联合应用沙美特罗替卡松与噻托溴铵对慢性阻塞性肺疾病肺功能的疗效

目的：联合应用沙美特罗替卡松与噻托溴铵治疗慢性阻塞性肺疾病（COPD）,并观察其疗效。方法：将88例中重度COPD患者随机分为3组,联合治疗组给予吸入沙美特罗替卡松50/500μg,每日2次与噻托溴铵干粉剂18μg,每日1次;噻托溴铵组给予吸入噻托溴铵干粉剂18μg,每日1次;沙美特罗替卡松组给予吸入沙美特罗替卡松50/500μg,每日2次,在治疗前及治疗后测定肺功能。结果：与同组治疗前相比,治疗后噻托溴铵组、沙美特罗替卡松组、联合治疗组第1秒用力呼气量（FEV1）显著提高（P〈0.05）,第1秒用力呼气容积/用力肺活量、第1秒用力呼气容积/预计值均较治疗前改善（P〈0.05）;联合治疗组第1秒用力呼气容积、第1秒用力呼气容积/用力肺活量（FEV1/FVC）、第1秒用力呼气容积/预计值改善优于沙美特罗替卡松组、噻托溴铵组,差异有统计学意义（P〈0.05）。结论：沙美特罗替卡松粉吸入剂联合噻托溴铵粉吸入剂治疗慢性阻塞性肺疾病疗效肯定,优于单用一种药物治疗,值得临床进一步推广应用及探讨。

Therapeutic effect of salmeterol/fluticasone propionate combined with tiotropium on patients with COPD

Objective： To explore the efficacy of combined salmeterol/fluticasone propionate with tiotropium bromide in patients with chronic obstructive pulmonary disease （COPD）. Methods： 88 patients with COPD were randomly divided into three groups, salmeterol/fluticasone propionate and tiotropium bromide treatment group （SFC＋TIO） were given salmeterol/fluticasone propionate 50/500 μg, twice per day and tiotropium bromide 18 μg per day; tiotropium bromide treatment group （TIO） were given tiotropium bromide 18 μg per day; salmeterol/fluticasone propionate treatment group （SFC） were given salmeterol/fluticasone propionate 50/500 μg, twice per day. Lung function of two groups was assessed before and after the therapeutic course. Results： The values of FEV1, FEV1/FVC and FEV1/predictive value in three groups increased in different extent than baseline values （P0.05）. And SFC＋TIO group improved more significantly than SFC alone and TIO alone group （P0.05）. Conclusion： Combined salmeterol/fluticasone propionate with tiotropium bromide in patients with chronic obstructive pulmonary disease has more effective compared with SFC alone and TIO alone, is worthy of further promote using and studying.