沙美特罗/丙酸氟替卡松治疗慢性阻塞性肺疾病的临床分析

目的观察吸入沙美特罗/丙酸氟替卡松(舒利迭)50/500μg干粉剂对慢性阻塞性肺疾病(COPD)急性期及稳定期中、重度的慢性阻塞性肺疾病(COPD)患者的临床疗效及生活质量的改善。方法将明确诊断的162例COPD病人随机分为治疗组(86例)和对照组(70例),两组病人的基础治疗和合并症方面差异无统计学意义,治疗组给予吸入沙美特罗/丙酸氟替卡松(舒利迭)50/500μg,每次1吸,每日2次;两组治疗均有常规的基本用药如茶碱缓释胶囊,氨溴索,部分病人使用沙丁胺醇临时雾化吸入;疗程为3个月。观察治疗前后肺功能指标测定和圣乔治呼吸问卷(SGRQ)生活质量评分进行比较。结果在观察前,治疗组和对照组的一秒钟用力呼气容积(FEV1)/用力肺活量(FVC)和FEV1/预计值的差异无统计学意义(P>0.05)。在观察结束时,治疗组FEV1/FVC和FEVI/预计值较观察前均有不同程度的提高(P<0.05);对照组FEV1/FVC和FEV1/预计值与试验前的差异无统计学意义(P>0.05);治疗组呼吸问卷生活质量评分比观察前明显减少(P<0.05),对照组除呼吸症状得到改善外其他指标无明显变化(P>0.05);两组因急性加重住院的比例治疗组明显低于对照组(P<0.05)。结论吸入沙美特罗/丙酸氟替卡松(舒利迭)50/500μg干粉剂能够改善中、重度的慢性阻塞性肺疾病(COPD)患者急性期及稳定期的肺功能和生活质量,降低COPD患者住院率。

Objective To evaluate clinical efficacy of salmeterol/fluticasone seretide（50/500）μg in single inhaler in treatment of patients with acute and stable moderate to severe chronic obstructive pulmonary disease（COPD）. Methods 162 patients with COPD were randomly divided into trial and control groups.Baseline treatments were similar in all patients. Patients in trial group received seretide 50/500μg inhalation twice daily for 3 months .Slow release theophylline 2 twice daily was additionally given to patients in control group for 3 months.Before and after the therapeutic course, tests for lung function in patients of these two groups were examined and compared with each other.According to the method of standard grade of respiratory diseases questionnaire（SGRQ）introduced by St. George. surveys of questionnaire on clinical symptoms and physical signs were graded. Results Before the experiment difference of FEV1/FVC and FEV1/predictive value between these two groups was not significant （P〉0.05）. At the end of experiment, the values of FEVI/FVC and FEV1/predictive value in trial group increased in different extent than baseline values（P〈0.05）. But the change of values of FEV1/FVC and FEV1/predictive value in control group after the experiment was not significant（P〉0.05）.In trial group. the value of SGRQ became significantly lower than that before experiment（P〈0.05）, but the value of SGRQ in control group was not reduced except respiratory symptoms（P〉0.05）. In trial group the proportion of hospitalized patients due to AECOPD was lower than that of control group（P〈0.05）. Conclusion salmeterol/fluticasone in single inhaler can improve lung function and life quality of patients with stable moderate to severe COPD,and it vail also reduce the rate of hospitalization of these patients.