沙美特罗替卡松粉吸入剂治疗中度 COPD 稳定期的临床研究牟江 桂天绪 万礼 雷仕鹏 万雄简

目的 观察应用沙美特罗替卡松粉吸入剂治疗中度慢性阻塞性肺病（COPD ）稳定期的临床疗效.方法 将100例中度COPD稳定期患者随机分为对照组和试验组.对照组49例,给予戒烟、预防呼吸道感染、按需使用支气管舒张剂.试验组51例,在对照组基础上给予沙美特罗替卡松粉吸入剂（50/250）,每次1吸,每日2次,经准纳器吸入;疗程均为6个月.分别于0、3、6月检测患者第1秒用力呼气量（FEV1）、6分钟步行试验（6-MWT）、COPD评估测量（CAT）、改良英国MRC呼吸困难指数（mMRC）.结果 试验组治疗后FFV1、6-MWT、CAT、mMRC明显改善,与治疗前比较,差异具有统计学意义（P〈 0.05）;而对照组各指标差异无统计学意义（P〉0.05）;治疗后两组间比较,差异具有统计学意义（P〈 0.05）.治疗期间无严重不良反应发生.结论 对于中度COPD稳定期患者长期吸入沙美特罗替卡松粉剂可改善肺功能及生活质量,提高运动耐力,值得临床进一步探讨及推广应用.

Therapeutic effect of salmeterol/fluticasone inhalation in the treatment of COPD patients at moderate stable stage

Objective To observe the therapeutic effect of salmeterol/fluticasone inhalation in the treatmentof COPD patients at moderate stable stage. Methods 100 moderate stable COPD patients were randomly divided into two groups. All patients were given smoking prevention, upper airway inflammation prevention and bronchial dilator if needed. The treatment course was 6 months. The study group （n = 51 ） were additionally treated with salmeterol/flu- ticasone inhalation （50/250, one inhalation per time, twice a day）. FEV, 6-MWT, CAT and mMRC were esti- mated at the 1st, 3rd and 6th months after the treatment. Results After the treatment, FEV-, 6-MWT, CAT and mMRC improved significantly in the study group, but there was no significant difference in the control group. No sig nificant side effect was observed during the treatment between the two groups. Conclusion Salmeterol/fluticasone inhalation can improve their lung function, quality of life and exercise tolerance in the treatment of COPD patients at moderate stable staze.