吸入舒利迭治疗稳定期中度慢性阻塞性肺疾病2年的临床分析

Clinical analysis of inhalable Seretide in the two-year treatment of patients with stable moderate COPD

目的观察长期使用舒利迭治疗稳定期中度慢性阻塞性肺疾病（COPD）的疗效。方法稳定期中度COPD患者64例随机平分为试验组和对照组。对照组给予常规治疗，试验组在常规治疗的基础上吸入舒利迭（50／250ug），观察2年。在治疗前、治疗24个月后测定肺功能，评价肺功能改善情况；并进行临床症状和体征评分、COPD急性加重次数及发作时间监测。结果试验组治疗前后肺功能各项指标比较差异均有统计学意义（P均〈0．01），而对照组治疗前后肺功能各项指标比较差异均无统计学意义（P均〉0．05）；在治疗24个月后两组临床症状和体征评分[（2．1±0．4）分与（4．4±0．3）分，t=2．365）、COPD急性发生率（29％与47％，x2=3．547）和发作时间[（5．0±1．2）d与（10．0±1．6）d，t=2．149]比较，差异均有统计学意义（P均〈0．01）。结论舒利迭能改善稳定期中度COPD患者的肺功能，减少急性发作次数，有一定的临床价值。

Objective To explore the effects of Seretide （50/250 ug）in the treatment of patients with stable moderate COPD. Methods Sixty-four patients in the stable period of moderate COPD were randomized into 2 groups, the test group and control group. The control group received routine treatment. The test group received the Seretide （50/250 ug）inhalation in addition to the routine treatment. During the 2-year observation, the pulmonary functions before and 12 and 24 months after treatment were recorded. The clinical symptoms, physical signs,the frequency of acute exacerbation of COPD and hospitaliztion duration were also graded. Results The difference of the parameters before and after the treatment was significant in the treatment group （P 〈 0. 01 ） but not in control group （ P 〉 0. 05 ）. The scores of symptoms and signs （ [ 2. 1 ± 0. 4 ] vs. [ 4.4 ± 0. 3 ], t = 2. 365 ）, the frequency of acute exacerbation of COPD （29% vs. 47 % , x2 = 3. 547 ） and hospitalization period （ [5.0 ± 1. 2]d vs. [ 10. 0 ± 1.6]d,t =2. 149）in the treatment group were significantly improved compared with control group after 24 months＇treatment （all P 〈 0. 01 ）. Conclusion Seretide（50/250 ug）is able to improve the lung function of the patients with stable moderate COPD and reduce the frequency of acute exacerbation, showing certain value in clinical practice.