噻托溴铵联合沙美特罗替卡松治疗慢性阻塞性肺疾病稳定期效果观察

Effects of tiotropium bromide combined with salmeterol and fluticasone propionate in treatment of chronic obstructive pulmonary disease at stable stage

目的探讨噻托溴铵联合沙美特罗替卡松治疗慢性阻塞性肺疾病稳定期的治疗效果。方法选取2016年2月‐2017年2月该院收治的慢性阻塞性肺疾病稳定期患者78例,根据随机数表法将所有患者分为两组,每组39例。对照组给予沙美特罗替卡松粉吸入剂治疗,观察组加用噻托溴铵吸入粉雾剂治疗,将两组患者的治疗疗效、治疗前后健康状况及肺功能指标变化情况进行对比,记录治疗期间不良反应发生情况。结果观察组患者的治疗总有效率(94.87%)明显较对照组(76.92%)高,差异有统计学意义(P<0.05);治疗后,观察组圣乔治呼吸问卷(SGRQ)评分明显较对照组SGRQ评分低,差异有统计学意义(P<0.05);治疗前,两组患者SGRQ评分、第一秒用力呼气量(FEV1)、用力肺活量(FVC)、第一秒用力呼气量占用力肺活量百分比(FEV1/FVC)及一秒用力呼吸肺活量占预计值的百分比(FEV1%)等肺功能指标对比,差异无统计学意义(P>0.05);治疗后,两组患者FEV1、FVC、FEV1/FVC及FEV1%等肺功能指标均较治疗前高,且观察组患者FEV1、FVC、FEV1/FVC及FEV1%等肺功能指标均明显高于对照组,差异有统计学意义(P<0.05);两组患者用药后不良反应发生率对比,差异无统计学意义(P>0.05)。结论噻托溴铵联合沙美特罗替卡松治疗慢性阻塞性肺疾病稳定期具有显著效果,可有效改善患者的肺功能,提高患者的生活质量,安全性较高。

【Objective】To investigate the curative effects of tiotropium bromide combined with salmeterol and fluticasone propionate in treatment of chronic obstructive pulmonary disease（COPD） at stable stage.【Methods】Seventy-eight COPD patients at sable stage admitted in our hospital from February 2016 to February 2017 were selected, and they were divided into two groups by random number table, 39 cases in each group. Control group was given inhalation of salmeterol and fluticasone propionate powder, while observation group was treated with inhalation of tiotropium bromide powder based on control group. The efficacy, health condition before and after treatment, changes of pulmonary function indexes were compared between the two groups. The adverse reactions during treatment were recorded.【Results】The total effective rate of the observation group（94.87%） was higher than that of the control group（76.92%）（P〈0.05）; after treatment, the St. George＇s Respiratory Questionnaire（SGRQ） score of the observation group was lower than that of the control group（P〈0.05）; before treatment, the SGRQ score, forced expiratory volume in one second（FEV1）, forced vital capacity（FVC）, FEV1/FVC, FEV1% between the two groups had no statistical difference（P〉0.05）; after treatment, the FEV1, FVC, FEV1/FVC, FEV1% of two groups were higher than those before treatment, and the FEV1, FVC, FEV1/FVC, FEV1% of the observation group were higher than those of the control group（P〈0.05）; there was no statistical difference in the incidence of adverse reactions between the two groups（P〉0.05）.【Conclusion】Tiotropium bromide combined with salmeterol and fluticasone propionate in treatment of COPD at stable stage is effective, and it can improve pulmonary function and increase living quality with high safety.