沙美特罗／丙酸氟替卡松治疗慢性阻塞性肺疾病的临床疗效

目的观察沙羡特罗／丙酸氟替卡松吸入剂（舒利迭）对稳定期、重度及重度以上的慢性阻塞性肺疾病（COPD）患者肺功能的影响和总经济费用的改变。方法将明确诊断的90例COPD患者随机分为对照组和试验组，对照组给予溴已新（必嗽平）和缓释茶碱片（舒弗美），必嗽平16mg口服，每日3次，舒弗美0．2g口服，每12小时1次，试验组在对照组治疗基础上给予舒利迭50／500btg，每次1吸，每12小时1次。观察期为6个月，期间各组均可按需使用短效扩张剂。在疗程前后分别检测肺功能指标和症状评分，并记录两组的总经济费用。结果与对照组比较，治疗后试验组1秒用力呼气容积（FEVI）（1．68±0．28）LVS（1．46±0．16）L（P〈0．05）、用力肺活量（FVC）（3．43±0．5）LVS（3．02±0．4）L（P〈0．05）、FEV1／FVC（53．4±9．0VS48．9±5．8，P〈0．01）；症状评分（37．6±0．9）分VS（42．5±0．8）分均有不同程度的改善，差异有统计学意义（P〈0．05）。试验组的急性加重次数、住院次数及天数、总经济费用明显低于对照组（均P〈0．01）。结论舒利迭能够改善稳定期、严重程度为重度及重度以上COPD患者的肺功能，降低总经济费用。

Clinical efficacy of salmeterol/fluticasone in treatment of patients with chronic obstructive pulmonary disease

Objective To observe the effects of inhaled salmeterol/fluticasone propionate（seretide） on lung function and economic cost of the patients with stable moderate to severe chronic obstructive pulmonary disease （COPD）. Methods 90 diagnosed COPD patients were randomly divided into experimental group and control group. Baseline treatments were similar in all patients. In experimental group, twice-daily 50/500 μg dosage form of seretide was additionally given to the patients for six months. In control group,twice daily peroral slow-release theopylline （0.2 g） and thrice daily peroral bromhexine hydrochloride（16 mg） were additionally given to the patients for six months. Before and after the treatment,lung functions of two groups were examined and economic cost was compared. Results At the end of experiment, compared to those of control group, lung functions of experimental group, including FEV, （1.68±0.28） L vs （1. 46±0. 16） L（ P 〈0.05） ,FVC（3. 43±0. 5） L vs （3.02±0. 4） L（ P 〈0.05） ,FEV1/FVC（53.4± 9.0 vs 48.9±5.8, P〈0.01） were increased in different extents. The value of SGRQ became significantly lower than that in control group （37.6 ± 0.9） scores vs （42.5 ± 0.8） scores（ P 〈0.05）. Moreover, the frequencies of acute exacerbation, hospitalization and the total of economic cost in experimental group became significantly lower in different extents than in control group （all P d0.01）. Conclusion Salmeterol/fluticasone propionate improves lung functions of COPD patients with stable moderate to severe stages and degrades the total of economic cost. Salmeterol/fluticasone propionate is fit to spread in primary level hospitals.