噻托溴铵联合沙美特罗替卡松治疗老年重度COPD的临床观察  

Clinical Observation of Tiotropium Bromide Combined with Salmeterol Fluticasone Aerosol in the Treatment of Elderly Severe COPD

作　　者：康剑云[1] 曹保森[1] 张学林[1] 王小强[1] 

机构地区：[1]河北北方学院附属第二医院呼吸内科,河北张家口075100

出　　处：《中国药房》2017年第20期2830-2833,共4页China Pharmacy

摘　　要：目的:观察噻托溴铵联合沙美特罗替卡松治疗老年重度慢性阻塞性肺疾病(COPD)的临床疗效及安全性。方法:选取2013年5月-2015年5月我院收治的老年重度COPD患者共90例,按随机数字表法分为对照组和观察组,各45例。对照组患者给予沙美特罗替卡松气雾剂1揿/次,bid;观察组患者在对照组基础上加用噻托溴铵粉吸入剂18μg,qd。两组患者均治疗8周。观察两组患者近期疗效及治疗前后呼吸困难评分、肺部通气功能指标[用力肺活量(FVC)、一秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1%)]、血气分析指标{氧分压[p(O_2)、二氧化碳分压[p(CO_2)]}、Spitzer生活质量指数表(QLI)评分,比较两组患者再住院次数及不良反应发生情况。结果:观察组患者近期治疗总有效率为97.78%,显著高于对照组的80.00%,差异有统计学意义(P<0.05)。治疗前,两组患者呼吸困难评分、肺部通气功能指标、血气分析指标、QLI评分比较,差异均无统计学意义(P>0.05);治疗后,两组患者呼吸困难评分、p(CO_2)水平显著降低,肺部通气功能指标、p(O_2)水平、QLI评分显著升高,且观察组患者显著优于对照组,差异均有统计学意义(P<0.05)。观察组患者再住院次数显著少于对照组,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:噻托溴铵辅助沙美特罗替卡松治疗老年重度COPD疗效显著,可有效缓解患者呼吸困难症状,改善肺部通气功能,提高日常生活质量,降低再次住院风险,且未增加不良反应发生率。OBJECTIVE： To observe the clinical efficacy and safety of tiotropium bromide combined with Salmeterol fluticasone aerosol in the treatment of severe COPD in elderly patients. METHODS： A total of 90 elderly patients with severe COPD selected from May 2013 to May 2015 in our hospital as research objects were divided into control group and observation group according to random number table, with 45 cases in each group. Control group was given Salmeterol xinafonate and fluticasone propionate aerosol 1 press/time, bid; observation group was additionally given Tiotropium bromide powder for inhalation 18 μg, qd, on the basis of control group. Both groups were treated for 8 weeks. The short-term clinical efficacy, dyspnea score, pulmonary ventilation function indexes [FVC, EFV1, EFV1%], blood gas analysis indexes [p（O2）, p（CO2）] and QLI score before and after treatment were observed in 2 groups. The re-hospitalization time and the occurrence of ADR were compared between 2 groups. RESULTS： The total response rate of short-term treatment in observation group was 97.78%, which was significantly higher than 80.00% of control group, with statistical significance （P〈0.05）. There was no statistical significance in dyspnea scores, pulmonary ventilation function indexes, blood gas analysis indexes or QLI scores between 2 groups before treatment （P〉0.05）. After treatment, dyspnea scores and p（CO2） of 2 groups were decreased significantly, while pulmonary ventilation function indexes, p（O2） and QLI scores were increased significantly; the observation group was significantly better than the control group, with statistical significance （P〈0.05）. The re-hospitalization time of observation group was significantly less than that of control group, with statistical significance（P〈0.05）. There was no statistical significance in the incidence of ADR between 2 groups（P〈0.05）. CONCLUSIONS： Tiotropium bromide assisted with Salmeterol fluticasone aerosol show significant therapeutic effica

关 键 词：噻托溴铵 沙美特罗替卡松 老年 慢性阻塞性肺疾病 疗效 安全性 

分 类 号：R714.253[医药卫生—妇产科学]