Discuss The Curative Effect Of Tiotropium In Patients With Chronic Obstructive Pulmonary Disease In Different Groups

Objective: Investigate the changes in symptoms, pulmonary function,exacerbation risk of patients with chronic obstructive pulmonary disease, who haveused tiotropium bromide inhalation powder one year regularly.Methods: It is a case-control study. In accordance with COPD diagnostic criteriaof Chinese Medical Association,there were64cases of patients with chronicobstructive pulmonary disease,who were divided into two groups,the tiotropium groupwith tiotropium bromide inhalation powder and the control group with routine treatmentexcept tiotropium. According to the criterion of the2011GOLD global strategy to theseverity of COPD, it was divided into A, B, C, D, each group of8people intotiotropium group. Assesse the differences between two groups and the correspondinggroup in mMRC, pulmonary function, the number of exacerbations after1year.Results: There was no statistical difference between two groups and thecorresponding groups in gender, age, mMRC, pulmonary function and frequentexacerbations of the past year. One year later, patients’ mMRC and frequentexacerbations in tiotropium group decreased significantly (P<0.05), but spirometry alsodecreased significantly (P<0.05); the control group of patients in mMRC and frequentexacerbations did not differ,but spirometry decreased obviously (P<0.001). It wassaying that clinical symptoms and frequent exacerbations of COPD could be improvedby tiotropium. Analyse the difference of spirometry in two groups, we found thatspirometry in tiotropium group decreased more significant than the control group(P<0.05).It shows that tiotropium can delay the decline of spirometry in COPDpatients.We found there was no difference in mMRC and frequent exacerbations in Agroups, but the degree of decline in the tiotropium group was more significant than thecontrol group (P<0.05); The mMRC of tiotropium group was lower than that of controlgroup in B gruops (P<0.05), spirometry of decline degree in tiotropium group was lower than that of control group (P<0.05), but no difference in frequent exacerbations. C groupof tiotropium group in frequent exacerbations was significantly lower than controlgroup (P<0.05), lung function decline was lower than that of the control group (P<0.05),but there was no difference between the two groups in mMRC. In D group,mMRC waslower than that of the control group (P<0.05), frequent exacerbations were less than thatof the control group (P<0.05), but the decline degree in lung function shows nodifference. It suggests that tiotropium can delay the rate of decline about pulmonaryfunction in A group, B group and C group, but no effect on D group. Tiotropium canreduce frequent exacerbations in the B group and D group, improve mMRC in B groupand D group.Conclusions: Tiotropium can reduce the rate of decline in lung function and thefrequent exacerbations, and also improve the mMRC.Tiotropium can delay the rate of decline about lung function in A group, B groupand C group,decrease frequent exacerbations in B group and D group and improve themMRC in B group and D group.