目的

观察规律与不规律药物治疗对慢性阻塞性肺疾病（chronic obstructive pulmonary，COPD）缓解期患者12 个月内急性发作次数、总治疗费用、呼吸困难指数（dyspnea index，mMRC）和COPD 评估测试评分（COPD evaluation test score，CAT）、第一秒最大用力呼气容量（forced expiratory capacity in the first second，FEV₁）的影响。

方法

选择2019 年9 月至2023 年9 月我院确诊COPD 缓解期患者117 例，根据用药是否规律情况，52 例不规律用药为对照组，65 例规律用药为观察组。 观察组长期规律吸入糖皮质激素（inhalated corticosteroids，ICS）联合长效β₂ 受体激动剂（long-acting β₂-receptor agonists，LABA），如沙美特罗氟替卡松粉吸入剂（舒利迭）、布地奈德福莫特罗粉吸入剂（信必可），或长期吸入长效抗胆碱能药物（long-acting muscarine anticholinergic，LAMA），如噻托溴铵，或三联制剂，如氟替美维、布地格福等。 观察两组治疗后12 个月急性加重次数、经济费用情况、mMRC 和CAT 评分、FEV₁。

结果

用药期间，观察组急性加重（主要为咳嗽、咳痰，在门诊接受治疗后缓解）次数出现1 次32 例、2 次2 例、3 次1 例；对照组急性加重（主要为咳嗽、咳痰，在门诊接受治疗后缓解；部分出现明显的呼吸困难、气短等症状，住院治疗后缓解）次数出现2 次27 例、3 次23 例、4 次2 例。 治疗12 个月后，观察组FEV₁ 值（1.11±0.31）L、mMRC 评分（1.85±0.89）分、CAT 评分（14.23±5.12）分低于对照组（0.74±0.15）L，（2.81±0.73）分，（25.86±2.84）分（P＜0.05）；观察组总医疗费用（7 096.25±2 731.87）元低于对照组（9 780.00±3 093.74）元（P＜0.05）。

结论

COPD 缓解期患者，遵从医嘱用药者，长期规律吸入药物治疗能改善患者肺功能，提高生活质量，减少住院次数，降低医疗费用。

Objective

To observe the effects of regular and irregular medication on the frequency of acute exacerbations，total treatment costs，dyspnea index （mMRC），COPD assessment test scores （CAT），and forced expiratory volume in the first second （ FEV₁） over a 12-month period for patients with COPD in remission.

Methods

A total of 117 patients diagnosed with COPD in remission at our hospital from September 2019 to September 2023 were select. Patients were divided into a control group of 52 who used medications irregularly and an observation group of 65 who used medications regularly. The observation group received longterm regular inhaled corticosteroids （ICS） combined with long-acting β₂ receptor agonists （LABA），such as salmeterol fluticasone powder inhaler （Sulair），budesonide formoterol powder inhaler （Xinafo），or long-acting anticholinergic drugs （long-acting muscarine anticholinergic，LAMA），such as tiotropium bromide，or triple formulations，such as fluticasone propionate and budesonide. Observe the number of acute exacerbations，total economic costs，mMRC and CAT scores，and FEV₁ in both groups at 12 months post-treatment.

Results

During the medication period，the observation group experienced 1 exacerbation （mainly coughing and sputum production，relieved after outpatient treatment） in 32 cases，2 in 2 cases，and 1 in 1 case； the control group experienced 2 exacerbations （mainly coughing and sputum production，relieved after outpatient treatment； some with significant dyspnea and shortness of breath，relieved after hospitalization） in 27 cases，3 in 23 cases，and 4 in 2 cases. After 12 months of treatment，the FEV₁ value （1.11±0.31） L，mMRC score （1.85±0.89） points，and CAT score （14.23±5.12） points in the observation group were lower than those in the control group （0.74±0.15） L，（2.81±0.73） points，and （25.86±2.84） points （P＜0.05）； the total medical expenses in the observation group （7 096.25±2 731.87） yuan were lower than those in the control group （9 780.00± 3 093.74）yuan （P＜0.05）.

Conclusion

For COPD patients in remission who follow medical advice and receive longterm regular inhalation therapy，improve lung function，enhance quality of life，reduce hospitalization frequency，and lower economic costs.