Analysis of the efficacy of tiotropium bromide combined with BiPAP in treatment of patients with AECOPD / 中国基层医药

ABSTRACT

Objective@#To analyze the efficacy of tiotropium bromide combined with bi level positive airway pressure ventilation(BiPAP) in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).@*Methods@#From 2014 to 2016, 60 patients with AECOPD in Tongde Hospital were selected in the research, and were randomly divided into the control group and observation group according to the digital table, with 30 cases in each group.The control group was given BiPAP treatment on the basis of conventional treatment, and the observation group was given tiotropium bromide combined with BiPAP treatment.The therapeutic effects, pulmonary function, arterial blood gas analysis, serum inflammatory factors and quality of life were compared between the two groups after 12 weeks of continuous treatment.@*Results@#After treatment, the total effective rate of the control group was 76.67%, which of the observation group was 96.67%, the difference between the two groups was statistically significant(χ2=5.192, P<0.05). Before treatment, one second forced expiratory volume(FEV1), forced expiratory volume in one second/forced vital capacity(FEV1/FVC), one second forced expiratory volume percentage(FEV1%) between the two groups showed no statistically significant differences(all P>0.05). After treatment, the FEV1, FEV1/FVC and FEV1% in the observation group were (2.73±0.63)L, (77.53±10.68)%, (73.85±11.21)%, respectively, which were higher than those in the control group [(2.02±0.57)L, (68.57±11.25)%, (64.38±12.74)%], the differences between the two groups were statistically significant(t=4.577, 3.163, 3.056, all P<0.05). Before treatment, the oxygen partial pressure(PaO2), partial pressure of carbon dioxide(PaCO2) between the two groups showed no statistically significant differences(all P>0.05). After treatment, the PaO2 of the observation group [(80.48±15.64)mmHg] was higher than that of the control group[(66.05±12.05)mmHg], the PaCO2 of the observation group [(53.11±8.38) mmHg] was lower than that of the control group [(60.33±9.95)mmHg], the differences between the two groups were statistically significant(t=4.003, 3.039, all P<0.05). Before treatment, the serum interleukin 6(IL-6), tumor necrosis factorα(TNF-α), high sensitive C reactive protein(hs-CRP) levels between the two groups showed no significant differences(all P>0.05). After treatment, the levels of serum IL-6, TNF-alpha and hs-CRP in the observation group were (85.83±27.35)ng/L, (85.35±29.15)ng/L, (2.25±0.64)mg/L, respectively, which were lower than those in the control group [(102.57±32.65)ng/L, (101.45±32.14)ng/L, (2.88±0.78)mg/L], there were significant differences between two groups(t=2.152, 2.032, 3.420, all P<0.05). Before treatment, the quality of life questionnaire(SF-36) score between the two groups had no statistically significant difference(P>0.05). After treatment, the SF-36 score of the observation group[(92.48±8.64)points]was higher than the control group[(79.22±17.04)points], there was statistically significant difference between the two groups(t=3.095, P<0.05).@*Conclusion@#Tiotropium bromide combined with BiPAP has better curative effect in the treatment of AECOPD, it can help to improve the patients' lung function and blood gas index, regulate the body's inflammatory state, so that patients get better quality of life, it is worthy of clinical application.