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《Chinese Journal of Difficult and Complicated Cases》 2017-07
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Effects of tiotropium bromide and ipratropium bromide on asthma chronic obstructive pulmonary disease overlap syndrome and their effects on serum TNF-α and IL-6

LI Ming;LI Linxu;WANG Shuo;JI Chunmei;Respiratory Medicine,Tangshan City Xiehe Hospital;  
Objective To compare the effect of tiotropium bromide and ipratropium bromide on asthma chronic obstructive pulmonary disease overlap syndrome and their effects on serum TNF-α and IL-6.Methods Ninety(rases of patients with asthma-chronic obstructive pulmonary disease overlap syndrome were selected,who were treated in hospital from March2014 to March 2016,and they were divided into the A group(45 cases) and B group(45 cases).The patients of two groups were all treated with routine treatment,including reduction of exercise load,oxygenation,administration of budesonide aerosol inhalants(1 suction/time,2 times/d).The patients of B group were treated with tiotropium inhalation powder(1 tablet/time,1 time/d).The patients of A group were treated with ipratropium bromide aerosol(1 spray/time,4 times/d).The patients of two groups were all treated for 8 weeks.The clinical efficacy,adverse reaction rate and changes of the levels of pulmonary function,TNF-α,IL-6 inflammatory cell levels,ACT,CAT and acute exacerbations of two groups were compared.Results After the appropriate treatment,the patients of the B group got a total effective rate of 91.1%,which was significantly better than the 73.3%of the A group(x~2=4.865,P =0.027);The levels of PEF,FVC,FEV,%,IC/TLC,DLCO of the B group were significantly higher than those of the A group(t=10.173,t=4.250,t=7.409,t=2.162,t=1.743,P 0.05);The RV/TLC levels of the B group were significantly lower than those of the A group(t=3.931,P =0.000);The levels of ACT score of the B group were significantly higher than those of the A group(t=12.083,P =0.000);The TNF-α,IL-6 levels,CAT scores,acute exacerbation of the B group were significantly lower than those of the A group(t =7.754,t =2.831,t=7.701,t=9.000,P 0.01);There were dry mouth,headache,palpitations,nausea,hoarseness,dysuria,constipation and other adverse reactions occurred in both two groups,but there were no statistically significant between the two groups(P 0.05).Conclusion Compared with ipratropium bromide,tiotropium bromide for the treatment of asthma-chronic obstructive pulmonary disease overlap syndrome can get the exact effect,significantly reduce the levels of inflammatory cells,improve the lung function,and il is safe and reliable,which makes it worthy of clinical promotion.
【CateGory Index】: R562.25;R563.9
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