噻托溴铵联合沙美特罗/氟替卡松治疗慢性阻塞性肺疾病的临床疗效  

Clinical efficacy of tiotropium bromide combined with salmeterol /fluticasone in the treatment of chronic obstructive pulmonary disease

作　　者：王臣[1] 谭明旗[1] 

机构地区：[1]中国医科大学附属盛京医院,沈阳110004

出　　处：《实用药物与临床》2016年第5期573-576,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的观察噻托溴铵与沙美特罗/氟替卡松联合治疗对慢性阻塞性肺疾病(COPD)的疗效。方法选取我院2013年3月至2015年1月收治的COPD患者40例,随机分为对照组与治疗组,对照组予以单纯沙美特罗/氟替卡松治疗,治疗组予以噻托溴铵与沙美特罗/氟替卡松联合治疗,对比两组治疗前后肺功能指标、动脉血气参数、呼吸困难评分、再入院率、不良反应。结果治疗前两组FEV1、FVC、FEV1%Pred、Pa O2、Pa CO2、呼吸困难评分比较差异均无统计学意义(P>0.05);治疗后治疗组平均FEV1、FVC、FEV1%Pred、Pa O2、Pa CO2、呼吸困难评分分别为(1.36±0.42)L、(2.48±0.48)L、50.12±10.30、(10.17±1.02)k Pa、(5.05±1.22)k Pa、(1.57±0.74)分,均显著优于治疗前,且优于同期对照组(P<0.05)。治疗组出院后病情平均急性加重(1.13±0.16)次,显著低于对照组(P<0.05)。治疗组4例咽部不适、1例窦性心动过速,均未影响正常治疗(P>0.05)。结论噻托溴铵与沙美特罗/氟替卡松联合治疗COPD能持久、稳定、显著地改善动脉血气、肺功能指标及呼吸状况,不良反应不明显,安全有效。Objective To observe the clinical efficacy of tiotropium bromide and salmeterol /fluticasone combination therapy in patients with COPD. Methods Forty patients in our hospital from March 2013 to January 2015 were selected and randomly divided into control group and treatment group. Patients in control group were adminisered with salmeterol /fluticasone; patients in treatment group were administered with tiotropium bromide and salmeterol /fluticasone.The pulmonary function, arterial blood gas parameters,dyspnea score, readmission rate and adverse reactions of two groups were compared before and after the treatment. Results There were no significant difference of FEV1 and FVC,FEV1%Pred,PaO_2,PaCO_2 or dyspnea score in the two groups before treatment（ P〈0. 05）. The mean FEV1（ 1. 36 ± 0. 42） L,FVC（ 2. 48 ± 0. 48） L,FEV1% Pred（ 50. 12 ± 0. 30）,average PaO_2（ 10. 17 ± 1. 02） kPa,PaCO_2（ 5. 05 ± 1. 22） kPa and average dyspnea score（ 1. 57 ± 0. 74） of the treatment group after treatment were significantly better than before treatment, and in the same period they were better than the control group（ P〈0. 05）. The average acute exacerbation after discharge（ 1. 13 ± 0. 16） of treatment group was significantly lower than that of control group（ P〈0. 05）. There were 4 cases of pharyngeal discomfort and 1 case of sinus tachycardia in treatment group. which did not affect the normal treatment（ P〈0. 05）. Conclusion Tiotropium bromide and salmeterol /fluticasone treatment for COPD can be lasting,more stable,more significant in improvement of arterial blood gas, lung function and respiratory status; adverse reactions are not obvious, and it＇s safe and effective.

关 键 词：噻托溴铵 沙美特罗 氟替卡松 慢性阻塞性肺疾病 疗效 

分 类 号：R563.9[医药卫生—呼吸系统]