沙美特罗替卡松联合噻托溴铵吸入治疗中重度COPD40例疗效观察

摘要

目的 观察沙美特罗替卡松(舒利迭)联合噻托溴铵粉吸入剂(思力华)对中重度COPD的治疗效果.方法 将40例临床诊断为中重度COPD的患者随机分为两组.A组:22例,舒利迭(50/500 ug)吸人,每天2次,加用思力华,使用吸入装置(HandiHaler)吸入,每次1粒胶囊(18 ug),每天1次.B组:18例,单纯舒利迭(50/500 ug)吸人,每天2次.疗程3个月.观察两组患者治疗前后呼吸困难的评分、血气分析及肺功能情况.结果 治疗3个月后,所有患者呼吸困难均减轻,但A组呼吸困难下降值明显高于B组( P <0.001).与B组比较,治疗后A组肺功能指标(FVC、FEV1及FEV1/FVC)及血气指标(SaO2、PaO2)明显升高,而PaCO2则明显下降( P <0.01).结论 长效抗胆碱药噻托溴铵与舒利迭联合应用可明显改善中重度COPD患者的呼吸困难、血气和肺功能,优于单纯应用舒利迭,可使COPD得到良好的控制.%Objective To investigate the effects of salmeterol/fiuticasone and tiotropium in patients with stable midrange or severe COPD. Methods Forty patients were randomized into two groups. The experimental group(22 cases) received the combination therapy of salmeterol/fluticasone( 50/500 ug) twice daily, and tiotropium 18 ug once daily. The control group (18 cases) received the single therapy of salmeteroL/fluticasone(50/500 ug) twice daily. All patients continued the therapy for 3 months, and the score of dyspneic, blood gas analysis and lung function were checked before and after therapy. Results Before the treatment, the score of dyspneic, blood gas analysis and lung function in the both groups were not statistically different ( P ＞ 0. 05 ). After the therapy, the degree of dyspneic respiration of all patients was improved, and the dyspnea improvements achieved statistical significance in the experimental group to the control group (P ＜ 0.01 ). Increased FVC, FEV1, FEV1/FVC and SaO2, PaO2 were superior in the experimental group to the control group, and descended PaCO2 was superior too ( P ＜ 0. 01 ). Conclusion Combining seretide and Tiotropium could improve the score of dyspneic, blood gas analysis and lung function significantly in stable midrange or severe COPD Patients.