噻托溴铵吸入剂联合沙美特罗替卡松粉吸入剂对中重度慢性阻塞性肺疾病患者稳定期的肺功能及预后的影响

Effect of tiotropium bromide inhalation combined with salmeterol xinafoate and fluticasone propionate powder inhalation on pulmonary function and prognosis in the treatment of moderate and severe chronic obstructive pulmonary disease

目的探讨噻托溴铵吸入剂联合沙美特罗替卡松粉吸入剂对中重度慢性阻塞性肺(COPD)疾病患者稳定期的肺功能及预后的影响。方法将80例中重度COPD患者随机分为对照组40例和试验组40例。对照组予以沙美特罗替卡松粉吸入剂进行治疗,50μg/500μg,每天早晚各1次;试验组在对照组的基础上加用噻托溴铵吸入剂治疗,18μg,每天1次,睡前吸入,疗程为3个月。比较2组患者的临床疗效、肺功能指标、6 min步行试验、呼吸困难评分以及药物不良反应发生率。结果治疗后,试验组和对照组总有效率分别为87.50%(35/40例)和67.50%(27/40例),差异有统计学意义(P<0.05);治疗后试验组和对照组的一秒钟用力呼气容积(FEV1)分别为(2.22±0.27),(1.80±0.35)L;最大肺活量(FVC)分别为(3.31±0.40),(2.97±0.59)L;FEV1/FVC分别为(65.36±8.00)%,(56.97±8.61)%;6 min步行试验分别为(421.68±30.24),(401.26±31.27)m;呼吸困难评分分别为(1.35±0.29),(1.70±0.39)分,差异均有统计学意义(均P<0.05)。2组患者药物不良反应主要为口干、恶心、声音嘶哑,试验组和对照组药物不良反应发生率分别为15.00%(6/40例)和10.00%(4/40例),差异无统计学意义(P>0.05)。结论噻托溴铵吸入剂联合沙美特罗替卡松粉吸入剂可改善肺功能,临床疗效显著,且安全性高。

Objective To investigate the effect of tiotropium bromide inhalation combined with salmeterol xinafoate and fluticasone propionate powder inhalation on pulmonary function and prognosis in treatment of patients with moderate and severe chronic obstructive pulmonary disease（COPD）. Methods Eighty patients with moderate and severe COPD were randomly divided into control group（40 cases） and treatment group（40 cases）. The control group was given salmeterol xinafoate and fluticasone propionate powder inhalation（50 μg/500 μg）,every night and evening; the treatment group was given tiotropium bromide inhalation18 μg on the basis of control group,every right before sleep. After 3months treatment, the clinical efficacy, pulmonary function index,6-minunte walking test,score of dyspnea and inciden of adverse drug reactions were compared. Results The total effective rates intreatment group and control group were 87. 50%（35/40 cases） and 67. 50%（27/40 cases） 95. 65% respectively,the difference was statistically significant（P〈0. 05）. The forced expiratory volume in one second（FEV1） of pulmonary function index in treatment group and control group were（2. 22 ± 0. 27）,（1. 80 ± 0. 35） L,forced vital capacity（FVC）were（3. 31 ± 0. 40）,（2. 97 ± 0. 59） L,FEV1/FVC were（65. 36 ± 8. 00） % and（56. 97 ± 8. 61） %,results of 6-minute walking test were（421. 68 ± 30. 24）,（401. 26 ± 31. 27） m; scores of dyspnea were 1. 35 ± 0. 29 and 1. 70 ± 0. 39 respectively,the differences were all statistically significant（P〈0. 05）. The main drug adverse reactions were dry mouth,nausea and hoarse voice. The incidences of drug adverse reactions in treatment group and control group were15. 00%（6/40 cases） and 10. 00%（4/40 cases） respectively,the difference was not statistically significant（P〈0. 05）.Conclusion Tiotropium bromide inhalation combined with salmeterol xinafoate and fluticasone propionate powder inhalation exerted positive effect with high safety in the treatment of moderate and severe COPD,indicating that the drug combination is worth to use in clinical practice.