Clinical Study Of Tiotropium Bromide In Treatment Of Stabilization Period Of Mid-severe Range COPD

Objective:Give stability through the stabilization period of mid-severe range chronic obstructive pulmonary disease in patients with Tiotropium bromide inhalation of salmeterol and fluticasone aerosol(long-actingβ2-receptor agonists and hormonal compound preparations, seretide) observed in patients with indicators of changes in blood gas analysis,Bode index score and the blood of MMP-9 Change,Evaluation of Tiotropium Bromide United Long-actingβ2-receptor agonist and estrogen on moderate to severe stable COPD patients,in order to further provide the basis for clinical application.Method:Choose the First hospital of Shanxi Medical University and the Armed Police General Hospital Dept of geriatrice respiratory stability during treatment of stabilization period of mid-severe range COPD patients 60 cases were randomly divided into Tiotropium Bromide group,salmeterol group and Tiotropium Bromide and salmeterol Group each of 20 cases,Drug therapy in each group was as follows,Tiotropium Bromide groups:one night smoke inhalation 18μg,salmeterol groups:one day sooner or later the inhalation,a dose of 50μg/250μg, Tiotropium Bromide and salmeterol group:One night smoke inhalation 18μg Tiotropium Bromide,sooner or later,the inhalation of 50μg/250μg once seretide,three groups were continuously exposed to the treatment 28 days later insist the treatment of two months,three patients are ease of oral theophylline release tablets for the foundation,sooner or later,the once-per-0.2g,and within the previous month did not receive any inhaled treatment.Indicators measured:three groups of patients were receiving inhaled treatment to do prior to blood gas analysis,BODE index score and venous blood in MMP-9 determination.4 weeks later to repeat the above examination and measured 12 weeks later to repeat the above examination and determination.Peripheral blood of MMP-9 levels were measured by enzyme-linked immunosorbent assay(ELISA) analysis.Result:1 Holds the bromine ammonium group and Shurly the repeat group BODE index obviously is lower than the treatment,the difference has statistics significance(P＜0.05).Around sai holds the bromine ammonium to add the Shurly repeat group to treat the BODE index grading condition to compare the Shurly repeat group and sai holds the bromine ammonium group to drop obviously, has statistics significance(P＜0.05).2 Tiotropium Bromide group compared with their pre-treatment MMP-9 were significantly decreased(P＜0.05),after treatment Tiotropium Bromide and salmeterol group,Tiotropium Bromide salmeterol group and were compared to MMP-9 are significantly lower,the difference has statistical significance(P＜0.05);but Tiotropium Bromide salmeterol group and Tiotropium Bromide Group MMP-9 was not significant(P＞0.05).3 Blood gas analysis to improve the situation of three groups before and after treatment compared to no significant.Conclusion:Tiotropium bromide is a stable first-line maintenance treatment of COPD,one of the drugs.At long-actingβ2-agonist(LABA) and hormone(ICS) of the United inhalation on the basis of the new inhaled anticholinergic drug Tiotropium Bromide,three drug combination therapy during severe stable COPD patients,with good synergy.Help to reduce the stable COPD Bode index,reducing MMP-9 expression can delay the progressive decline in lung function,to improve the symptoms of COPD patients with emphysema,airway remodeling and then alleviate further improve the prognosis of patients is of great significance.