噻托溴铵与沙美特罗/氟替卡松联合治疗慢性阻塞性肺疾病的疗效观察

目的探讨噻托溴铵与沙美特罗/氟替卡松联合治疗重度慢性阻塞性肺疾病(COPD)患者的效果。方法采用随机数字表法将100例重度、极重度COPD患者分为两组:联合治疗组(噻托溴铵+沙美特罗/氟替卡松治疗)和对照组(沙美特罗/氟替卡松治疗),各50例。对两组患者治疗前和治疗6个月后的肺功能指标、呼吸困难评分、6 min步行距离、体质量指数、生活质量评分进行比较。结果治疗6个月后,联合治疗组和对照组的肺功能指标(FEV1、FEV1%)、6 min步行距离、生活质量评分、呼吸困难评分较治疗前均有改善,差异有统计学意义(P<0.05),联合治疗组改善更为显著(P<0.05)。联合治疗组和对照组治疗6个月后体质量指数较治疗前均略有增加,差异无统计学意义(P>0.05),联合治疗组体质量指数增加值略高于对照组,差异无统计学意义(P>0.05)。结论联合使用噻托溴铵+沙美特罗/氟替卡松比单用沙美特罗/氟替卡松可以更好地改善重度COPD患者的肺功能、运动耐量、临床症状及生活质量。

Therapy Efficacy of Tiotropium Combined Salmeterol/Fluticasone in Patients with Chronic Obstructive Pulmonary Disease

Objective To explore the therapy efficacy of tiotropium plus salmeterol/fluticasone in patients with chronic obstructive pulmonary disease(COPD).Methods 100 patients with severe-to-very severe COPD were randomly divided into two groups:combination treatment group(tiotropium combined salmeterol/fluticasone),control group(tiotropium),50 patients in each group.The pulmonary function,degree of dyspnea,6 minute walk distance,body mass index,and the scores of quality of life before the treatment and 6 months after the treatment were compared between the two groups.Results By the end of 6 months treatment,the pulmonary function(FEV1,FEV1%),6 minute walk distance,the scores of quality of life and the scores of degree of dyspnea were significantly improved in both groups(P<0.05),and the improvement in combination group was more significant(P<0.05).The body mass index was improved in both groups,but the difference was not significant(P>0.05),the difference between the two groups was not significant(P>0.05).Conclusion The joint usage of tiotropium and salmeterol/fluticasone in patients of severe COPD is better than salmeterol/fluticasone in improving pulmonary function,exercise tolerance,symptoms,and quality of life.