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ENGLISH ABSTRACT
多索茶碱用于慢性阻塞性肺疾病急性加重恢复期的效果观察
张学平
张莹
马小芬
李新
胡振彩
翟云青
作者及单位信息
·
DOI： 10.3760/cma.j.issn.1008-6706.2019.21.007
Effect of doxofylline on acute exacerbation of chronic obstructive pulmonary disease in convalescent stage
Zhang Xueping
Zhang Ying
Ma Xiaofen
Li Xin
Hu Zhencai
Zhai Yunqing
Authors Info & Affiliations
Zhang Xueping
Department of Respiratory Medicine, Binzhou Central Hospital, Binzhou, Shandong 251700, China
Zhang Ying
Ma Xiaofen
Li Xin
Hu Zhencai
Zhai Yunqing
·
DOI： 10.3760/cma.j.issn.1008-6706.2019.21.007
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摘要

目的研究多索茶碱在慢性阻塞性肺疾病(以下简称慢阻肺)急性加重恢复期中作用，降低早期再发风险。

方法选取滨州市中心医院2016年1月至2018年1月收治的慢阻肺急性加重治疗缓解患者共164例，随机数字表法分为对照组和观察组各82例。对照组给予吸入噻托溴铵和布地奈德/福莫特罗，观察组在吸入药物基础上给予口服多索茶碱联合治疗8周，观察两组恢复期时间、再次急性加重发生率、第一秒用力呼气量(FEV 1)占预计值的百分比(FEV 1%)、慢性阻塞性肺疾病评估测试量表(CAT)评分和6分钟步行试验。

结果观察组恢复期时间短于对照组[(16.89±5.15)d比(19.12±6.29)d， t＝2.48， P＝0.014)]，再次急性加重发生率低于对照组(26.83%比41.46%，χ 2＝4.58， P＝0.032)，两组FEV 1%差异无统计学意义[(45.59±9.82)%比(44.26±9.03)%， t＝0.90， P＝0.369)]，CAT评分优于对照组[(19.32±6.16)分比(21.71±6.62)分， t＝2.39， P＝0.018]，6分钟步行距离远于对照组[(146.32±10.20)m比(135.69±11.59)m， t＝6.23， P＝0.000)]，指脉氧(SpO 2)高于对照组[(94.12±5.09)%比(92.06±6.21)%， t＝2.23， P＝0.026)]，呼吸频率慢于对照组[(20.38±7.32)次/min比(22.86±6.53)次/min， t＝2.29， P＝0.023)]，两组心率差异无统计学意义[(98.24±12.35)次/min比(101.38±15.03)次/min， t＝1.46， P＝0.146)]，两组均未发现严重药物不良反应。

结论多索茶碱在慢阻肺急性加重恢复期作为吸入药物的有益补充，可缩短恢复期时间，降低早期急性加重发生率，改善症状。

肺疾病，慢性阻塞性;用力呼气量;多索茶碱
ABSTRACT

ObjectiveTo study the effect of doxofylline on acute exacerbation of chronic obstructive pulmonary disease (COPD) and reduce the risk of early recurrence.

MethodsFrom January 2016 to January 2018, 164 patients with acute exacerbation of COPD in Binzhou Central Hospital were randomly divided into two groups by random digital table: control group ( n=82) and observation group ( n=82). The control group was given tiotropium bromide and budesonide/formoterol.The observation group was treated with oral doxophylline bid for 8 weeks on the basis of inhaled drugs.The recovery time, acute exacerbation rate, FEV 1, CAT score and 6-minute walking test were compared between the two groups.

ResultsThe time of convalescent stage in the observation group was shorter than that in the control group[(16.89±5.15)d vs.(19.12±6.29)d, t=2.48, P=0.014], and the acute exacerbation rate of the observation group was lower than that of the control group (26.83% vs.41.46%, χ 2=4.58, P=0.032). There was no statistically significant difference in FEV 1[(45.59±9.82)% vs.(44.26±9.03)%, t=0.90, P=0.369], and the CAT score of the observation group was better than that of the control group [(19.32±6.16)points vs.(21.71±6.62)points, t=2.39, P=0.018]. The 6-minute walking distance of the observation group was longer than that of the control group[(146.32±10.20)m vs.(135.69±11.59)m, t=6.23, P=0.000], and the finger pulse oxygen of the observation group was higher than that of the control group[(94.12±5.09)% vs.(92.06±6.21)%, t=2.23, P=0.026]. The respiratory rate in the observation group was slower than that in the control group[(20.38±7.32)times/min vs.(22.86±6.53)times/min, t=2.29, P=0.023], and there was no statistically significant difference in heart rate[(98.24±12.35)bpm vs.(101.38±15.03)bpm, t=1.46, P=0.146]. No serious adverse drug reactions were found in both two groups.

ConclusionAs a beneficial supplement of inhaled drugs in convalescent COPD, doxofylline can shorten the recovery time, reduce the early acute exacerbation rate and improve the symptoms, which is worthy of clinical reference.

Pulmonary disease, chronic obstructive;Forced expiratory volume;Doxofylline
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引用本文

张学平,张莹,马小芬,等. 多索茶碱用于慢性阻塞性肺疾病急性加重恢复期的效果观察[J]. 中国基层医药,2019,26(21)：2588-2592.

DOI:10.3760/cma.j.issn.1008-6706.2019.21.007

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慢性阻塞性肺疾病(以下简称慢阻肺)为我国四大慢性病之一，最新的流行病学调查发现我国40岁以上成年人患病率8.6%，严重危害人民身体健康，并给社会及家庭带来沉重负担 [ 1 ]。慢阻肺分为急性加重期和稳定期，而在临床上，患者在急性加重症状由部分缓解到完全缓解至稳定期往往经历一段时间的恢复期。恢复期治疗强度弱于急性加重期治疗，强于稳定期的单纯吸入治疗，而急性加重控制8周内的早期复发是一种预后更差的标志 [ 2 ]。加强慢阻肺急性加重恢复期的管理，降低早期再次急性加重的风险，改善患者生活质量，成为疾病治疗关注的重点。多索茶碱为风险效益比较好的黄嘌呤类药物，具有扩张气道、抗炎、改善呼吸肌肌力等多种作用，是有效和安全的治疗慢阻肺的药物 [ 3 ]。现探讨口服多索茶碱在慢阻肺急性加重恢复期的临床疗效，为临床实践提供依据。
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