscosity of the three groups were observed and recorded on day 1, day 2 and day 3. The effects of different induction methods on sputum properties were observed by parallel comparison. The sputum volume on day 0 and day 1 of each patient in three groups were compared to observe the effect of induced sputum discharge. 5. Statistical analysis: the original data collected were stored in the form of Excel day by day. The data were counted by SPSS20.0, and analyzed by single factor analysis of variance (ANOVA) in SPSS, accurate fisher test and non-parametric test of independent samples. P0.05 indicates that the difference is statistically significant. Results: 1. Sputum volume: the daily sputum volume in group C was more than that in group A and group B (P all 0.05, the difference was significant, statistically significant). 2. Viscosity: daily sputum viscosity in group C was lower than that in group A and group B (P0.05). 3. Sputum dry / wet weight: daily sputum dry / wet weight in group C was lower than that in group A and group B (P0.05). 4. Side effects: there was a significant oral salty sensation in the atomization process in group B, and no special discomfort was reported in the other groups. Conclusions: 1. Normal saline, 3% sodium chloride solution and ambroxol atomization inhalation are beneficial to the sputum efflux of the patients. The expectoration effect of ambroxol atomization inhalation was better than that of normal saline, 3% sodium chloride solution group.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R974
本文編號：2437968
[Abstract]:Background: ultra-prescriptive drug use, that is, "unregistered drug usage (unlabeled uses)", refers to the indication of drug use, the use of drug delivery methods or doses that are not in the instructions approved by the drug regulatory department. Although some books have introduced the aerosol of ambroxol and the atomization inhalation of ambroxol, and there are many related literature reports of the atomization inhalation of ambroxol, most of them are small sample investigation in China, and the reliability is not high. The current clinical application of ambroxol injection manual (revised 2008 edition) still does not mention the use of ambroxol atomization inhalation, so the use of ambroxol is still ultra-prescriptive, it is necessary to look for evidence-based medicine. Objective: intravenous infusion of ambroxol injection is a common clinical expectorant method. In this paper, normal saline, 3% sodium chloride and aerosol inhalation of ambroxol injection were used to induce expectoration in three groups of patients, respectively. The expectorant effect of 30mg atomization inhalation of ambroxol injection was observed by comparing the relative indexes. Information and methods: 1. Participants: from November 2013 to January 2014, 30 patients with acute exacerbation of (AECOPD) with chronic obstructive pulmonary disease (COPD) who were hospitalized in the Department of Respiratory Medicine, Eastern Hospital of Shandong Provincial Hospital, were randomly divided into three groups. There were 10 cases in group A (saline group), 9 cases in group B (3% sodium chloride solution group) and 11 cases in group C (ambroxol group). 2. Atomization inhalation method: in this experiment, oxygen-driven atomization was given to patients in group A: normal saline (NS) 8ml atomized inhalation twice a day in (bid); B group; NS6ml 10%NaCl2ml atomization inhalation in bid;C group; NS4ml ambroxol 4ml atomization inhalation in bid. group Each atomization inhalation time is about 15min. 3. Collection of sputum specimens: the sputum was collected one day before atomization inhalation (day 0) and three days after atomization (day 1, day 2, day 3). The sputum samples were collected from 7: 00 a.m. to 7: 00 a.m. on the same day and 24-hour sputum from 7: 00 a.m. to 7: 00 a.m. on the following day (day 1, day 2, day 3). 4. Observation indexes: the sputum volume, dry / wet weight and viscosity of the three groups were observed and recorded on day 1, day 2 and day 3. The effects of different induction methods on sputum properties were observed by parallel comparison. The sputum volume on day 0 and day 1 of each patient in three groups were compared to observe the effect of induced sputum discharge. 5. Statistical analysis: the original data collected were stored in the form of Excel day by day. The data were counted by SPSS20.0, and analyzed by single factor analysis of variance (ANOVA) in SPSS, accurate fisher test and non-parametric test of independent samples. P0.05 indicates that the difference is statistically significant. Results: 1. Sputum volume: the daily sputum volume in group C was more than that in group A and group B (P all 0.05, the difference was significant, statistically significant). 2. Viscosity: daily sputum viscosity in group C was lower than that in group A and group B (P0.05). 3. Sputum dry / wet weight: daily sputum dry / wet weight in group C was lower than that in group A and group B (P0.05). 4. Side effects: there was a significant oral salty sensation in the atomization process in group B, and no special discomfort was reported in the other groups. Conclusions: 1. Normal saline, 3% sodium chloride solution and ambroxol atomization inhalation are beneficial to the sputum efflux of the patients. The expectoration effect of ambroxol atomization inhalation was better than that of normal saline, 3% sodium chloride solution group.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R974
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