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中国临床药理学与治疗学 ›› 2005, Vol. 10 ›› Issue (1): 91-95.

• 研究原著 • 上一篇    下一篇

小剂量茶碱与溴化异丙托品联用治疗慢性阻塞性肺疾病的临床观察

翁海霞, 戴元荣, 吴成云, 林洁   

  1. 温州医学院第二附属医院呼吸内科, 温州 325027, 浙江
  • 收稿日期:2004-09-20 修回日期:2004-11-19 出版日期:2005-01-26 发布日期:2020-11-19
  • 通讯作者: 翁海霞, 女, 学士, 主治医师, 研究方向:慢性阻塞性肺疾病。Tel:0577-88816209 E-mail:wenghaix@126.com

Clinical observation of efficacy of combinative usage of ipratropium bromide and small dosage of theophylline on patients with COPD

WENG Hai-xia, DAI Yuan-rong, WU Cheng-yun, LIN Jie   

  1. Department of Respiratory, the Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325027, Zhejiang, China
  • Received:2004-09-20 Revised:2004-11-19 Online:2005-01-26 Published:2020-11-19

摘要: 目的: 观察抗胆碱能吸入剂溴化异丙托品分别与小剂量茶碱控释片及沙丁胺醇联用治疗慢性阻塞性肺疾病(COPD) 的效果。方法: 将40 例稳定期COPD 患者随机分为茶碱组、沙丁胺醇组, 每组20例。茶碱组吸入溴化异丙托品2 喷, tid, 并口服茶碱控释胶囊0.1, 12 h 1 次, 治疗1 周时测定血浆茶碱峰谷浓度, 沙丁胺醇组吸入溴化异丙托品和硫酸沙丁胺醇2 种气雾剂合剂2 喷, tid, 进行8 周观察;入选时测定基础肺功能, 在第1、4、8 周测试日停用所有药物后, 测定FEV1.0, 与基础值比较得出测试日的FEV1.0改善率(△′FEV1.0), 用沙丁胺醇行支气管舒张试验, 测得FEV1.0 改善率(△FEV1.0), 每日测定早晚最大呼气流速(PEFR), 测定PEFR 日间变异率。结果: △FEV1.0 茶碱组在第8 周显著增加(P <0.01), 沙丁胺醇组逐渐下降(P <0.001), 在第4 周起茶碱组△FEV1.0高于沙丁胺醇组(P <0.01);两组△′FEV1.0 均有增加, 但茶碱组增加显著(P <0.001);PEFR 日间变异率茶碱组下降(P <0.01),沙丁胺醇组无改变;血浆茶碱峰浓度为8.7±2.1 mg·L-1, 谷浓度6.1±2.3 mg·L-1;两组不良反应少。结论: 小剂量茶碱具有抗炎和免疫调节作用,与溴化异丙托品联用是治疗慢性阻塞性肺疾病的一种有效方法, 而溴化异丙托品与沙丁胺醇长期联用治疗稳定期COPD, 可造成对沙丁胺醇的反应性低下, 建议不要长期联用。

关键词: 溴化异丙托品, 小剂量茶碱, 沙丁胺醇, 慢性阻塞性肺疾病

Abstract: AIM: To contrastively observe the effects of combinative usage of ipratropium bromide, anti-cholinergic inhalant and the small dosage of controlled release theophylline tablets or salbutamol on the patients with COPD.METHODS: Forty patients with stable COPD were randomly divided into two groups (n=20 in each): theophylline group or salbutamol group.In theophylline group, each case inhaled 2 puffs of ipratropium bromide ter in die, meanwhile take 0.1 g ophylline capsule orally every 12 hours, measured the maximum and minimum concentration of ophylline.In salbutamol group, each case inhaled 2 puffs of ipratropium bromide and salbutamol ter in die.During 8-weeks trial, the base FEV1.0 before using medicine and the FEV1.0 when all the drug were stopped at the end of 1st, 4th, and 8th week was measured, separately.The FEV1.0 amelioration ratio (△′ FEV1.0) compared with base FEV1.0 was obtained, and another FEV1.0 amelioration ratio (△FEV1.0) was also detected after bronchodilatation test by salbutamol.Furthermore, PEFR aberration rate was evaluated by measuring peak expiratory flow rate in morning and evening daily.The maximum concentration of ophylline is 8.7±2.1 mg·L-1, the minimum is 6.1±2.3 mg·L-1.RESULTS: △FEV1.0 increased markedly at end of 8th week in theophylline group (P <0.01) and decreased gradually in salbutamol group (P < 0.001).It showed that △FEV1.0 in theophylline group increased more significantly than that in salbutamol group from 4th week (P < 0.01).△′FEV1.0 increased in both two groups but more apparently in theophylline group (P <0.001), and PEFR aberration rate descended in theophylline group(P < 0.01).There were few side effects in both two groups. CONCLUSION: Combinative usage of ipratropium bromide and small dosage of theophylline have anti-inflammatory and immunonondulatory effect to treat COPD.The long-time combinative usage of ipratropium bromide and salbutamol, used for stable COPD, will decrease the reactivity of patient to salbutamol.

Key words: ipratropium bromide, small dosage theophylline, salbutamol, chronic obstructive pulmonary disease

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