吸入噻托溴铵联合信必可治疗稳定期中重度COPD的有效性与安全性

The efficacy and safety of inhalation of tiotropium bromide vombined with dymbicort in the treatment of moderate to devere COPD at dtable phase

目的探讨吸入噻托溴铵联合信必可治疗稳定期中重度慢性阻塞性肺疾病(COPD)的有效性与安全性。方法将2015年1月~2017年1月在我院接受治疗的60例稳定期中重度COPD患者作为研究对象,并给予随机分组,对照组30例给予单纯信必可吸入治疗;干预组30例,在对照组基础上加用噻托溴铵治疗,对两组患者治疗前后的肺功能相关指标、临床症状评分、临床治疗效果以及不良反应发生情况进行综合评价。结果干预组患者治疗后的FEV1、FVC、FEV1/FVC等肺功能指标显著优于对照组,差异有统计学意义(P<0.05);干预组治疗1个月、2个月后的临床症状评分与对照组比较有明显差异(P<0.05);且干预组治疗后有28例患者显示有效,占93.3%,显著高于对照组的70.0%,差异有统计学意义(P<0.05);干预组患者治疗后不良反应发生率仅为6.7%,显著低于对照组的23.3%,差异有统计学有意义(P<0.05)。结论采用吸入噻托溴铵联合信必可治疗稳定期中重度COPD,能够促进患者临床症状缓解,改善肺功能,疗效优于单纯信必可治疗,值得推广应用。

Objective To investigate the efficacy and safety of inhaled tiotropium bromide combined with symbicort in the treatment of moderate to severe chronic obstructive pulmonary disease（COPD） at stable phase. Methods 60 pa- tients with moderate to severe COPD at stable phase who were treated in our hospital from January 2015 to January 2017 were selected as the study subjects and were randomized to groups. The control group of 30 cases was given in- halation therapy of symbicort alone; the intervention group of 30 cases was further given tiotropium bromide on the ba- sis of the control group. The lung function related indicators, clinical symptoms score, clinical therapeutic effect and the incidence of adverse reactions before and after the treatment were comprehensively evaluated in both groups. Re- suits The lung function indices of FEV1, FVC, FEV1/FVC were significantly better in the intervention group than in the control group, which was statistically significant（P〈O.05）; there was significant difference in the scores of clinical symptoms at 1 month and 2 months after the treatment between the two groups（P〈O.05）, and there was statistically sig- nificant difference between the two groups（P〈O.05）; 28 patients were effective after the treatment in the intervention group, accounting for 93.3%, which was significantly higher than that of 70% in the control group, and the difference was statistically significant（P〈0.05）; the incidence rate of adverse events in the intervention group was only 6.7%, which was significantly lower than that of 23.3% in the control group, and the difference was statistically significant （P〈0.05）. Conclusion Inhalation of tiotropium bromide combined with symbicort in the treatment of moderate to severe COPD at stable phase can promote the alleviation of clinical symptoms of patients and improve the patient＇s lung function, and the effect is better than symbicort alone, which is worthy of promotion and application.