噻托溴铵与沙美特罗在联合用药治疗老年哮喘中的临床效果比较

目的比较噻托溴铵与沙美特罗在联合用药治疗老年中重度哮喘中的临床效果。方法将30例老年中、重度慢性持续期哮喘患者随机分为A、B两组,两组患者每天均吸入布地奈德气雾剂并口服孟鲁司特。A组加服噻托溴铵,B组联合吸入沙美特罗,疗程均为12周,随访1年。比较两组患者治疗前后临床症状改善情况及肺功能变化,同时记录不良反应发生情况及随诊期间哮喘急性发作次数。结果两组患者临床症状控制情况及随诊期间哮喘急性发作次数差异无统计学意义（P〉0.05）;治疗后两组患者第1秒用力呼气容积占预计值百分比（FEV1%预计值）较治疗前显著增加,呼气峰流速变异率（PEFR）较治疗前显著降低（P〈0.05）,但治疗后两组患者之间上述两指标的差异无显著性意义（P〉0.05）;噻托溴铵不良反应的发生率低于沙美特罗（P〈0.05）。结论噻托溴铵与沙美特罗在联合用药治疗老年中重度哮喘中疗效相当,且噻托溴铵不良反应的发生率较低。

Clinical effect of Tiotropium Bromide on the elderly asthma compared with Salmeterol in combination therapy

【Objective】 To compare the clinical effect of tiotropium bromide with salmeterol in combination therapy on the moderate to severe asthma of the elderly.【Methods】30 cases of elderly patients with moderate to severe asthma in chronic duration were randomLy divided into group A and group B,budesonide aerosols were inhaled and montelukast taken orally by patients in two groups every day.Additionally,tiotropium bromide and salmeterol were inhaled by patients in group A and B respectively.【Resluts】After 12 weeks of treatment,the percentage of forced expiratory volume in1 second to expected value（FEV1 % expected value） increased significantly,and the peak expiratory flow variation rate（PEFR） of patients was lower than that before treatment in two groups（P 0.05）.There was no statistical significance between the difference in controlling clinical symptoms of patients,improvement of FEV1 % expected value and PEFR,and the frequencies of asthma acute episode in the follow-up period in group A and B after treatment（P 0.05）.The incidence of adverse reaction in patients treated with tiotropium bromide was lower than that with salmeterol.【Conclusion】It concluded that there were comparative clinical effect between tiotropium bromide and salmeterol in combination therapy on the moderate to severe asthma and tiotropium bromide had better security with lower incidence of adverse reaction in the elderly patients.