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目的:察沙美特罗替卡松与噻托溴铵联合应用较单用其中一种药物对重度慢性阻塞性肺疾病(COPD)稳定期患者的疗效与预后的影响。方法:取2014年10月至2015年5月于我院呼吸科门诊就诊的90例稳定期重度COPD患者,采用完全随机法分成三组,一组单用沙美特罗替卡松(SL组),一组单用噻托溴铵(ST组,一组联合应用沙美特罗替卡松和噻托溴铵(联合组),共治疗12个月。分别于用药后12个月测定患者肺功能(FEV1、FVC),6分钟步行试验,急性加重次数,急性加重出现时间。结果:组患者治疗后不同时期肺功能指标(FEV1、FVC)、6分钟步行试验较治疗前均有明显改善(P<0.05),联合组各项指标改善更明显(P<0.05)。联合组急性加重次数较其他2明显减少(P<0.05),且急性加重出现的时间推迟(P<0.05)。三组间不良反应无显著差异(P>0.05)。结论:沙美特罗替卡松与噻托溴铵联合应用于重度、极重度COPD患者,较单用进一步改善肺功能、运动耐量及生活质量,减少急性加重发生,且不良反应未见明显增加。
OBJECTIVE: To investigate the effect of trazodone and tiotropium in combination with one of these drugs on the efficacy and prognosis of patients with severe chronic obstructive pulmonary disease (COPD) at stable stage. Methods: From October 2014 to May 2015, 90 patients with severe stable COPD were enrolled in our Department of Respiratory Clinic. The patients were divided into three groups according to a randomized trial. One group was given salmeterol / , A group of single use of tiotropium (ST group, a combination of salmeterol and tiaprost and tiotropium (combination group), a total of 12 months of treatment were measured in patients with pulmonary function after 12 months (FEV1, FVC), 6-minute walk test, the number of acute exacerbations and the time of acute exacerbation.Results: The pulmonary function indexes (FEV1, FVC) and 6-minute walk test in all groups were significantly improved after treatment <0.05), and the indexes in the combined group improved more obviously (P <0.05), and the number of acute exacerbations in the combined group was significantly decreased (P <0.05) and the time of acute exacerbation was delayed (P <0.05) (P> 0.05) .Conclusion: Salmeterol and tirofiban combined with tiotropium in patients with severe and severe COPD, compared with single use to further improve lung function, exercise tolerance and quality of life, reduce acute Increased incidence, and no significant increase in adverse reactions.