噻托溴铵与沙美特罗氟替卡松联用对COPD患者的疗效及细胞免疫功能的影响

Clinical curative effect and cellular immune function analysis of tiotropium combined with salmeterol/fluticasone for COPD patients

目的研究噻托溴铵与沙美特罗/氟替卡松联用对慢性阻塞性肺疾病（COPD）患者的疗效及细胞免疫功能的影响。方法选择2012年9月~2015年9月接受治疗的COPD患者132例进行研究。根据数字法将患者随机分成观察组66例及对照组66例。两组均常规给予吸氧、止咳平喘以及抗感染等药物对症治疗,对照组给予沙美特罗/丙酸氟替卡松治疗,观察组则在对照组用药基础上增加噻托溴铵,治疗3个月后评价两组疗效。结果观察组的总有效率是98.48%,明显高于对照组的87.77%,差异有统计学意义（P〈0.05）。治疗后两组的FVC、FEV1及FEV1/FVC水平均较治疗前明显上升,但观察组的上述指标均显著高于对照组,差异有统计学意义（P〈0.05）。两组治疗后的Th1及Th1/Th2分别高于各自治疗前,差异有统计学意义（P〈0.05）。观察组治疗后的Th1及Th1/Th2高于对照组治疗后,差异有统计学意义（P〈0.05）。观察组用药后不良反应发生率12.12%,与对照组的6.06%相比,差异无统计学意义（P〉0.05）。结论噻托溴铵联合沙美特罗/氟替卡松治疗COPD具有较好的临床疗效,且能够明显改善患者的肺功能,安全性较好,是治疗COPD较好的临床选择。

Objective To study clinical curative effect and cellular immune function analysis of tiotropium combined with salmeterol/fluticasone for COPD patients.Methods 132 COPD patients were randomly divided into observation group（66cases）and control group（66cases）,according to digital method.The two groups were routinely treated by oxygen inhalation,antitussive,antiasthmatic and anti-infection drugs for the symptomatic treatment.The control group was treated with salmeterol/fluticasone propionate treatment.The observation group was treated with tiotropium based on the control group therapy.3months after treatment,the curative effect were observed.Results The total effective rate of the observation group was 98.48%,which was significantly higher than that of the control group（87.77%）.The difference was statistically significant（P0.05）.After treatment,the levels of FEV1/FVC,FEV1 and FVC in the two groups were significantly higher than those before treatment,but the observation group were significantly higher than those in the control group.The difference was statistically significant（P0.05）.Th1 and Th1/Th2 of the two groups after treatment were higher than that before treatment（P0.05）.Th1 and Th1/Th2 group of observation group f after treatment were higher than that of the control group after treatment（P0.05）.The total adverse reaction rate of the observation group（12.12%）was not statistically significant different from that of e control group（6.06%）（P0.05）.Conclusion Tiotropium combined with salmeterol/fluticasone in the treatment of COPD has better curative effect and can significantly improve the pulmonary function of the patients.