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目的:观察噻托溴铵粉联合沙美特罗替卡松粉吸入剂对慢性阻塞性肺疾病(COPD)的疗效。方法:60例中、重度COPD患者随机分为两组,对照组30例给予沙美特罗替卡松粉吸入剂治疗,治疗组30例在对照组治疗基础上加用噻托溴铵粉吸入剂。观察治疗前以及治疗6周、12周临床症状,测定1 s用力呼气容积(FEV_1)、用力肺活量(FVC)等肺功能指标及急性发作情况。结果:两组治疗6周后Borg评分均较治疗前明显下降(P<0.05)。两组治疗12周后,FEV_1和FVC与治疗前比较,差异有统计学意义(P<0.05)。治疗组治疗6周、12周后肺功能改善程度优于对照组(P<0.05),急性发作次数亦明显少于对照组(P<0.05)。对照组与治疗组总有效率分别为83.3%和96.7%,两组总有效率比较,差异有统计学意义(P<0.05)。结论:噻托溴铵粉与沙美特罗替卡松粉吸入剂联合应用能改善呼吸困难,增加运动耐量,治疗COPD疗效确切,并且减少急性发作。
Objective: To observe the effect of tiotropium bromide combined with salmeterol and fluticasone powder inhalers on chronic obstructive pulmonary disease (COPD). Methods: Sixty patients with moderate-to-severe COPD were randomly divided into two groups. The control group was treated with salmeterol and fluticasone powder inhalation. Thirty patients in the treatment group were treated with tiotropium bromide inhalation on the basis of the control group . The clinical symptoms, the forced expiratory volume (FEV_1), forced vital capacity (FVC) and other acute lung injury were observed before treatment and 6 weeks and 12 weeks after treatment. Results: The Borg scores of both groups after 6 weeks of treatment were significantly lower than those before treatment (P <0.05). After 12 weeks of treatment, FEV_1 and FVC were significantly different from those before treatment (P <0.05). The improvement of pulmonary function in treatment group was better than that in control group (P <0.05), and the number of acute attacks was also significantly less than that in control group (P <0.05). The total effective rate of the control group and the treatment group were 83.3% and 96.7%, respectively. The total effective rate of the two groups was statistically significant (P <0.05). CONCLUSIONS: Tiotropium bromide in combination with salmeterol and fluticasone propionate inhalers can improve dyspnea, increase exercise tolerance, have a definite effect in treating COPD and reduce acute attacks.