摘要
目的观察孟鲁司特钠联合沙美特罗替卡松治疗哮喘—慢性阻塞性肺疾病重叠综合征(ACOS)的临床疗效。方法选取2018年1月—2021年6月南平市第一医院收治的ACOS患者130例,按照随机数字表法分为A组和B组,各65例。A组给予沙美特罗替卡松粉吸入剂治疗,B组在A组基础上增加孟鲁司特钠片治疗,2组均治疗4周。比较2组治疗前、治疗4周后呼吸困难量表(mMRC)评分、哮喘控制测试(ACT)评分、炎性因子[8-异前列腺素(8-isoPG)、髓过氧化物酶(MPO)、白三烯B4(LTB4)和白介素-6(IL-6)、呼出气一氧化氮(FeNo)]、肺功能指标[第1秒用力呼气容积占预计值百分比(FEV_(1)%)、第1秒用力呼气容积与用力肺活量比值(FEV_(1)/FVC)、每分钟最大通气量(MVV)]、血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(Pa CO_(2))],不良反应。结果2组治疗4周后mMRC评分低于治疗前,ACT评分高于治疗前(P<0.01);且B组mMRC评分低于A组,ACT评分高于A组(P<0.01)。2组治疗4周后8-isoPG、MPO、LTB4、IL-6、FeNO水平低于治疗前(P<0.01);且B组8-isoPG、MPO、LTB4、IL-6、FeNO水平低于A组(P<0.05)。2组治疗4周后FEV_(1)%、FEV_(1)/FVC、MVV、PaO_(2)高于治疗前,PaCO_(2)低于治疗前(P<0.01);且B组FEV_(1)%、FEV_(1)/FVC、MVV、PaO_(2)高于A组,Pa CO_(2)低于A组(P<0.05)。2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论孟鲁司特钠联合沙美特罗替卡松治疗ACOS可有效减轻患者机体炎症,并减轻肺功能损伤,从而改善血气,促进临床症状缓解,且不会增加不良反应。
Objective To observe clinical efficacy of montelukast sodium combined with salmeterol fluticasone in the treatment of ACOS. Methods A total of 130 cases of patients with ACOS were selected from January 2018 to June 2021 in Nanping First Hospital, which were divided into group A and group B according to the random number table method, with 65 cases in each group. Group A was treated with salmeterol fluticasone powder inhalation, while group B was treated with montelukast sodium tablets on the basis of group A. Both groups were treated for 4 weeks. The mMRC score, ACT score, laboratory indexes(8-isoPG, MPO, LTB4 and IL-6, FeNo), pulmonary function indexes(FEV_(1)%, FEV_(1)/FVC, MVV), blood gas analysis indexes(PaO_(2), Pa CO_(2)) before and after 4 weeks of treatment and incidence of adverse reactions were compared between the two groups. Results After 4 weeks of treatment, mMRC score in the two groups was lower than that before treatment, and ACT score was higher than that before treatment(P<0.01). After 4 weeks of treatment, the mMRC score of group B was lower than that of group A, but the ACT score was higher than that of group A(P<0.01). The levels of 8-isoPG, MPO, LTB4, IL-6 and FeNO after 4 weeks of treatment in the two groups were lower than those before treatment(P<0.01). After 4 weeks of treatment, the levels of 8-isoPG, MPO, LTB4, IL-6 and FeNO of group B were lower than those of group A(P<0.05). After 4 weeks of treatment, FEV_(1)%, FEV_(1)/FVC, MVV, PaO_(2)in the two groups were higher than those before treatment, while Pa CO_(2)was lower than that before treatment(P<0.01). After 4 weeks of treatment, FEV_(1)%, FEV_(1)/FVC, MVV and PaO_(2)in group B were higher than those in group A, while Pa CO_(2)was lower than that in group A(P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05). Conclusion Montelukast sodium combined with salmeterol fluticasone can effectively reduce the inflammation of patients with ACOS, and reduce the damage of pul
作者
董烈
蔡剑锋
张祥斌
DONG Lie;CAI Jianfeng;ZHANG Xiangbin(Department of Respiratory Medicine,Nanping First Hospital,Nanping 353000,China)
出处
《临床合理用药杂志》
2023年第3期20-23,27,共5页
Chinese Journal of Clinical Rational Drug Use
关键词
慢性阻塞性肺疾病
哮喘
重叠综合征
孟鲁司特钠
沙美特罗替卡松
Chronic obstructive pulmonary disease
Asthma
Overlapping syndrome
Montelukast sodium
Salmeterol fluticasone
