目的 探讨噻托溴铵(思力华)联合沙美特罗/氟替卡松(舒利迭)对COPD稳定期患者的肺功能、生活质量和急性发作次数等的改变.方法 基础治疗为吸入舒利迭50/500 ug、Q 12 h,对照组加予复方异丙托溴铵(可必特) 气雾剂2喷、Bid,治疗组加予思力华18 ug、Qd.每月复诊一次,观察6月.结果 治疗6月后,治疗组FEV1增加0.20 L(1.24±0.15 vs 1.04±0.13),症状评分平均下降7.1分;对照组FEV1增加0.11 L(1.12±0.11 vs 1.01±0.15),症状评分平均下降4.1分;同组间前后有统计学差异(P<0.05);两组之间有统计学差异(P<0.05).而不良反应相似且较轻.结论 两种治疗均能改善重度及以上COPD患者的肺功能和临床症状;但噻托溴铵组更为优越,应在临床中推广.%Objective To explore the therapeutic effects of tiotropium combined with salmeterol/fluticasone on severe chronic ob-structive pulmonary disease ( COPD ) in stable stage. Methods Patients of severe COPD were randomly divided into two groups, the con-trol group received Compound Ipratropium Bromide Aerosol ( Combivent) with salmeterol/fluticasone ( Seretide 50/500 ug ) and the treat-ment group received Tiotropium dry powder inhalation ( Spiriva ) combined with salmeterol/fluticasone ( Seretide 50/500 ug ) powder inha-lation. Patients returned visit monthly and the treatment course lasted for 6 months. The lung function, life quality and the number of acute episode in the two griups were analyzed and compared. Results After six months' treatment, value of forced expiratory volumn in 1 sec-ond ( FEV| % ) increased by 0. 11 L ( 1. 12 ±0. 11 vs 1. 01 ±0. 15 ) in the treatment group and symptom scores dropped by 7. 1 points, and the control group increased by 0. 20 L( 1. 24 ±0. 15 vs 1. 04 ±0. 13 ) and symptom scores dropped by 4. 1 points. There was signifi-cant differences between before and after treatment in each group, and between the two groups after treatment ( P < 0. 05 ). Adverse reac-tions of the two groups got mild, but without significant differences. Conclusions The two treatment methods can improve lung function and clinical symptom of patients with severe COPD, but tiotropium is superior to Ipratropium Bromide Aerosol and hence, it can be sprea-ded in the clinic.
展开▼
