多索茶碱联合沙美特罗/氟替卡松对稳定期中重度慢性阻塞性肺疾病的疗效观察  

Effects of doxofylline combined with salmeterol/fluticasone in moderate to severe stable chronic obstructive pulmonary disease

作　　者：郑冠英[1] 陈愉生[1] 林桂阳[1] 姚秀娟[1] 谢宝松[1] 

机构地区：[1]福建医科大学省立临床医学院福建省立医院呼吸内科,福州350001

出　　处：《福建医药杂志》2016年第5期100-103,共4页Fujian Medical Journal

基　　金：福建省卫生厅青年科研课题(2013-1-1)

摘　　要：目的评估多索茶碱联合沙美特罗/氟替卡松在稳定期中重度慢性阻塞性肺疾病(COPD)治疗中的安全性和有效性。方法将符合GOLD指南诊断标准的75例稳定期的中重度COPD患者随机分成3组,分别接受沙美特罗/氟替卡松(50/250μg)+多索茶碱(A组)、沙美特罗/氟替卡松(50/500μg)+维生素B6(B组)、沙美特罗/氟替卡松(50/250μg)+维生素B6(C组)治疗6个月。分别于治疗前、治疗后3、6个月,动态监测患者FEV1、FVC及6min步行距离的变化。结果与治疗前相比,3组FEV1、FVC及6min步行距离得到显著提高(P<0.05),尤其是A、B组,但组间差异无统计学意义;与治疗后3个月相比,同组患者治疗后6个月的肺功能指标有所下降,但差异无统计学意义(P>0.05)。组间对比显示,A组治疗后6个月FEV1明显优于C组(P<0.05);不论是治疗后3或6个月,A、B组的FVC、6min步行距离较C组均有所改善,但差异无统计学意义(P>0.05)。结论稳定期中重度以上COPD患者,在联合使用长效β2受体激动剂和吸入糖皮质激素的基础上,加用多索茶碱安全、有效并可减少吸入糖皮质激素的用量。Objective To assess the effect and safety of doxofylline combined with salmeterol/fluticason in moderate to severe stable chronic obstructive pulmonary disease（COPD）.Methods In total,75 patients with moderate to severe COPD,complied with global initiative for chronic obstructive lung disease（GOLD）guideline,were randomly divided into three groups.They were respectively treated with salmeterol/fluticasone（50/250μg）＋ doxofylline（group A）,salmeterol/fluticasone（50/500μg）＋ vitamin B6（group B）,and salmeterol/fluticasone（50/250μg）＋ vitamin B6（group C）for six months.Forced expiratory volume in one second（FEV1）,forced vital capacity（FVC）and six-minute walking distance of each patient were respectively monitored before,three and six months after treatment for comparison.Results Pulmonary function after treatment in three groups,including FEV1,FVC and six-minute walking distance,was significantly improved as compared with that before treatment（P〈0.05）,especially in group A and group B.But there was no statistically significant difference between group A and group B（P〉0.05）.After treatment for six months,pulmonary function in the same group decreased as compared with that after treatment for three months,but there was no statistically significant difference（P〉0.05）.Comparison between groups showed that FEV1 in group A after six months treatment was obviously better than that in group C（P〈0.05）.FVC and6-minute walking distance in group A and B were better than those in group C,no matter in three months or six months after treatment,but there was no statistically significant difference（P〉0.05）.Conclusion For patients with moderate to severe stable COPD,on the basis of combination of long-actingβ2agonists and inhaled corticosteroids,doxofylline addition is safe and effective which could reduce the amount of inhaled corticosteroids.

关 键 词：慢性阻塞性肺疾病 稳定期 多索茶碱 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统]