单用沙美特罗氟替卡松与联合噻托溴铵治疗中重度慢性阻塞性肺病的对比研究

Comparative study of effect of Salmeterol/Fluticasone only and Salmeterol/Fluticasone in combination with Tiotropium Bromide in treatment of moderate-severe chronic obstructive pulmonary disease

目的观察对比单用沙美特罗/氟替卡松和沙美特罗/氟替卡松与噻托溴铵联用治疗对中重度慢性阻塞性肺疾病(COPD)患者的疗效。方法将68例中重度稳定期COPD患者随机分为观察组36例和对照组32例,对照组采用沙美特罗/氟替卡松(沙美特罗50μg/氟替卡松500μg)吸入;观察组给予沙美特罗/氟替卡松与噻托溴铵(粉吸入剂18μg×10粒)吸入,疗程均为6个月。比较两组患者治疗前后的肺功能,并采用6 min步行距离(6MWD)评价其运动耐量,采用呼吸困难量表(MMRC)评价其呼吸困难情况。结果随着治疗时间延长,两组患者肺功能各指标均有改善,而且观察组均优于对照组,差异有统计学意义(P<0.001)。两组治疗后6MWD。MMRC评分均呈上升趋势,且观察组较对照组更明显,差异有统计学意义(P<0.001)。结论沙美特罗/氟替卡松联合噻托溴铵治疗中重度COPD效果优于单药舒利迭治疗,可明显改善患者肺功能、运动耐量及呼吸困难症状。

Objective To explore the curative effect of Salmeterol/Fluticasone only and Salmeterol/Fluticasone in combination with Tiotropium Bromide in treatment of moderate-severe chronic obstructive pulmonary disease（COPD）. Methods Sixty-eight patients with moderate-severe COPD were randomly divided into observation group（36 cases） and control group（32 cases）. The observation group was given Salmeterol 50 μ g/Fluticason 500 μ g,comined with Tiotropium Bromide; the control group was given only Salmeterol 50 μg/Fluticason 500 μg. The course were both 6 months. Indexes of lung function, 6-minute walk distance（6MWD） and modified medicalresearch council（MMRC） were measured before and after treatment. Results With the time prolonged, all indexes of lung function were improved, and the indexes in observation group were all better those in control group（P〈0.001）. Rising tendency of 6MWD and MMRC score was found in both groups after treatment, and the tendency in observation group was more obvious than that in control group（P〈0.001）. Conclusion Salmeterol/Fluticasone in combination with Tiotropium Bromide are more effective than only Salmeterol/Fluticasone in treatment of patients with moderate-severe COPD,which can improve the lung function, exercise tolerance and symptoms of dyspnea.