噻托溴铵粉联合布地奈德福莫特罗吸入治疗支气管哮喘慢性阻塞性肺疾病重叠综合征的短期疗效

目的观察噻托溴铵粉吸入剂（思力华）联合布地奈德福莫特罗（信必可）吸入治疗支气管哮喘慢性阻塞性肺疾病重叠综合征的短期疗效。方法将152例支气管哮喘慢性阻塞性肺疾病重叠综合征患者随机分为试验组（80例）和对照组（72例）。在一般治疗基础上，对照组给予信必可吸入；试验组给予思力华联合信必可吸入，疗程均为4周。观察两组治疗效果。结果治疗后，两组肺功能指标均得到改善，试验组第1秒用力呼气容积（FEV1）、第1秒用力呼气容积占用力肺活量（FEV1/FVC）指标高于对照组（P<0.05）；残气量/肺总量（RV/TLC）指标低于对照组（P<0.05）。两组慢性阻塞性肺疾病评分（CAT评分）均降低，试验组更为明显(P<0.05)。两组ACT评分均升高，试验组更明显，组间比较（23±4）分 vs (15±2）分(P<0.05)。两组急性加重次数均减少，试验组更明显(P<0.05)。两组治疗均未出现严重不良反应。患者平均治疗费用试验组同对照组比较，差异无统计学意义(P>0.05)。结论在支气管哮喘慢性阻塞性肺疾病重叠综合征患者治疗中联用思力华和信必可吸入可提高疗效，且治疗费用增加不明显。

Short term efficacy of tiotropium bromide combined with budesonide and formoterol fumarate dihydrate in bronchial asthma COPD overlap syndrome

ObjectiveTo analyze the short term efficacy of tiotropium bromide (Spiriva) combined with budesonide and formoterol fumarate dihydrate (Symbicort) in bronchial asthma COPD overlap syndrome. MethodsA total of 152 patients with bronchial asthma COPD overlap syndrome were selected and divided into test group (80 cases) and control group (72 cases). Test group patients took treatment of Spiriva combined with Symbicort based on regular treatment， control group patients adopted mucosolvan sheet and seretide treatment for four weeks. Treatment effect of patients was compared between two groups. ResultsAfter treatment，the lung function was improved in both groups of patients. The indexes of forced expiratory volume in one second (FEV1) and forced expiratory volume in one second occupation force vital capacity (FEV1/FVC) in test group were significantly higher than in control group (P<0.05); the index of residual volume/total lung capacity (RV/TLC) in test group was significantly lower than that in control group (P<0.05). The COPD score (CAT score) was decreased in both groups， and was significantly lower in test group than in control group (P<0.05). The asthma control test scores (CAT score) was increased in both groups and was significantly higher in test group than in control group (23±4 vs 15±2，P<0.05). The number of exacerbation was decreased in both groups and was significantly lower in test group than in control group. No severe adverse reaction occurred in both groups. There was no significant difference in the average cost between test group and control group (P>0.05). ConclusionIn patients with bronchial asthma COPD overlap syndrome， Spiriva combined with Symbicort inhalation can improve the efficacy and cost of treatment did not significantly increase.