噻托溴铵联合夜间氧疗对COPD夜间睡眠低氧的疗效研究

目的:探讨噻托溴铵联合夜间氧疗对慢性阻塞性肺疾病（Chronic obstructive pulmonary disease，COPD）夜间睡眠低氧的治疗作用，并间接评价噻托溴铵对夜间睡眠低氧的疗效。方法：选择存在夜间睡眠低氧的稳定期中重度COPD患者40例，随机分为２组，观察组（20例）给予吸入噻托溴铵（18 μg，每日午后1次）联合夜间氧疗（2 L/min），对照组（20例）给予单纯夜间氧疗（2 L/min），分别在治疗前和治疗4周后检测夜间睡眠血氧饱和度、血气分析、肺功能。结果：2组治疗后与治疗前比较：观察组夜间平均血氧饱和度（Nocturnal mean SaO2，MSaO2）、夜间最低血氧饱和度（Nocturnal minimum SaO2，MmSaO2）、动脉血氧分压（Arterial partial pressure of oxygen，PaO2）、动脉血氧饱和度（Arterial oxygen saturation，SaO2）、第1秒用力呼气容积（Forced expi－ratory volume in one second，FEV1）、FEV1占预计值百分比（Percentage of FEV1 in the predicted value，FEV1%Pred）、用力肺活量（Forced vital capacity，FVC）、深吸气量（Inspiratory capacity，IC）、呼气峰值流速占预计值百分比（Percentage of peak expiratory flow rate in the predicted value，PEF%Pred）显著提高；对照组MSaO2、MmSaO2、PaO2、SaO2明显升高，而FEV1、FEV1%Pred、FVC、IC、PEF%Pred则无明显改变；2组夜间血氧饱和度小于90%的时间占总睡眠时间的百分比（T90）显著降低；观察组动脉血二氧化碳分压（Arterial partial pressure of carbon dioxide，PaCO2）明显降低，而对照组PaCO2则明显升高。2组治疗后比较：观察组MSaO2、MmSaO2、PaO2、SaO2明显提高，T90、PaCO2显著降低，FEV1、FEV1%Pred、FVC、IC、PEF%Pred显著提高。结论：噻托溴铵联合夜间氧疗能显著改善COPD夜间睡眠低氧，并优于单纯夜间氧疗；噻托溴铵也能改善COPD夜间睡眠低氧。

Therapeutic effect of tiotropium bromide in combination with nocturnal oxygen therapy on nocturnal hypoxemia in patients with chronic obstructive pulmonary disease

Objective To optimize the extract technology of active lignins from the fruits of Schisandra chinensis. Methods The content of schizandrin, gomisin A, and deoxyschizandrin were selected as standards to evaluate the efficiency of smashing tissue extraction (STE). Solid-liquid ratio, extracting times, ethanol concentration, and extracting time were investigated through orthogonal test. Results The optimized conditions for STE were ten times amount of 80% EtOH, extracting for three times, and 2 min for each time. Conclusion STE could obtain relatively higher yield, simplicity of operation, and benefit for environment protection. It could be better choice for the extraction of S. chinensis.