噻托溴铵联合沙美特罗替卡松吸入剂治疗中-重度稳定期慢性阻塞性肺疾病患者疗效观察

Curative effect of the combination of Tiotropium Bromide and Salmeteroi Fluticasone inhalant in treatment of moderate-to-severe stable chronic obstructive pulmonary disease

目的分析噻托溴铵（思力华）与沙美特罗替卡松（舒利迭）联合应用于中重度慢性阻塞性肺疾病（COPD）患者的临床效果。方法选取2011年8月至2012年11月，我院相关科室所收治的中重度COPD患者110例为研究对象，并将其随机分成两组，对照组55例患者以沙美特罗替卡松单药治疗，实验组55例患者则以噻托溴铵与沙美特罗替卡松联合治疗。对两组患者的疗效进行对比分析。结果经过3个月的治疗，两组患者呼吸困难的现象均有所改善，但实验组患者的效果明显更好，组间差异明显，P〈O．05。此外，相比于对照组，实验组患者各项血气指标与肺部功能指标（除PaCO2）均明显升高，组问差异较大，P〈O．05。结论相比于沙美特罗替卡松单药治疗，噻托溴铵与沙美特罗替卡松联合治疗中重度COPD患者的疗效更佳，患者无论是血气、肺部功能，还是呼吸困难情况均得到明显的改善，且临床不良反应少，值得肯定，在临床治疗中应普及应用。

Objective To analyze the clinical effect of the combination of Spiriva （Tiotropium Bromide） and Seretide （Salmeterol Flutieasone） in treatment of moderate-to-severe chronic obstructive pulmonary disease （COPD）. Methods A total of 110 moderat-to-severe COPD patients in our hospital from August 2011 to November 2012 were selected as the subjects, who were randomized into two groups, with 55 patients of the control group treated by Seretide and 55 patients of the experimental group treated by the combination of Spiriva and Seretide. The curative effects of two groups were compared. Results After 3 months of treatment, dyspnea was relieved in both two groups, but patients of the experimental group had better effects, with significant difference shown among groups （ P〈0.05）. In addition, indexes of blood gas and pulmonary function in patients of the experimental group were significantly improved compared with those of the control group, showing significant difference among groups （ P〈0.05）. Conclusions Compared with Seretide monotherapy, combination Spiriva and Seretide has better curative effect in treatment of moderate-to-severe COPD. The blood gas, pulmonary function and dyspnea condition of patients can all be improved with less clinical side effects. Thus it is worthy of being widely used in clinical treatment.