沙美特罗替卡松联合呼吸操对慢性阻塞性肺疾病患者肺功能的影响

A study to assess the effects of combining salmeterol/fluticasone propionate and respiratory exercise on patients with COPD

目的:探讨沙美特罗替卡松(舒利迭)联合呼吸操对慢性阻塞性肺疾病(COPD)患者肺功能的影响。方法:40例COPD患者随机分为舒利迭组(对照组)和舒利迭加呼吸操组(试验组)各20例,两组入院期间均给予常规抗感染?吸氧?化痰和平喘对症治疗。临床症状缓解以后,对照组加用舒利迭治疗;试验组加用舒利迭治疗同时予以呼吸操锻炼。患者全部掌握舒利迭用法及呼吸操要领后出院,共随访观察12周。两组均于症状缓解开始应用舒利迭和呼吸操治疗前查肺功能,12周后再次测肺功能,同时评估两组生活质量的改善情况。结果:两组治疗前肺功能无明显差异,治疗后两组肺功能较治疗前均有显著改善。试验组较对照组第1秒用力呼气容积(FEV1)?用力肺活量(FVC)?FEV1/FVC和FEV1占预计值百分比(FEV1%Pred)等明显改善,差异有显著性;试验组较对照组生活质量评分下降,差异有显著性;试验组较对照组每天按需使用万托林次数减少,差异有显著性。结论:舒利迭联合呼吸操对COPD患者肺功能更有显著的改善作用。

Objective To explore the effects of combining salmeterol/fluticasone propionate （seretide） and respiratory exercise on patients with chronic obstructive pulmonary disease （COPD） by analyzing lung function. Methods 40 patients with COPD were randomly divided into two groups： experimental group （20 cases） and control group （20 cases）. The basic treatments for the two groups were antibiotics, xygens inhalation, dissipate phlegm and antiasthma etc. After relief of clinical symptoms, the control group were given seretide; the experimental group were given seretide and respiratory exercise. The patients can discharge from hospital when they entirely master usage of seretide and main points of respiratory exercise. All patients were checked on lung function before making use of seretide and respiratory exercise. Lung function was checked after 12 weeks, too. Simultaneously, to evaluate the improvement of quality of life in two groups. Results Before treatment, lung functions in both groups were not statistically different （P 〉 0.05 ）. After treatment, there was improvement of lung function than before treatment （ P 〈 0.05 ）. FEV1, FVC , FEV1/FVC and FEV1%Pred were superior in experimental group to control group ;The scores of quality of life of experimental group were lower than control group; Experimental group used ventolin less than control group. Conclusion Combining seretide and respiratory exercise can improve lung ruction significantly.