The effect of tiotropium bromide powder on the sleep quality and lung function in patients with moderate and severe chronic obstructive pulmonary disease in stable period / 中国医师进修杂志

ABSTRACT

Objective To explore the influence of tiotropium bromide powder inhalant or budesonide powder inhalant on sleep quality and lung function in patients with moderate and severe chronic obstructive pulmonary disease (COPD) in stable period. Methods Sixty-three patients with moderate and severe COPD in stable period were divided into 2 groups by random sortition method:tiotropium bromide group(31 cases,the patients inhaled tiotropium bromide powder inhalant 5 μg/time, 1 time/12 h) and budesonide group (32 cases, the patients inhaled budesonide powder inhalant 200 μg/time, 1 time/12 h). All patients were treated for 3 months. The lung function monitoring and polysomnography were detected before and after treatment. Results Seven patients withdrawn 3 patients were in tiotropium bromide group,and 4 patients were in budesonide group.The forced expired volume in 1 second(FEV1),forced vital capacity(FVC),FEV1/FVC,peak expiratory flow(PEF)and forced expiratory flow from 25% to 75% (MMEF) after treatment in 2 group were significantly improved compared with those before treatment, and there were statistical differences (P<0.05). The FEV1, FVC and FEV1/FVC levels after treatment in tiotropium bromide group were significantly higher than those in budesonide group (2.29 ± 0.43) L vs. (2.01 ± 0.42) L, (4.19 ± 0.26) L vs. (3.93 ± 0.23) L and (52.03 ± 10.45) % vs. (49.73 ± 10.21) %, and there were statistical differences (P<0.05). The percentages of S1 phase,S2 phase,rapid eye movement(REM)phase and activity apnea-hypopnea index (AHI)after treatment in 2 groups were significantly improved compared with those before treatment,and the indexes in tiotropium bromide group were significantly better than those in budesonide group(29.99 ± 8.43)% vs. (26.91 ± 11.66)%, (48.99 ± 10.26)% vs. (45.45 ± 10.13)%, (14.83 ± 8.36)% vs. (13.33 ± 7.44)% and (8.70 ± 5.11) times/h vs. (11.72 ± 10.09) times/h, and there were statistical differences(P<0.05).Conclusions Tiotropium bromide has better effect in promoting the lung function and sleep quality compared with budesonide in patients with moderate and severe COPD in stable period.