沙美特罗联合丙酸氟替卡松治疗老年稳定期COPD临床观察

Effect of Salmeterol/Fluticasone Propionate on the Stable COPD of Elder Patients

目的:探讨沙美特罗联合丙酸氟替卡松吸入剂对老年稳定期慢性阻塞性肺疾病(COPD)的治疗作用及药物的安全性。方法:将确诊的56例老年稳定期COPD患者随机分为对照组(28例)和实验组(28例)。在进行基础治疗的同时,实验组患者给予沙美特罗联合丙酸氟替卡松粉吸入剂。采用圣乔治的呼吸疾病问卷(SGRQ)评价患者的临床症状及体征检查情况;测定一秒用力呼气容积(FEV1),用力肺活量(FVC)及FEV1%预计值等肺功能指标;同时比较8AM时最大呼气流速(peak expiratory flow,PEF)变化情况。结果:对照组的临床症状评分及肺功能指标在治疗前后无明显变化,而实验组治疗后临床症状评分(2.57±1.32)分明显低于治疗前(4.07±1.05)分,实验组的PEF治疗24 h后即明显升高;患者治疗后的FEV1(1.05±0.16)及FEV1%预计值(56.9±14.4)均高于治疗前FEV1(0.95±0.17)及FEV1%预计值(49.4±11.9)。与对照组相比,实验组的临床症状评分及肺功能指标均有明显变化。结论:沙美特罗联合丙酸氟替卡松可改善老年稳定期COPD患者的基础肺功能,缓解咳嗽、咳痰、气促等临床症状,其早期副作用轻,老年患者耐受性较好,但远期疗效及安全性还需进一步探讨。

Objective： To discuss the effect and safety of salmeterol/fluticasone propionate on the chronic obstructive pulmonary disease（COPD） in elder patients.Methods： 56 cases of diagnosed patients were randomly divided into control group（28 cases） and experimental group（28 cases）.Baseline treatments were similar in all patients,and salmeterol/fluticasone were additionally given to the patients in the experimental group.The methods of standard grade of respiratory diseases questionnaire（SGRQ） was used to grade the clinical symptom and physical examination.Pulmonary functional parameters including FEV1,FEV1 / FVC and FEV1 / predictive value（%） were examined,and the pulmonary functional changes before and after therapy were evaluated,and daily measurements of morning peak expiratory flow（PEF） of 8AM were recorded.Results： After treatment,the clinical symptom scores and pulmonary functional parameters in control group showed no significant changes.In the experimental group,the clinical symptom score（2.57±1.32） min was significantly lower after treatment（4.07±1.05） min,Greater increases in morning PEF from baseline were observed approximately 24 h after the initiation of treatment in the experimental group;FEV1（1.05 ± 0.16） and FEV1% predicted（56.9±14.4） were higher than before treatment FEV1（0.95±0.17） and FEV1% predicted（49.4±11.9）.Compared with the control group,the clinical symptom scores and pulmonary functional parameters of the experimental group have the statistic significant.Conclusion： Salmeterol/fluticasone propionate can improve baseline lung function,relieve clinical symptoms and improve the quality of life of the old patients with stable COPD.It’s side effects were light at early stage and old patients reacted well,but long-term results and side effects need to be observed deeply.