布地奈德福莫特罗联合噻托溴铵治疗尘肺合并稳定期慢性阻塞性肺疾病的疗效观察

Observation on effect of budesonide/formoterol combined with tiotropium in the treatment of pneumoconiosis patients with stable COPD

目的观察患者给予布地奈德福莫特罗联合噻托溴铵和单独吸入布地奈德福莫特罗治疗尘肺病合并稳定期慢性阻塞性肺疾病(COPD)的疗效。方法调查尘肺病合并COPD患者78例,随机分组,吸入给药。治疗组40例,吸入布地奈德福莫特罗(160/4.5μg,2次/d)联合噻托溴铵粉剂(18μg,1次/d);对照组38例,吸入布地奈德福莫特罗(160/4.5μg,2次/d)。治疗12周,观察比较两组患者治疗前后肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC]和动脉血气[血氧分压(Pa O2)和二氧化碳分压(Pa CO2)]指标。结果治疗12周后,治疗组患者的FVC、FEV1、FEV1/FVC%分别为(2.98±0.19)L、(62.40±0.76)L和(66.40±5.72)%,动脉血气的Pa O2为(78.1±1.24)mm Hg,高于对照组,Pa CO2为(58.9±1.56)mm Hg,低于对照组;各指标结果与对照组比较,其差异均有统计学意义(均P<0.05)。结论吸入布地奈德-福莫特罗联合噻托溴铵对尘肺病合并COPD患者的治疗效果优于单独吸入布地奈德-福莫特罗。

[Objective] To compare the effect between budesonide/formoterol combined with tiotropium and single inhalation of budesonide/formoterol in the treatment of pneumoconiosis patients with stable chronic obstructive pulmonary diseases （COPD）. [Methods]78 pneumoconiosis patients with COPD were randomly divided into treatment group （n=40） and the control group （n=38）. The treatment group was given the budesonide/formoterol （160/4.5μg, twice daily） and tiotropium （18 μg, once daily） by inhalation administration, while the control group was treated with budesonide/formoterol （160/4.5 μg, twice daily） by inhalation administration. The pulmonary function （FVC, FEV1 and FEV1/ FVC） and arterial blood gas （PaO2 and PaCO2） was observed before and after treatment of 12 weeks. [Results]After 12 weeks treatment,the level of FVC,FEV1 and FEV1/FVC% in the treatment group was respectively （2.98±0.19） L, （62.40±0.76） L and （66.40±5.72） %. The PaO2 level in the treatment group was （78.1±1.24） mm Hg, which was higher than that in the control group, and PaCO2 level in the treatment group was （58.9±1.56） mm Hg, which was lower than that in the control group. The differences in all items between two groups were statistically significant （all P〈0.05）. [Conclusion]This study demonstrates that combination treatment with tiotropium plus budesonide/ formoterol results in greater therapeutic benefits than Budesonide/formoterol alone.