舒利迭干粉吸入剂联合噻托溴铵治疗慢性阻塞性肺疾病稳定期的临床疗效

Clinical effects of seretide inhalation combined with tiotropium on COPD in stable phase

目的观察舒利迭联合噻托溴铵对慢性阻塞性肺疾病（COPD）稳定期患者肺功能及其血清中肿瘤坏死因子-α（TNF-α）的影响。方法收集60例COPD稳定期患者，随机分为对照组和治疗组各30例，对照组给予舒利迭（50／500μg），早晚各1次，吸入；治疗组在此基础上联合每天1次吸入噻托溴铵干粉吸入剂18μg，治疗期间两组患者均给予常规抗感染、平喘等对症治疗，并于治疗前后检测肺功能；并通过ELISA法测定治疗前后患者血清中的TNF-α。结果与对照组相比较，治疗组患者COPD的肺功能改善更明显（P〈0．05），且患者血清中TNF—α的表达有所降低（P〈0．05）。结论舒利迭联合噻托溴铵治疗COPD稳定期患者可以明显改善患者的肺功能，降低患者血清中TNF-α的表达，且疗效优于舒利迭单药治疗。

Objective To observe the clinical effect of seretide inhalation combined with tiotropium on chronic obstructive pulmonary disease（COPD） in stable phase and its effect on TNF-α. Methods Sixty patients with COPD in stable phase were randomly divided into two groups： the control group （ n = 30） and the treatment group （ n = 30）. The control group was treated with inhalation of seretide （50/500 μg, bid）, while the treatment group was treated with inhalation of seretide plus tiotropium （18μg, qd）. Meanwhile, patients in both groups received conventional anti-infective, anti-asthmatic and symptomatic treatment, and the lung function was detected before and after treatment; and serum TNF-α was measured by ELISA before and after treatment. Results The pulmonary function of COPD in stable phase obviously improved, the expression of TNF-α decreased in treatment group. There were significant differences compared with the control group （P 〈 0. 05 ）. Conclusions Inhalation of seretide plus tiotropium could improve the pulmonary function and reduce the expression of TNF-α, and was more effective than seretide monotherapy.