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目的评价联合吸入噻托溴铵及舒利迭对稳定期重、极重度COPD患者肺过度充气及运动耐量的影响。方法 42例稳定期重度-极重度COPD患者随机分为联合吸入噻托溴铵及舒利迭组(联合治疗组,n=20)和舒利迭组(n=22)。联合治疗组吸入噻托溴铵干粉胶囊18μg,每日1次及沙美特罗/丙酸氟替卡松干粉剂(50μg/500μg)1吸,每日2次;舒利迭组吸入沙美特罗/丙酸氟替卡松干粉剂(50μg/500μg)1吸,每日2次。在用药前及用药后1月和3月分别测定肺功能深吸气量(IC)、功能残气量(FRC)及COPD评估测试(CAT)评分、6 min步行试验(6MWT)距离。结果联合治疗组及舒利迭组治疗1月后IC及FRC 2组比较差异无统计学意义(P>0.05),治疗3月后2组比较差异有统计学意义(P<0.05);6MWT及CAT评分在治疗1月及3月后2组比较差异均有统计学意义(P<0.05)。结论联合吸入噻托溴铵及舒利迭能减轻稳定期重度-极重度COPD患者肺过度充气(提高IC、降低FRC)、提高运动耐量、改善生活质量,较单独吸入舒利迭疗效好。
Objective To evaluate the effects of combined inhalation of tiotropium and seretide on lung hyperinflation and exercise tolerance in patients with stable and severe COPD. Methods Forty-two patients with stable severe-severe COPD were randomly divided into combined inhalation of tiotropium and seretide (combination therapy group, n = 20) and seretide (n = 22). The combined treatment group inhaled tiotropium powder capsules 18μg, once daily and salmeterol / fluticasone propionate dry powder (50μg / 500μg) 1 inhalation, twice daily; the seretide group inhaled salmeterol / propionic acid Fluticasone dry powder (50μg / 500μg) 1 suction, 2 times a day. The lung function inspiratory capacity (IC), functional residual capacity (FRC) and COPD assessment test (CAT) score, 6 min walk test (6MWT) distance were measured before and after treatment. Results There was no significant difference in IC and FRC 2 between the two groups after 1 month of treatment (P> 0.05), and there was a significant difference between the two groups after 3 months of treatment (P <0.05) CAT score in the treatment of 1 month and 3 months after the two groups were statistically significant differences (P <0.05). Conclusions Combined inhalation of tiotropium and seretide can relieve lung hyperinflation (increase IC, decrease FRC), improve exercise tolerance and improve quality of life in stable severe-severe COPD patients, which is better than that of seretide alone.