2-tone练习器----有助患者正确使用定量吸入器用药
2007/08/01
鉴于临床上有些患者很难正确使用定量吸入器（MDIs）用药，因此影响其治疗效果。Raid A.M. Al-Showair等借助2-tone练习器[2T]（Canday Medical Ltd; Newmarket, UK）以使患者能掌握这种技术，在出院后仍能很好的使用定量吸入器，并做了相关试验以验证其效果。
研究者将哮喘患者分成三组，一组为经过简单介绍后即使用MDI的所谓“技术优良组”（GT组，36人），其余的被随机分成了两组，一组口头指导其使用方法（VT组，35人），一组为口头指导后加用了2T练习器的试验组（2T组，36人）。测定这些患者使用MDI时的吸入峰流速(PIF)，一秒量（FEV1），并进行Juniper哮喘生活质量问卷调查(AQLQ)。6周后回访再次检测上述指标。结果发现，2次调查中各组患者间的FEV1没有改变。GT组的PIF和AQLQ评分无改变，在VT和2T组，AQLQ评分增加明显（平均差分别为0.33，95%CI为0.14-0.53; p < 0.001和0.74，95% CI为0.62-0.86; p < 0.001），VT和2T组，在第1次检测时所有患者均吸入> 90 L/min，到后来随访时减少到分别只有12个患者和1个患者吸入这样的剂量（p均< 0.001）。2T组在两次检查时PIF和AQLQ评分较VT组均有显著提高（p < 0.001）。
该试验说明2T练习系统可以使患者保持定量吸入器的使用方法，且其AQLQ评分也有所提高。
研究者将哮喘患者分成三组，一组为经过简单介绍后即使用MDI的所谓“技术优良组”（GT组，36人），其余的被随机分成了两组，一组口头指导其使用方法（VT组，35人），一组为口头指导后加用了2T练习器的试验组（2T组，36人）。测定这些患者使用MDI时的吸入峰流速(PIF)，一秒量（FEV1），并进行Juniper哮喘生活质量问卷调查(AQLQ)。6周后回访再次检测上述指标。结果发现，2次调查中各组患者间的FEV1没有改变。GT组的PIF和AQLQ评分无改变，在VT和2T组，AQLQ评分增加明显（平均差分别为0.33，95%CI为0.14-0.53; p < 0.001和0.74，95% CI为0.62-0.86; p < 0.001），VT和2T组，在第1次检测时所有患者均吸入> 90 L/min，到后来随访时减少到分别只有12个患者和1个患者吸入这样的剂量（p均< 0.001）。2T组在两次检查时PIF和AQLQ评分较VT组均有显著提高（p < 0.001）。
该试验说明2T练习系统可以使患者保持定量吸入器的使用方法，且其AQLQ评分也有所提高。
（于娜 沈阳,中国医科大学附属第一医院呼吸内科 110001 摘译）
(Chest. 2007; 131:1776-1782)
The Potential of a 2Tone Trainer To Help Patients Use Their Metered-Dose Inhalers*
Raid A.M. Al-Showair, PhD; Stanley B. Pearson, DPhil and Henry Chrystyn, PhD
Raid A.M. Al-Showair, PhD; Stanley B. Pearson, DPhil and Henry Chrystyn, PhD
Abstract 摘要
Background: Many patients have problems using the correct inhalation technique when they use their metered-dose inhalers (MDIs). We have investigated whether a training aid (2Tone Trainer [2T]; Canday Medical Ltd; Newmarket, UK) helps to maintain the correct inhaler technique after patients leave the clinic
Methods: Ethics committee approval was obtained, and patients gave consent. Asthmatic patients who had been prescribed an MDI had their inhalation technique assessed. Their peak inhalation flow (PIF) when using their MDI, FEV1, and the Juniper asthma quality of life questionnaire (AQLQ) score were measured. Those patients using the recommended MDI technique were the good-technique (GT) group. The remainder were randomized to receive verbal training (VT) or VT plus the 2T to improve their MDI technique. All patients returned 6 weeks later.
Results: There were 36, 35, and 36 asthmatic patients, respectively, who completed the GT, VT, and 2T procedures. FEV1 did not change within all groups between visit 1 and 2. PIF and AQLQ score did not change in the GT group. In the VT and 2T groups, the AQLQ score increased by mean differences of 0.33 (95% confidence interval [CI], 0.14 to 0.53; p < 0.001) and 0.74 (95% CI, 0.62 to 0.86; p < 0.001). At visit 1, all patients in the VT and 2T groups inhaled > 90 L/min decreasing to 12 patients and 1 patient, respectively, at visit 2 (p < 0.001 both groups). The overall changes in the 2T group for PIF and AQLQ score, between visits 1 and 2, were significantly (p < 0.001) greater than the corresponding changes in the VT group.
Conclusion: The 2T helps patients to maintain the recommended MDI technique posttraining with improvements in AQLQ score.
Key Words: asthma quality of life·metered dose inhaler·slow inhalation rate·2Tone trainer
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