Clinical Effects Of Budesonide,terbutaline Combined With Ambroxolaerosol Inhalation In The Treatment Of Acute Exacerbation Of Chronic Cor Pulmonale

Objective:To analyze the clinical efficacy of Budesonide suspension combined with Terbutaline sulfate atomization solution and Ambroxol hydrochloride under oxygen-driven nebulization in patients with acute exacerbation of chronic cor pulmonale;Evaluate brain natriuretic peptide,arterial blood gas analysis and pulmonary arterial pressure improvement and adverse reactions before and after treatment,and provide clinical basis for clinical combination therapy.Method:We collecte 60 inpatients with acute exacerbation of chronic cor pulmonale during chronic obstructive pulmonary disease from October2016 to October 2017 in the emergency department of the First Affiliated Hospital of Hebei North College.The patients were randomly divided into two groups: the control group and the therapy group;the control group was given atomization inhalation of physiological saline,oxygen therapy,anti-infection,relieve cough and anti-asthma,cardio diuresis and other symptomatic routine treatment,a total of 30 cases,male to female ratio 2:1,age(45-80)years old,average(63.733 ± 8.936)years old.The therapy group was based on the above treatment,and was given Budesonide suspension 2mg+ Terbutaline sulfate atomization solution 5mg+ Ambroxol hydrochloride injection 15 mg in Oxygen-driven aerosol inhalation.oxygen flow 5-7L/min,15-20 min each time,2 times per day,continuous use for 7days,the therapy group 30 cases,male to female ratio 11:4,age(46-82)years old,the average age was(64.233 ± 9.05)years old.The efficacy oftreatment was evaluated by observing clinical symptoms and signs.BNP,arterial blood gas analysis(Pa O2,Pa CO2),and pulmonary artery pressure data were recorded before and after treatment in the two groups of patients,and adverse reactions were recorded.Result:(1)Before treatment,there was no significant difference between the control group and the therapy group in general conditions and Pa O2,Pa CO2,BNP,and pulmonary artery pressure(P>0.05).After treatment,the Pa O2,Pa CO2,BNP,and pulmonary arterial pressure in both groups were significantly improved compared with those before treatment(control group t=-6.237,9.277,5.625,2.98,therapy group t=-11.213,16.534,10.999,4.614).The differences were statistically significant(P<0.05).Bsides the pulmonary arterial pressure(t=-0.575,P > 0.05),Pa O2,Pa CO2,and BNP in the therapy group were more significantly changed than those in the control group(t=-3.791,2.876,3.430),the difference was statistically significant(P<0.05).(2)After treatment,the observed rate was 16.67% in the therapy group and the total effective rate was 90%;the control group showed effective rate of 6.67% and the total effective rate of 66.67%.The difference between the therapy group and the control group was statistically significant(?2=6.24,P=0.044<0.05).(3)During the treatment,there was no serious adverse reaction in the two groups.The main adverse reactions were dyspepsia,nausea and nebulization.The incidence of adverse events was 6.7% in the control group and 10% in the therapy group,with no statistical difference(?2=2.33,P>0.05)..Conclusion:(1)Budesonide suspension,Terbutaline sulfate atomization solution and Ambroxol hydrochloride combined with inhalation of ambroxol in the treatment of patients with acute exacerbation of chronic pulmonary heartdisease,it is effective to improve Pa O2,reduce Pa CO2,relieve the condition of anoxia;Meanwhile,reducing the BNP index is beneficial to the recovery of the patient's heart function,so that the cardiopulmonary function is relieved at the same time.However,the improvement of pulmonary arterial pressure is not obviously better than that of conventional treatment.It is related to the number of samples,the time of treatment and the design of the scheme.It is still necessary to study a large sample and a multi course of treatment.(2)The combined atomization inhalation of three drugs is simple and convenient to use.The drug can be used directly to the affected area.It has good absorption,no obvious increase in adverse reaction and no serious adverse reactions.It can be used for reference for clinical treatment.