长期小剂量阿奇霉素联合布地奈德/福莫特罗治疗Ⅲ、Ⅳ级COPD稳定期患者的疗效

Efficacy Observation of Long-term low doses of Azithromycin combined with Budesonide / Fomoterol in the treatment of stable Ⅲ to Ⅳ COPD patients

目的:探讨长期小剂量阿奇霉素联合布地奈德/福莫特罗对Ⅲ、Ⅳ级慢性阻塞性肺疾病(COPD)稳定期患者的安全性与疗效分析。方法:采用前瞻性随机对照的研究方法,选择我院87例Ⅲ、Ⅳ级COPD稳定期患者作为研究对象,随机分为对照组(布地奈德/福莫特罗160μg/4.5μg每吸,1吸/次,2次/d),联合治疗组(布地奈德/福莫特罗160μg/4.5μg每吸,1吸/次,2次/d+阿奇霉素250 mg,1次/d。观察两组治疗3、6个月后PEF、FEV1、FEV1/FVC、m MRC、6MWT,急性加重次数。结果 :联合治疗组在3、6个月后的PEF、FEV1、FEV1/FVC改善较对照组显著(P<0.05);两组在3个月后的m MRC、6MWT、急性加重次数改善程度相仿(P>0.05),6个月后联合治疗组较对照组改善显著(P<0.05)。结论:长期小剂量阿奇霉素联合布地奈德/福莫特罗治疗较单一吸入布地奈德/福莫特罗能明显改善患者相关的肺功能指标,且随着用药时间延长,联合治疗较单一治疗更能显著改善相关临床症状,并降低急性加重次数。

Objective To investigate the safety and efficacy of long-term low doses of Azithromycin combined with Budesonide/Fomoterol in the treatment of stable Ⅲ to Ⅳ COPD patients. Methods Collect the confirmed COPD patients of our hospital, they were randomly divided into two groups： the control group （160 0μg/4.5 0μg, Bid）, the joint group （160 0μg/4.5 0μg/ Bid ＋ azithromycin 250 mg qd）. Then Observe the PEF, FEV1, FEV1/FVC, mMRC, 6 MWT, AECOPD of the two groups after treatment for 3 months and 6 months. Results the index of PEF, FEV~, FEVt/FVC of joint group improved more significantly （P 〈 0.05） than control group after 6 months; the mMRC, 6 MWT, AECOPD, of the two groups improve the similar degree in terms of 3 months （P 〉 0.05）, joint group improved more significantly than control group after 6 months （P 〈 0.05）. Conclusion the therapy of Long-term low doses of azithromycin combined with Budesonide/Fomoterol can more significantly improve lung function index, as the treatment time extended, it can significantly improve clinical symptoms , reduce the number of exacerbations than single inhaled Budesonide/Fomoterol .