Clinical observation of montelukast sodium combined with tiotropium bromide in the treatment of 51 cases with acute exacerbation of chronic obstructive pulmonary disease / 中国基层医药

ABSTRACT

Objective:To investigate the therapeutic effect of montelukast sodium combined with tiotropium bromide in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its effect on serum tumor necrosis factor like weak apoptosis inducing factor (TWEAK), monocyte chemoattractant protein-1 (MCP-1) and inflammatory factor.Methods:From January 2019 to January 2020, 102 patients with AECOPD were selected from Kecheng Xiangyuan Hospital of Traditional Chinese Medicine of Quzhou.According to the method of random table, they were divided into observation group and control group, with 51 cases in each group.The observation group was treated with montelukast sodium tablets combined with tiotropium bromide, while the control group was treated with tiotropium bromide.The course of treatment in both two groups was 2 weeks.The therapeutic effect, lung function and blood gas analysis, TWEAK, MCP-1 and inflammatory factors were compared before and after treatment.Results:The total effective rate of the observation group (92.16%, 47/51) was higher than that of the control group (72.55%, 37/51) (χ 2=6.746, P<0.05). After treatment, the PEF[(2.98±0.21)L/s], FEV 1[(2.13±0.15)L] and PaO 2[(87.81±6.31)mmHg] in the observation group were higher than those in the control group[(2.43±0.35)L/s, (1.76±0.23)L and (74.39±5.48)mmHg], while PaCO 2[(36.28±4.15)mmHg] was lower than that in the control group[(49.83±4.26)mmHg], the differences were statistically significant ( t=9.623, 9.620, 11.467, 16.271, all P<0.05). The serum levels of TWEAK[(0.46±0.07)pg/L] and MCP-1[(93.42±13.27)ng/L] in the observation group were lower than those in the control group[(0.58±0.06)pg/L and (115.63±18.43)ng/L]( t=9.295, 6.984, all P<0.05). The levels of IL-13[(94.56±13.24)ng/L], IL-18[(43.87±3.89)ng/L] and TNF-α[(131.29±15.36)ng/L] in the observation group were lower than those in the control group[(113.21±15.53)ng/L, (56.78±4.25)ng/L and (131.29±15.36)ng/L]( t=6.526, 15.941, 8.726, all P<0.05). Conclusion:Montelukast sodium combined with tiotropium bromide is effective in the treatment of AECOPD.It can reduce the levels of serum TWEAK and MCP-1, and reduce the inflammatory response.