联合应用噻托溴铵与沙美特罗／氟替卡松治疗中重度COPD稳定期的临床观察

目的观察联合应用噻托溴铵与沙美特罗／氟替卡松治疗中重度慢性阻塞性肺疾病（COPD）稳定期的临床疗效。方法选取中重度COPD稳定期患者97例，随机分为A、B、C3组：在常规家庭氧疗及祛痰等治疗基础上，A组给予吸入噻托溴铵干粉剂（18μg，每日1次）与沙美特罗／氟替卡松（50／500μg，每日2次）；B组给予吸入噻托溴铵干粉剂（18μg，每日1次）；C组给予吸入沙美特罗／氟替卡松（50／500μg，每日2次），治疗3个月后观察3组患者的血气、肺功能改善情况。结果经3个月的治疗后，A组肺功能及血气改善率明显高于B、C两组，差异有统计学意义（P〈0．05）。结论联合应用噻托溴铵与沙美特罗／氟替卡松对COPD患者具有更强的扩张支气管作用，能够显著改善COPD患者的肺功能，有重要的临床意义。

Clinical observation of tiotropium bromide and salmeterol/fluticasone in the treatment of moderate/severe COPD in the stable stage

Objective To observe the clinical effects of tiotropium bromide combined with salmeterol/fluticasone in the treatment of moderate/severe chronic obstructive pulmonary disease （COPD） in the stable stage. Methods Ninety-sev- en patients suffering from moderate/severe COPD in stable stage were randomly divided into three groups： group A, group B, and group C. Besides the conventional home oxygen therapy and expectorant in all three groups, group A was provided with inhaled dry powder tiotropium bromide （18 μg each time, once per day） and salmeterol/fluticasone （50/ 500μg each time, twice a day）; group B was only given inhaled dry powder tiotropium bromide with the same admin- istration as group A; group C was merely treated with salmeterol/fluticasone （50/500μg each time, twice a day）. The improvements of blood gas and lung function were observed in a course of 3 months. Results After 3-month treatment, the improvement rates of blood gas and lung function in group A were remarkably higher than those in the other two groups with a statistical difference （P 〈 0.05）. Conclusion The combination of tiotropium bromide and salmeterol/fluti- casone has a greater effect on dilating bronchus, can significantly improve the lung function of COPD patients, which has an important clinical guidance.