噻托溴铵联合大剂量沙美特罗/氟替卡松治疗重度支气管哮喘合并COPD稳定期的临床观察

Clinical observation of tiotropium combined with large dose salmeterol/fluticasone in the treatment of severe bronchial asthma with COPD stabilization

目的探讨噻托溴铵联合沙美特罗/氟替卡松（大剂量）治疗重度支气管哮喘合并慢性阻塞性肺疾病稳定期临床应用效果。方法选取浙江省台州医院于2015年1月～2016年12月期间收治的60例重度支气管哮喘合并慢性阻塞性肺疾病稳定期患者作为本次研究对象,经单双数字法随机分为对照组和观察组,每组各30例。对照组在常规治疗基础上加用大剂量沙美特罗/氟替卡松,研究组在对照组基础上加用噻托溴铵,比较2组治疗前后FEV1、FVC、FEV1/FVC、PEF肺功能指标变化情况。结果 2组患者治疗前FEV1、FVC、FEV1/FVC、PEF肺功能指标对比;治疗后研究组FEV1、FVC、FEV1/FVC、PEF指标较治疗前改善幅度优于对照组（P〈0.05）。结论噻托溴铵联合大剂量沙美特罗/氟替卡松治疗重度支气管哮喘合并慢性阻塞性肺疾病稳定期可显著提高患者临床疗效。

Objective To evaluate the clinical efficacy of tiotropium combined with large dose salmeterol/fluticasone in the treatment of severe bronchial asthma with chronic obstructive pulmonary disease（COPD）.Methods 60 patients with severe bronchial asthma with COPD stabilization in Taizhou hospital of Zhejiang province from January 2015 to December 2016 were selected and divided into the control and the study group according to the time of visiting hospital,30 cases in each group.The control group were given large dose Salmeterol/fluticasone on the basis of conventional treatment,the study group were treated with tiotropium bromide on the basis of control group.Results FEV1、FVC、FEV1/FVC、PEF and pulmonary function index were compared before the treatment between two groups.After treatment,FEV1,FVC,FEV1/FVC、PEF and pulmonary function index in the study group were better than the control group（P〈0.05）.Conclusion The combination of tiotropium and large dose salmeterol/fluticasone can significantly improve the clinical efficacy in the treatment of severe bronchial asthma and chronic obstructive pulmonary disease.