沙美特罗替卡松联合噻托溴铵治疗稳定期COPD的临床观察  

Clinical observation of salmeterol /fluticasone propionate combined with tiotropium bromide in the treatment of COPD patients at stable stage

作　　者：韩轶群[1] 张鹏[1] 刘书盈[1] 孙继萍[1] 

机构地区：[1]济南军区总医院呼吸内科,山东济南250031

出　　处：《临床肺科杂志》2013年第10期1793-1795,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的观察吸入不同剂量沙美特罗替卡松联合噻托溴铵治疗稳定期COPD患者的疗效。方法门诊选取90例稳定期中-重度度COPD患者,随机分成3组,A组单独吸入噻托溴铵(18μg 1/日),B组吸入沙美特罗替卡松(50/250μg 2/日)+噻托溴铵(18μg 1/日)和C组吸入沙美特罗替卡松(50/500μg 2/日)+噻托溴铵(18μg 1/日),共治疗12周。用药前后分别检测患者肺功能,6分钟步行试验(6MWT),MMRC评分。结果 A组患者治疗后肺功能、6MWD及MMRC评分均有所好转,但无统计学差异(P>0.05);B组中度COPD患者治疗后的肺功能显著改善,6MWT力增加,MMRC评分降低(P<0.05);重度患者的疗效均无统计学差异(P>0.05);C组患者疗效显著(P<0.05),中度患者较B组无更大获益。结论沙美特罗替卡松(50/250μg 2/日)联合噻托溴铵(18μg 1/日)治疗稳定期中度COPD患者疗效确切,且减少患者经济负担和药物副作用。Objective To observe the efficacy of different doses of salmeteral/fluticasone propionate combined with tiotropium bromide in the treatment of COPD patients at stable stage. Methods 90 patients with moderate to severe COPD at stable stage were ran- domly divided into three groups. The group A inhaled tiotropium bromide （ 18 ~Lg once daily） alone. The group B inhaled salmeterol/fluti- casone propionate （50/250 p^g twice daily） and tiotropium bromide （ 18 ~g once daily）. The group C inhaled salmeterol/fluticasone pro- pionate （50/500 txg twice daily） and tiotropium bromide （18 fxg once dally）. The total treatment course was 12 weeks, and pulmonary function, 6-minute walk test （6MWT） and MMRC score were detected and compared among the three groups before and after the treat- ment. Results There was no significant improvement of pulmonary function, 6MWTand MMRC score in the group A after the treatment （P 〉 0. 05 ）. The moderate COPD patients in the group B had significant improvement on pulmonary function, 6MWTand MMRC score （P 〈 0. 05 ）, but there was no significant improvement to the severe patients in the group B （P 〉 0. 05 ）. The group C showed significant im- provement （ P 〈 0.05 ）, but the moderate patients in the group C had less benefit than those in the group B. Conclusion SalmeteroL/flu- ticasone propionate combined with tiotropium bromide has a certain curative effect in the treatment of COPD patients were certain, which can reduce the economic burden of patients and drug side reactions.

关 键 词：慢性阻塞性肺病 沙美特罗替卡松粉 噻托溴铵 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统]