噻托溴铵联合氟替卡松治疗稳定期中重度慢性阻塞性肺疾病的疗效观察

Clinical efficacy of tiotropium combined with fluticasone in the treatment of stable moderate-severe chronic obstructive pulmonary disease

目的评价噻托溴铵联合氟替卡松治疗稳定期中重度慢性阻塞性肺疾病(COPD)的临床疗效。方法将60例COPD患者随机分为治疗组和对照组,每组各30例。对照组给予氟替卡松,吸入给药,一日2次,每次100μg;治疗组在对照组基础上联合使用噻托溴铵,吸入给药,一日1次,每次18μg,两组疗程均为12周。比较两组患者治疗前后用力肺活量(FVC)、1秒钟用力呼气容积(FEV_1)、FEV_1/FVC、最大呼气流量(PEF)和FEV_1%预计值,计算不良反应发生率。结果治疗12周,治疗组和对照组FVC、FEV_1、FEV_1/FVC、PEF及FEV_1%均有所提高,且治疗组较对照组增加更为明显,组间差异具有统计学意义(P<0.05),两组不良反应发生率无明显差异(P>0.05)。结论噻托溴铵联合氟替卡松治疗稳定期中重度COPD的临床疗效优于氟替卡松单用,两药联用具有协同作用,且不增加不良反应,值得临床推广。

Objective To observe the clinical efficacy oftiotropium combined with fluticasone on the patients with stable moderate-severe chronic obstructive pulmonary disease （COPD）. Methods Sixty COPD patients were randomly divided into treatment group and control group as 30 cases each group. The patients in control group were given inhaled fluticasone for 100μg, twice a day, while the patients in treatment group were given additional inhaled tiotropium for 18μg once a day. Both treatments took 12 weeks. The forced vital capacity （FVC）, forced expiratory volume in one second （FEV1）, FEV1/FVC, peak expiratory flow （PEF）, FEV1% and the incidence of adverse reactions of two groups were compared. Results The FVC, FEV1, FEV1/FVC, PEF and FEV1% of both group were improved after treatment, and all the indexes of treatment group were higher than those of control group, the differences were significant （P〈0.05）. The incidence of adverse reactions were no significant difference （P〉0.05）. Conclusion Tiotropium combined with fluticasone is superior to administrating fluticasone alone in the treatment of stable COPD （stage moderate to severe）. The combination therapy has a synergistic effect and does not increase adverse reactions incidence, which is worth for clinical practice.