联合噻托溴铵和单用舒利迭治疗重度COPD的对比观察

Effect of Salmeterol Combined with Tiotropium Bromide in Treatment of Patients with Severe Chronic Obstructive Pulmonary Disease

目的:观察联合噻托溴铵和单用舒利迭治疗重度慢性阻塞性肺疾病(COPD)深吸气量(inspiratory capacity,IC)的变化。方法:将58例重度COPD患者随机分为观察组30例和对照组28例。对照组给予舒利迭(沙美特罗50μg,氟替卡松500μg),早晚各1次吸入;观察组在此基础上联合使用噻托溴铵胶囊(18μg),每天上午吸入1次。疗程均为6个月。比较治疗前、治疗3个月时和治疗6个月时患者的肺功能、深吸气量,同时采用6 min步行距离评价运动能力,采用呼吸困难指数mmRC评价生活质量。结果:治疗3个月时及6个月时观察组IC优于对照组(P<0.05);在各治疗阶段呼吸困难指数mmRC观察组均优于对照组(P<0.05)。结论:舒利迭联合噻托溴铵治疗重度COPD较单用舒利迭对IC、肺功能和生活质量的改善作用更明显,并可早期改善COPD的运动耐量,延缓肺功能的下降。

Objective：To study the changes of the IC in patients with severe Chronic obstructive pulmonary disease（COPD） after inhalation of corticosteroids（Salmeterol） combined with long-acting β2 agonists（Tiotropium Bromide）.Methods：58 patients with moderate or severe COPD were randomly divided into observation group and control group.The observation group was given Salmeterol 50 μg,Fluticason 500 μg inhaling twice daily and comined with Tiotropium Bromide 18 μg once daily;the control group was given Salmeterol 50 μg,Fluticason 500 μg inhaling twice daily,which all for 6 months.Had Pulmonary function testing and IC testing before treatment and after 3 months、6 months.Had the 6min walk distance evaluation of exercise capacity;dyspnea index mmRC evaluated the quality of life.Results：There was in observation group IC than in the control group after 3 months and 6 months（P0.05）;Dyspnea index mmRC in observation group than in the control group at various stages（P0.05）.Conclusion：Salmeterol combined with Tiotropium Bromide are more effective than only Salmeterol in treatment of the patients with severe COPD,and IC of lung function and quality of life of the improvement are also very obvious.