联合应用沙美特罗/氟替卡松与噻托溴铵对慢性阻塞性肺疾病肺功能的疗效  

Therapeutic effect of salmeterol/fluticasone propionate combined with tiotropium bromide therapy for patients with COPD

作　　者：张秀伟[1] 杨健[1] 朱颖[1] 武良权[1] 杨旸[1] 文昱婷[1] 施毅[2] 

机构地区：[1]南京市江宁医院呼吸科,江苏南京211100 [2]南京军区总医院呼吸科,江苏南京210002

出　　处：《临床荟萃》2009年第2期114-116,共3页Clinical Focus

摘　　要：目的本研究联合应用噻托溴铵与沙美特罗/丙酸氟替卡松治疗慢性阻塞性肺疾病(COPD),并观察其疗效。方法45例中重度COPD患者随机分为3组:联合组给予吸入噻托溴铵干粉剂(18μg,每日1次)与沙美特罗/丙酸氟替卡松(50/500μg,每日2次);噻托溴铵组给予吸入噻托溴铵干粉剂(18μg,每日1次);沙美特罗/丙酸氟替卡松组给予吸入沙美特罗/丙酸氟替卡松(50/500μg,每日2次),在治疗前及治疗后14天测定肺功能。结果治疗后第14天,与噻托溴铵组及沙美特罗/丙酸氟替卡松组相比,联合治疗组第1秒用力呼气量(FEV1)显著提高,(0.941±0.088)L、(0.935±0.078)L vs(1.136±0.086)L(P<0.01),用力肺活量(FVC)显著提高,(1.580±0.156)L、(1.575±0.181)L vs(1.808±0.180)L(P<0.01)。结论3种药物联合治疗,对COPD患者具有更强的支气管扩张作用,能够显著改善COPD患者的肺功能。Objective To explore the efficacy of combined salmeterol/flutieasone propionate with tiotropium bromide in patients with chronic obstructive pulmonary disease（COPD）. Methods A randomized clinical trial was conducted in 45 stable moderate to severe patients with COPD. They were randomized into three groups： salmeterol/ flutieasone propionate and tiotropium bromide treated group（SFC＋TIO）, tiotropium bromide treated group （18 μg once per day,TIO）, salmeterol/flutieasone propionate treated group （50/500 μg twice per day, SFC）. Lung function assessment included plethysmography and spirometry on day 14. Results SFC ＋ TIO significantly improved FEVI （1.136±0.086） Lvs （0.941±0.088） L,（0. 935±0.078）L （P 〈0. 01）,and FVC （1.808±0.180） L vs （1.580± 0.156） L, （1.575 ± 0.181） L （ P 〈0.01） compared with TIO alone and SFC alone on Day 14. Conclusion In terms of improvement in lung function, the combination of salmeterol/flutieasone propionate and tiotropium bromide is more effective in patients with moderate-to-severe COPD than either of the two bronchodilators administered alone.

关 键 词：肺疾病 慢性阻塞性 噻托溴铵 沙美特罗/丙酸氟替卡松 

分 类 号：R563[医药卫生—呼吸系统]