噻托溴铵联合沙美特罗替卡松吸入治疗中重度支气管哮喘合并慢性阻塞性肺疾病的临床疗效分析

Curative effect analysis of tiotropium combined with salmeterol fluticasone propionate in medium and heavy bronchial asthma merger chronic obstructive pulmonary disease

目的探讨噻托溴铵（思力华）联合沙美特罗替卡松（舒利迭）吸人治疗中重度支气管哮喘（简称哮喘）合并慢性阻塞性肺疾病（COPD）的临床疗效。方法将126例中重度哮喘合并COPD患者随机分入对照组与观察组，对照组患者接受沙美特罗替卡松吸入，给予观察组患者噻托溴铵联合沙美特罗替卡松吸入。比较两组患者治疗前及治疗后1年肺功能的改变、急性发作次数、住院次数、急性发作的间隔时间以及生活质量。结果治疗后观察组第1秒用力呼气容积（FEV1）、FEV1占预计值百分比（FEV，％pred）和用力肺活量（FVC）显著优于对照组（P〈0．05）；随访1年，观察组急性发作次数及住院次数显著少于对照组（P〈0．05），急性发作的间隔时间差异无统计学意义（P〉0．05）；观察组生活质量SGRQ评分各维度及总分显著低于对照组，差异有统计学意义（P〈0．05）。结论噻托溴铵联合沙美特罗替卡松吸入可显著改善中重度哮喘合并COPD患者肺功能，提高临床疗效及患者生活质量。

Objective To explore the clinical effect of tiotropium combined with salmeterol fluticasone propionate in medium and heavy bronchial asthma （asthma） merger chronic obstructive pulmonary disease （COPD）. Methods 126 cases with medium and heavy asthma merger COPD were randomly divided into control group and experience group. Control group were given salmeterol fluticasone propionate inhalation, and experience group were treated with tiotropium combined with salmeterol fluticasone propionate. The change of lung function, time of acute attack, frequency of hospitalization and acute onset of the next interval before and 1 year after treatment were compared between two groups. Results FEV1 , FEV1% pred and FVC after treatment in experience group were superior to that in control group （P〈0.05）. In the follow-up of 1 year, time of acute attack and frequency of hospitalization in experience group were much less than that in control group （ P〈0.05）, and there was no significant different of acute onset of the next interval between two groups （ P〈0.05）. Each dimension and total score of SC-RQ after intervention in experience group were much lower than that in control group （ P〈0.05）. Conclusions Tiotropium combined with salmeterol fluticasone propionate for medium and heavy asthma merger COPD can greatly improve the lung function, clinical effect and patients life quantity.