The Clinical Research Of Different Therapeutic In Patients With Stable Chronic Obstructive Pulmonary Disease

Objective:The clinical research of different therapeutic in patients with stable chronic obstructive pulmonary disease.Methods:The patients were divided into three groups:The inhaled combination group(n=40),inhaled salmeterol(50ug) fluticasone(250ug) twice daily; The drug combination group(n=37),sprayed Compound ipratropium bromide four times daily and theophylline sustained-release tablets 0.1g twice daily; The control group(n=45),used the drug in need.All the patients were followed 1 year.The lung function(FEV1,FVC),Quality of life(St.George's scores),6-miniter walk trail,the frequency of exacerbations and hospitalization during one year,dyspnea scale were carried out in the day of hospital discharge and in 1,3,6,12 mouth after hospital discharge.The severe COPD patients compare with hypercapnemia were divided into two groups:the mechanical ventilation group(n=20),patients accept long-term domiciliary non-invasive positive pressure ventilation. The control group(n=26).Followed up 1 year. The FEV1,FVC,PSQI,SGRQ scores,arterial gasometry were carried out in the day of hospital discharge and 1year after hospital diacharge.Results:1 FEV1 and FVC in the inhaled combination group were statistically different compare to the control group(all P<0.05).FEV1 in the drug combination group was statistically different compare to the control group(P<0.05). FEV1 in the drug combination group was statistically different compare to the control group (P<0.05). FEV1 and FVC in the drug combination group were no statistically significant different compare to the inhaled combination group (all P<0.05).2 SGRQ scores in the inhaled combination group and drug combination group was statistically different compare to control group (all P<0.05). SGRQ scores in the inhaled combination group was no statistically significant different compare to the drug combination group(P>0.05).3 6-MWT in the three groups was no statistically significant different (P>0.05).4 The frequency of exacerbations of chronic obstructive pulmonary disease in the inhaled combination group and drug combination group was statistically different compare to the control group (all P<0.05). The frequency of exacerbations during 1 year in the inhaled combination group was no statistically significant different compare to the drug combination group(P>0.05).5 The frequency of hospitalization in the three groups was no statistically significant different(P>0.05).6 In 12 mouth after hospital discharge, the MMRC dyspnea scale in the inhaled combination group and drug combination group was statistically different compare to the control group (all P<0.05). The MMRC dyspnea scale in the inhaled combination group was no statistically significant different compare to the drug combination group(P>0.05).7 No severe adverse events in the three groups. The compliance is 76% in the inhaled combination group,86% in the drug combination group.8 The FEV1 and FVC in the mechanical ventilation group was no statistically significant different compare to the control group in the severe COPD patients with hypercapnemia(P>0.05).9 SGRQ scores in the mechanical ventilation group was statistically different compare to the control group in the severe COPD patients with hypercapnemia(P>0.05).10 The PH,PCO2,PO2 were statistically significant different(P<0.05) between the mechanical ventilation group and control group. The PCO2 in the mechanical ventilation group decreased significantly after 12 mouth (P<0.05). The PCO2 in the control group increased significantly after 12 mouth (P<0.05).The PO2,PH in the mechanical ventilation group and control group did not change after 12 mouth (P>0.05).11 The PSQI scores in the mechanical ventilation group was no statistically significant different compare to the control group in the severe COPD patients with hypercapnemia(P>0.05). the MMRC dyspnea scale in the mechanical ventilation group was statistically significant different compare to the control group in the severe COPD patients with hypercapnemia(P<0.05).12 The 6-MWT were statistically significant different(P<0.05) between the mechanical ventilation group and control group. The frequency of hospitalization were statistically significant different(P<0.05) between the mechanical ventilation group and control group.Conclusions:1 The moderate to severe COPD patients, regular use the inhaled combination or drug combination can effect the rate of decline in FEV1 and FVC Improving the health status. Improving the exercise performance. Reducing the sensation of breathlessness. Reducing the frequency of exacerbations of chronic obstructive pulmonary disease. But the benefit of inhaled combnation and drug combination for the patients was no evidence different.2 The stable COPD patients with chronic hypercapnic.long-term domiciliary non-invasive positive pressure ventilation have no benefit for the lung faction. but can reduce the artery PCO2, to releave hypoxia.Improving life statues. Reducing the frequency of hospitalization.Improving the exercise tolerance.No obviously effect for PSQI scores.