噻托溴铵联合大剂量沙美特罗/替卡松治疗中重度慢性阻塞性肺疾病稳定期患者的疗效观察

目的观察联合使用噻托溴铵粉吸入剂（思力华）和大剂量沙美特罗替卡松（舒利迭）对中重度慢性阻塞性肺疾病（COPD）的稳定期患者的临床疗效。方法将75例临床确诊为中重度COPD稳定期患者随机分为A、B、C3组。A组给予吸入噻托溴铵干粉剂（18μg）,1吸/次,1次/d;B组给予吸入沙美特罗/替卡松松吸入剂（50/500μg）1吸/次,2次/d;C组给予吸入噻托溴铵干粉剂（1吸/次,1次/d）与大剂量沙美特罗/丙酸氟替卡松（1吸/次,2次/d）,在治疗前及治疗后3个月后测定第1秒用力呼气容积（FEV1）,6min步行距离（6MWT）。结果治疗后3个月,C组FEV1及6MWT与A组及B组相比差异有统计学意义（P〈0.01）,A组FEV1及6MWT与B组相比差异无统计学意义。结论噻托溴铵联合沙美特罗替卡松吸入剂对中重度稳定期COPD患者的疗效优于单用噻托溴铵或沙美特罗替卡松吸入剂单药治疗,联合治疗明显改善稳定期COPD患者的肺功能。

The therapy observation of combination Tiotropium inhalation capsules and Salmeterol/Fluticasone in patients with moderate-severe chronic obstructive ulmonary disease at stable stage

Objective To observe the therapy observation of combination Tiotropium inhalation capsules and Salmeterol/Fluticasone in patients with moderate-severe chronic obstructive pulmonary disease at stable stage.Methods Seventy five patients with moderate-severe chronic obstructive pulmonary disease at stable stage were randomly divided into three groups,25 patients in every group.Group A received Tiotropium dry powder(18 μg) once inhalation once every day;group B were given Salmeterol/Fluticasone(50/500 μg) once inhalation twice every day in 25 patients with moderate-severe COPD at stable stage;group C were treated with combination Tiotropium inhalation capsules(18 μg) once inhalation once every day and Salmeterol/Fluticasone(50/500 μg) once inhalation twice every day in 25 patients with moderate-severe COPD at stable stage.FEV1 and 6MWT were compared in the three groups before and after the treatment three months later.Results The different of the FEV1 and 6MWT had statistical significance(P < 0.05) between group C compared with group A or group B,there was no significance between group A compared with group B of FEV1 and 6MWT.Conclusion Combination Tiotropium inhalation capsules and Salmeterol/Fluticasone in patients with moderate-severe chronic obstructive pulmonary disease at stable stage has stronger bronchiectasis effect,which can significantly improve FEV1 and 6MWT.