Ib qho kev tshuaj ntsuam meta-tshaj tawm hauv Internal Medicine qhia tau hais tias cov tshuaj tua kab mob thiab cov kab mob glucocorticoids cuam tshuam nrog kev kho mob tsawg dua hauv cov neeg laus nrog.COPDexacerbations piv rau cov placebo lossis tsis muaj kev cuam tshuam kho mob.

Txhawm rau ua qhov kev tshuaj xyuas thiab ntsuas ntsuas ntsuas, Claudia C. Dobler, MD, Bond University, Australia, thiab lwm tus tau soj ntsuam 68 qhov kev sim tswj tsis tau, suav nrog 10,758 tus neeg mob laus uas mob hnyav heev ntawmCOPDuas tau kho hauv tsev kho mob lossis tus neeg mob sab nraud.Txoj kev tshawb no piv cov kev cuam tshuam pharmacological nrog cov placebo, kev saib xyuas niaj hnub lossis lwm yam kev cuam tshuam pharmacological.

Cov txiaj ntsig ntawm cov tshuaj tua kab mob thiab cov kab mob glucocorticoids

Hauv kev sib piv ntawm 7-10 hnub ntawm kev siv tshuaj tua kab mob thiab cov placebo lossis kev saib xyuas zoo rau cov neeg mob hauv tsev kho mob lossis cov neeg mob sab nraud, thaum kawg ntawm kev kho mob, cov tshuaj tua kab mob cuam tshuam txog kev tshem tawm ntawm tus kab mob exacerbation, tab sis tsis muaj dab tsi cuam tshuam nrog Qhov hnyav ntawm qhov exacerbation thiab kev kho ib puag ncig ( LOSSIS = 2.03; 95% CI, 1.47- -2.8; cov pov thawj tsis zoo).Tom qab qhov kawg ntawm kev kho mob, nyob rau hauv txoj kev tshawb no ntawm cov neeg mob sab nraud nrog mob me ntsis exacerbations, kab mob tshuaj tua kab mob yuav txo tau cov kev kho mob tsis ua hauj lwm npaum li cas (los yog = 0.54; 95% CI, 0.34-0.86; me me pov thawj muaj zog).Cov neeg mob hauv tsev kho mob thiab cov neeg mob sab nraud uas muaj mob me mus rau nruab nrab lossis nruab nrab mus rau qhov hnyav heev, cov tshuaj tua kab mob tuaj yeem txo qis ua pa nyuaj, hnoos thiab lwm yam tsos mob.

Ib yam li ntawd, rau cov neeg mob hauv tsev kho mob thiab cov neeg mob sab nraud, cov kab mob glucocorticoids raug muab piv nrog cov placebo lossis kev saib xyuas ib txwm.Tom qab 9-56 hnub ntawm kev kho mob, cov kab mob glucocorticoids tsis tshua muaj kev poob qis (OR = 0.01; 95% CI, 0- 0.13; cov pov thawj tsis zoo), tsis hais qhov chaw kho mob lossis qib ntawm kev mob hnyav heev.Thaum kawg ntawm 7-9 hnub ntawm kev kho mob, cov neeg mob uas mob me me mus rau qhov hnyav hnyav hauv tsev kho mob sab nraud thiab pw hauv tsev kho mob tau ua rau lawv ua tsis taus pa.Txawm li cas los xij, cov kab mob glucocorticoids cuam tshuam nrog kev nce hauv cov naj npawb ntawm tag nrho thiab endocrine-txog cov xwm txheej tsis zoo.

Cov kws tshawb fawb ntseeg hais tias raws li lawv qhov kev tshawb pom, cov kws kho mob thiab cov npoj yaig yuav tsum tau paub tseeb tias cov tshuaj tua kab mob thiab cov kab mob glucocorticoids yuav tsum tau siv nyob rau hauv ib qho kev mob hnyav.COPD(txawm tias mob me).Nyob rau yav tom ntej, lawv tuaj yeem txiav txim siab zoo dua cov neeg mob yuav tau txais txiaj ntsig zoo tshaj plaws los ntawm cov kev kho mob no thiab cov neeg mob yuav tsis tau txais txiaj ntsig (raws li biomarkers, suav nrog C-reactive protein lossis procalcitonin, ntshav eosinophils).

Xav tau pov thawj ntxiv

Raws li cov kws tshawb nrhiav, tsis muaj cov ntaub ntawv txiav txim siab txog qhov nyiam ntawm cov tshuaj tua kab mob lossis kev kho glucocorticoid, thiab cov pov thawj ntawm kev siv lwm cov tshuaj, suav nrog aminophylline, magnesium sulfate, tshuaj tiv thaiv kab mob, nqus tau cov tshuaj corticosteroids, thiab cov tshuaj bronchodilators luv luv.

Tus kws tshawb fawb tau hais tias nws yuav txwv tsis pub cov kws kho mob siv cov kev kho tsis tau pov thawj, xws li aminophylline thiab magnesium sulfate.Cov kws tshawb fawb ntseeg tias txawm hais tias muaj ntau qhov kev tshawb fawb txog COPD, ntau cov tshuaj kho mob hnyav heev ntawm COPD muaj pov thawj tsis txaus.Piv txwv li, hauv kev xyaum kho mob, peb niaj hnub siv cov tshuaj bronchodilators luv luv los txo qhov ua tsis taus pa thaum mob hnyav ntawm COPD.Cov no suav nrog luv-acting muscarinic receptor antagonists (ipratropium bromide) thiab luv-acting beta receptor agonists (salbutamol).

Ntxiv nrog rau kev tshawb fawb zoo dua, kev tshawb fawb txog kev kho tshuaj, cov kws tshawb fawb kuj tau taw qhia tias lwm hom kev cuam tshuam kuj tseem tsim nyog kawm.

"Ib lub cev loj hlob ntawm cov pov thawj qhia tau hais tias qee qhov kev kho tsis yog tshuaj kho mob, tshwj xeeb tshaj yog cov uas pib tawm dag zog thaum ntxov ntawm lub sijhawm exacerbation, tuaj yeem txhim kho qhov mob nruab nrab mus rau qhov hnyav ntawm cov neeg mob COPD hauv tsev kho mob.American Thoracic Society/European Respiratory Conference nyob rau hauv 2017 Cov lus qhia uas tau tshaj tawm suav nrog cov lus pom zoo (cov pov thawj tsis zoo) thaum mus pw hauv tsev kho mob ntawm tus mob COPD, tsis txhob pib kho mob ntsws, tab sis qee cov pov thawj tshiab tau tshwm sim txij thaum ntawd los uas peb xav tau kev kho mob ntsws. Muaj ntau cov ntaub ntawv pov thawj zoo ntawm kev tawm dag zog thaum ntxov thaum lub sijhawm mob hnyav ntawm COPD los Txheeb xyuas qhov ua tau zoo ntawm kev tawm dag zog thaum ntxov rau kev mob hnyav ntawm COPD.