联合应用噻托溴铵与沙美特罗氟替卡松治疗COPD疗效观察

【目的】探讨噻托溴铵联用沙美特罗氟替卡松治疗中重度慢性阻塞性肺疾病（COPD）稳定期患者的临床疗效及安全性。【方法]54例确诊为稳定期的中重度COPD患者随机分为三组，每组18例：联合组（A组）给予吸入噻托溴铵干粉剂和沙美特罗氟替卡松；噻托溴铵组（B组）给予吸入噻托溴铵干粉剂；沙美特罗氟替卡松组（C组）给予吸入沙美特罗氟替卡松。比较三组治疗前及治疗后I、3个月临床症状、生活质量评分、肺功能、6分钟步行距离（6MWD）及药物不良反应。【结果】三组COPD患者经治疗后临床症状、生活质量评分、肺功能、6分钟步行距离均有明显改善（P〈0．05），而联合治疗组其改善作用更为显著（P〈0．05）。【结论】中重度COPD稳定期患者使用噻托溴铵与沙美特罗氟替卡松联合吸入治疗可提高疗效。

Effect of Tiotropium Bromide Combined with Salmeterol Fluticasone for the Treatment of Chronic Obstructive Pulmonary Disease

[Objective]To explore the clinical efficacy and safety of tiotropium bromide combined with salmerterol fluticasone for the treatment of stable moderate-severe chronic obstructive pulmonary disease （COPD）. [Methods] Totally 54 stable moderatesevere patients with COPD were divided into three group with 18 in each. The combination group（group A） was given the inhalation of tiotropium bromide dry powder and salmeterol fluticasone. The tiotropium bromide group（group B） was given the inhalation of tiotropium bromide dry powder. The salmeterol fluticasone group（group C） was given the inhalation of salmeterol flutiea- sone. Clinical symptoms, the scores of quality of life, pulmonary function, 6 minute walking distant and side effects before treatment and at 1 month and 3 months after treatment were compared among three groups. [Results]After treatment, clinical symptoms, the scores of quality of life, pulmonary function and 6-minute walking distant were significantly improved in all three groups（ P 〈0.05）, and the improvement in combination group was more significant（ P 〈0.05）. [Conclusion] The combination of tiotropium bromide and salmeterol flutieasone for the treatment of patients with stable moderate-severe COPD can improve the efficacy.