沙美特罗/氟替卡松吸入治疗稳定期慢性阻塞性肺疾病的疗效

Observation of Therapeutic Effect of Salmeterol/fluticasone on Obstructive Pulmonary Diseases

【目的】探讨沙美特罗/氟替卡松吸入治疗稳定期慢性阻塞性肺疾病(COPD)的疗效和不良反应。【方法】159例中重度COPD稳定期患者随机分为三组:分别吸入沙美特罗/氟替卡松(A组)、丙酸氟替卡松加硫酸沙丁胺醇(B组)、丙酸氟替卡松(C组),疗程3个月,治疗前后分别测定肺通气功能[FEV1、FEV1/FVC、FEV1占预计值(%)]、SGRQ调查评分、观察治疗期间的不良反应。【结果】经3个月治疗,三组治疗后肺通气功能指标FEV1、FEV1/FVC、FEV1占预计值(%)、SGRQ分值均较治疗前明显改善(P<0.05或P<0.01);A组治疗后FEV1、FEV1/FVC、FEV1占预计值(%)优于B组和C组(P<0.01);B组治疗后FEV1、FEV1/FVC、FEV1占预计值(%)优于C组(P<0.05);A组与B组SGRQ评分优于C组(P<0.05);三组患者治疗期间的不良反应发生率无明显差别(P>0.05)。【结论】沙美特罗/氟替卡松吸入对COPD的疗效明显优于丙酸氟替卡松加硫酸沙丁胺醇和丙酸氟替卡松,是目前临床治疗COPD的较理想药物。

[Objective] To investigate the therapeutic effect of salmeterol/fluticasone on chronic obstructive pulmonary diseases（COPD） by comparison. [Methods]All 159 patients of stable COPD were randomized three groups： experiment group（inhale salmeterol/fluticasone）, control group A（inhale fluticasone plus salbutamol sulphate）, control group B（inhale fluticasone propionate）. After 3 months treatment, pulmonary functional parameters including FEV1, FEV1 or FVC, FEV1 in the anticipation value（ % ）and SGRQ score were examined. Adverse effects were recorded during the treatment. [Results]After 3 months treatment, pulmonary functional parameters[FEV1, FEV1 or FVC, FEV1 in the anticipation value（ % ）] and SGRQ score in 3 groups were improved more significantly than those of pre-treatment （ P 〈0.05 or P 〈0.01）. Pulmonary functional parameters in experiment group were improved significantly compared with control group A and B, and those of control group A were improved more significantly than those of control group B（ P 〈0. 05 or P 〈0.01）. SGRQ scores in experiment group and control group A were decreased significantly compared with control group B （ P 〈0.05）. During the treatment period, there were same incidence of adverse effects in three groups （ P 〉0.05）. [Conclusion] Salmeterol/fluticasone can presently serve as a more ideal medicine for stable COPD due to its more significant curative effect than that of fluticasone plus salbutamol sulphate or fluticasone.