沙美特罗替卡松粉吸入剂对稳定期慢性阻塞性肺疾病患者气道炎症及咳嗽和咳痰症状的影响

Effects of salmeterol and fluticasone propionate powder for inhalation on airway inflammation,cough and expectoration in patients with stable chronic obstructive pulmonary disease

目的探究沙美特罗替卡松粉吸入剂对稳定期慢性阻塞性肺疾病(COPD)患者气道炎症及咳嗽、咳痰症状的影响。方法选取2017年2月至2019年5月四川省广元市中心医院收治的稳定期COPD患者86例,按随机数字表法分为对照组和观察组,各43例。对照组在常规治疗基础上给予噻托溴铵吸入剂治疗,观察组在常规治疗基础上给予沙美特罗替卡松粉吸入剂治疗,比较2组患者的临床疗效、肺功能恢复情况、气道炎症相关指标及生活质量。结果观察组的总有效率明显高于对照组[90.7%(39/43)比72.1%(31/43)],差异有统计学意义(P=0.027)。治疗后,2组患者的肺功能指标均有不同程度的改善,且观察组用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC及最大呼气流量均明显高于对照组,差异均有统计学意义(均P<0.05)。治疗后,观察组痰上清液中嗜酸粒细胞趋化因子、调节激活正常T细胞表达分泌因子水平均明显低于对照组[(2.5±0.5)ng/L比(4.3±1.3)ng/L、(2.1±0.3)ng/L比(4.2±1.1)ng/L](均P<0.05);患者的圣·乔治医院呼吸疾病调查问卷评分均有不同程度的下降,其中,观察组的具体症状(咳嗽、咳痰、气喘)、活动情况(家务、上楼、慢走)、疾病影响(失眠、焦虑、紧张)评分均明显低于对照组[(46±8)分比(53±8)分、(50±4)分比(56±6)分、(39±6)分比(48±10)分],差异均有统计学意义(均P<0.05)。结论沙美特罗替卡松粉吸入剂能有效改善稳定期COPD患者的临床症状,提高治疗效果,改善患者的肺功能,并能有效减轻气道炎症,缓解咳嗽、咳痰等症状。

Objective To investigate the effect of salmeterol and fluticasone propionate powder on airway inflammation,cough and sputum symptoms in patients with stable chronic obstructive pulmonary disease(COPD).Methods Totally 86 COPD patients were randomly divided into observation group(43 cases)and control group(43 cases).The control group was given Tiotropium bromide inhalation on the basis of conventional treatment;the observation group was given salmeterol and fluticasone propionate powder inhalation on the basis of conventional treatment.The clinical curative effect,lung function recovery,airway inflammation related indexes and quality of life before and after treatment were compared between the two groups.Results The total effective rate of observation group was higher than that of control group[90.7%(39/43)vs 72.1%(31/43),P=0.027].After treatment,lung function indexes were increased.The forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),FEV1/FVC and peak expiratory flow in observation group were higher than those in control group(P<0.05).After treatment,levels of eosnophilse chemokine(Eotaxin)and regulated upon activation normal T cell expressed and secreted(RANTES)in observation group were lower than those in control group[(2.5±0.5)ng/L vs(4.3±1.3)ng/L,(2.1±0.3)ng/L vs(4.2±1.1)ng/L](P<0.05).The scores of St George’s Respiratory Questionnaire(SGRQ)were decreased.The scores of symptoms(cough,expectoration,asthma),activity(housework,going upstairs,slow walking)and disease effects(insomnia,anxiety,tension)in observation group were lower than those in control group[(46±8)vs(53±8),(50±4)vs(56±6),(39±6)vs(48±10)](all P<0.05).Conclusion Salmeterol and fluticasone propionate powder for inhalation can effectively improve clinical symptoms of COPD patients,improve curative effect,improve lung function,reduce airway inflammation and relieve cough and expectoration.