噻托溴铵和布地奈德／福莫特罗治疗慢性阻塞性肺疾病的疗效与安全性研究  

Study on the efficacy and safety of tiotropium bromide and budesonide/formoterol treatment in chronic obstructive pulmonary disease

作　　者：张剑青[1] 刘凌[1] 方利洲[1] 赵芝焕[1] 戴路明[1] 

机构地区：[1]昆明医学院第一附属医院呼吸内二科,650032

出　　处：《中国医师进修杂志》2010年第22期12-15,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的观察联合吸入噻托溴铵和布地奈德／福莫特罗治疗慢性阻塞性肺疾病（COPD），对减少COPD急性发作、改善患者肺功能和健康状况的效果。方法86例COPD患者按照随机数字表法分为三组，联合治疗组29例：吸入布地奈德／福莫特罗粉吸入剂160μg／4．5μg，每日2次，并且吸入噻托溴铵干粉胶囊18μg，每日1次；布地奈德／福莫特罗组29例（160μg/4．5μg，每日2次）；噻托溴铵组28例（18μg，每日1次），疗程为3个月。结果三组患者试验后肺功能、临床症状和健康状况均有显著改善，联合治疗组第1秒用力呼气容积为（1．24±0．18）L，较试验前提高了11．7％，且明显高于其他两组，差异有统计学意义（P〈0．01）；联合治疗组使用缓解药次数及急性发作次数较其他两组明显减少，差异有统计学意义（P〈0．01）；联合治疗组St．George呼吸疾病问卷（SGRQ）评分为（35．6±13．9）分，明显低于其他两组，差异有统计学意义（P〈0．01）。三组间不良事件发生率差异无统计学意义（p〉0．05）。结论联合吸入噻托溴铵和布地奈德／福莫特罗治疗COPD，可以控制患者的临床症状并改善肺功能，疗效优于单药治疗，不良反应未增加。Objective To observe the efficacy of inhaled tiotropium bromide combined with budesonide/formoterol on reducing the frequency of acute episodes of symptom exacerbation and improving lung function,health status in chronic obstructive pulmonary disease （COPD）. Methods Eighty-six patients with COPD were divided into 3 groups, combination group[ 29 cases, inhaled budesonide/formoterol （ 160μg/4.5μg, twice one day） and tiotropium bromide （ 18 μ g, once one day） ], budesonide/formoterol group（29 cases, 160μg/4.5 μg, twice one day） and tiotropium bromide group（28 cases, 18μg, once one day）. The treatment continued for 3 months. Results Lung function, symptoms and health status improved obviously in three groups. The forced expiratory volume in one second （FEV1） of combination group after treatment was （1.24 ±0.18 ） L , which was improved by 11.7 % compared with before treatment. It was significantly higher than that in budesonide/formoterol group and tiotropium bromide group （P 〈 0.01 ）. The rescue medication consumptions and the times of acute episode of combination group were significantly decreased compared with those in the other groups,and there was significant difference （P 〈 0.01 ）. The SGRQ score of combination group was （35.6 ± 13.9） points which was significantly lower than that of budesonide/formoterol group and tiotropium bromide group, and there was significant difference （P 〈 0.01 ）. There was no statistical difference in the adverse events occurred in three groups （P 〉 0.05 ）. Conehlsions Combination treatment produces better control of symptoms and lung function and has no greater risk of sideeffects, compared with the treatment of budesonide/formoterol alone and tiotropium bromide alone. The combination treatment should be considered for patients with COPD.

关 键 词：肺疾病 慢性阻塞性 布地奈德 噻托溴铵 福莫特罗 呼吸功能试验 

分 类 号：R563.9[医药卫生—呼吸系统]