长期吸入沙美特罗/氟替卡松联合小剂量红霉素口服治疗支气管扩张症的疗效观察

目的观察长期吸入沙美特罗/氟替卡松联合小剂量红霉素对支气管扩张症的临床疗效。方法 62例确诊为支气管扩张症的患者在经过急性期治疗、病情得到控制后,随机分为3组并进行6个月的维持治疗。A组单纯口服红霉素,B组吸入沙美特罗/氟替卡松,C组吸入沙美特罗/氟替卡松的同时口服红霉素。观察患者的临床症状、呼吸困难评分、急性发作频率及肺功能等变化。结果有8例患者因故退出本试验,54例完成研究。单纯使用沙美特罗/氟替卡松虽可在一定程度上改善患者的肺功能,但不能改善患者的咳嗽及咳痰,也不能减少患者的急性发作次数。长期小剂量红霉素能够改善支气管扩张症患者的临床症状,减少急性发作次数,当与沙美特罗/氟替卡松联合使用时效果更佳,并可在一定程度上改善肺功能指标。结论吸入性糖皮质激素/β2激动剂联合长期小剂量红霉素对支气管扩张症有较好的临床效果,可减轻患者的症状并减少急性发作次数,改善肺功能,能够作为长期治疗支气管扩张症的一种选择。

Efficacy of Long-term Inhaled Salmeterol/Fluticasone Combined with Low-dose Oral Erythromycin in Patients with Bronchiectasis

Objective To evaluate the efficacy of long-term inhaled salmeterol/fluticasone combined with low-dose oral erythromycin in patients with bronchiectasis. Methods Sixty-two patients with bronchiectasis after exacerbation and maintained stable were randomly divided into three groups. Group A was treated with low-dose oral erythromyein, group B inhaled salmeterol/flutieasone, and group C inhaled salmeterol/tluticasone plus low-dose oral erythromycin. The study duration lasted for 6 months. The clinical symptoms, dyspnea scale, exacerbation frequency, and pulmonary function parameters were measured and compared. Results Fifty-four patients completed the whole study and 8 cases withdrew. The results showed that 6 months of low-dose erythromycin therapy can improve the clinical symptoms, whine exacerbation frequency was also decreased. Inhaled salmeterol/fluticasone improved lung function, however, had no effect on cough, expectoration and exacerbation frequency. Inhaled salmeterol/fluticasone combined with erythromycin was more significantly effective in improving lung functions as well as symptoms. Conclusions Long-term inhaled salmeterol/flnticasone combined with low-dose oral erythromycin can improve the clinical symptoms and lung function, decrease the frequency of exacerbation in patients with bronchiectasis. It may be as an alternative to the maintenance treatment of bronchiectasis.