Objective To observe the clinical curative effect of tiotropium bromide combined with inhaled corticosteroids in the treatment of asthma-COPD overlap syndrome ( ACOS ) without using long-acting β2 agonist. Methods 60 patients which met 'ACOS' diagnostic criteria were randomly divided into the tiotropium bromide group, and the budesonide group and the combined inhalation group. Their lung function, ACT score, CAT score and num-bers of exacerbation were compared. Results After treatment, the improvement of lung function was more pro-nounced in the combined inhalation group than in the rest two groups ( P<0. 05 ) . ACT scores were superior in the combined inhalation group than in the rest two groups (P<0. 05). Conclusion Tiotropium bromide joint glucocorti-coid inhalation can significantly improve lung function and symptoms of ACOS and reduce the numbers of exacerba-tion, and its efficacy is superior to single-use inhaled corticosteroids and tiotropium bromide.%目的 观察不使用长效β2-激动剂情况下,应用噻托溴铵联合吸入糖皮质激素对哮喘-慢阻肺重叠综合征( ACOS)患者的治疗作用,并与单用噻托溴铵及单纯吸入糖皮质激素的治疗手段进行对比. 方法根据"ACOS"诊断标准选择60例患者,分为噻托溴铵联合布地奈德粉吸入剂组、单用布地奈德粉吸入剂组、单用噻托溴铵组,三组分别进行肺功能、ACT、CAT及急性加重次数的比较. 结果 治疗后3组患者中噻托溴铵联合布地奈德 (C)组肺功能改善率明显高于噻托溴铵(A)组、布地奈德粉吸入剂(B)组(P<0. 05).治疗后三组患者用于哮喘症状评估的ACT评分噻托溴铵联合布地奈德 ( C)组较单用噻托溴铵、单用布地奈德治疗的两组症状改善更明显 (P<0. 05),而治疗后三组患者CAT评分噻托溴铵联合布地奈德 (C)组较单用噻托溴铵、单用布地奈德治疗的两组症状改善更明显. 结论 噻托溴铵联合糖皮质激素吸人治疗可以明显改善ACOS患者的肺功能和临床症状,减少急性发作次数,其疗效优于单用糖皮质激素吸入和单用噻托溴铵吸入治疗,可改善其短期预后.
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