肺康复联合噻托溴铵对慢性阻塞性肺疾病稳定期患者BODE指数的影响

目的 观察肺康复联合吸入噻托溴铵粉剂对中-重度COPD稳定期患者BODE指数的影响.方法 选择我院呼吸科门诊2013年10月至2015年7月确诊COPD稳定期患者60例,分为联合组(肺康复联合噻托溴铵)和对照组.对照组给予常规COPD药物基础上吸入单一噻托溴铵粉吸入剂治疗.联合组指在常规药物治疗基础上给予肺康复(包括呼吸功能锻炼、长期家庭氧疗、营养支持、心理疏导等综合治疗),联合每日吸入噻托溴铵粉吸入剂.对比2组治疗后3个月、6个月的BODE指标及BODE指数变化.结果 联合组与对照组比较治疗3个月后BODE指标(BMI、呼吸困难程度、6MWD、FEV1％ pred)、BODE指数有改善,差异有统计学意义(t=2.23,P＞0.05;t=2.44、7.78、4.36、2.61,P＜0.05),治疗6个月后BODE指标(BMI、呼吸困难程度、6MWD、FEV2％ pred)、BODE指数有显著改善,差异有统计学意义(t=4.26、3.25、23.74、9.73、4.78,P＜0.05).结论 中-重度COPD稳定期患者实施肺康复联合吸入噻托溴铵粉剂治疗后,BODE相关指标及BODE指数显著改善,长期的肺康复及噻托溴铵使用有更大获益.

Influence of pulmonary rehabilitation with tiotropium bromide to BODE index of patients with chronic obstructive pulmonary disease in stable period

Objective To observe the effect of pulmonary rehabilitation combined with tiotropium bromide inhalation to BODE index of patients with moderate to severe chronic obstructive pulmonary disease (COPD) in stable period.Methods Sixty patients with stable COPD seen at the Mentougou Hospital's Department of Respiratory Medicine from October 2013 to July 2015 were enrolled in the study.They were divided into two groups:the combined group (treated with pulmonary rehabilitation combined with tiotropium bromide) and the control group (treated with routine drug on single inhalation of Tiotropium Bromide Powder for Inhalation COPD).Patients in the combine group,in addition to being treated with the conventional therapy,also received pulmonary rehabilitation (including respiratory function exercise,long-term oxygen therapy at home,nutrition support,psychological counseling).Plus,they inhaled tiotropium bromide inhalation powder on the daily basis.After 3 months and 6 months' treatment,both groups' BODE index data were analyzed and compared.Results The combined group and the control group.After 3 months' treatment,the combined group's BODE index (BMI,degree of dyspnea,6MWD,FEV1％ pred) were improved better comparing with that of the control group.The improvement difference was statistically significant (t =2.23,P ＞ 0.05;t =2.44,7.78,4.36,2.61,P ＜ 0.05).After 6 months' treatment,the combined group's BODE index (BMI,degree of dyspnea,6MWD,FEV1 ％ pred) were improved significantly better comparing with that of the control group.The improvement difference was statistically significant (t =4.26,3.25,23.74,9.73,4.78,P ＜ 0.05).Conclusions For patients with stable COPD,treatment of pulmonary rehabilitation,combined with tiotropium bromide inhalation after treatment,will improve the BODE index and its related indexes significantly.The longer the treatment lasts,the better the improvement will be.