title: [Combination of thiotropium bromide with almitrine and pulmonary rehabilitation in the treatment of patients with chronic obstructive pulmonary disease].
abstract: OBJECTIVE
  To elucidate efficacy of a combination almitrine+thiotropium bromide (TB)+pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) of stage II-III complicated with chronic respiratory failure (CRF).
  
  
  METHODS
  Efficacy of therapy was compared in two groups of patients: group 1 (n = 22) received TB in a dose 18 mcg/day for one year, almitrine in a dose 10 mg/kg/day for 3 months, an 8 week course of PR, group 2 (n = 17) received TB and PR. The treatment efficacy was determined by spirometric parameters of external respiration function, blood gases, dyspnea indices, exercise tolerance assessed by 6-min walk test, quality of life (St. George Hospital Respiratory Questionnaire).
  
  
  RESULTS
  Group 1 patients walked longer distance after a course of PR and 1 year later (by 90.5 +/- 25.4 and 44.5 +/- 10.2 m, respectively, p < 0.05), had reduced desaturation measured by pulsoxym-etry at the end of 6-min walk test, increased PaO2 in baseline under 70 mmHg (by 5.8 +/- 1.2 mmHg, p > 0.05), decreased exacerbation rate per 1 patient a year (by 25%).
  
  
  CONCLUSIONS
  Combination treatment with TB, almitrine and PR is indicated for COPD patients with moderate hypoxemia.
authors.forename: O N
authors.initials: ON
authors.lastname: Titova
authors.forename: V A
authors.initials: VA
authors.lastname: Ignat'ev
authors.forename: M D
authors.initials: MD
authors.lastname: Didur
authors.forename: M Iu
authors.initials: MIu
authors.lastname: Kameneva
authors.forename: O A
authors.initials: OA
authors.lastname: Sukhovskaia
mesh_terms: D000280:Administration, Inhalation; D015765:Almitrine / Q000008:administration & dosage*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000534:rehabilitation*; D011788:Quality of Life; D012602:Scopolamine Derivatives / Q000008:administration & dosage*; D000069447:Tiotropium Bromide; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D012602:Scopolamine Derivatives; D015765:Almitrine; D000069447:Tiotropium Bromide