思力华与舒利迭联合应用治疗稳定期COPD的疗效观察

目的探讨思力华联合舒利迭治疗稳定期慢性阻塞性肺病(chronic obstructive pulmonary diseases,COPD)的疗效及安全性。方法研究对象为2010年11月~2011年12月我院收治的258例稳定期COPD患者,随机分为治疗组(129例)、对照组(129例)。治疗组吸入舒利迭50μg/250μg/次,2次/d,思力华18μg/次,1次/d;对照组仅吸入舒利迭50μg/250μg/次,2次/d,用药12周,比较分析两组疗效。结果治疗组显效率(65.9%)及总有效率(93.8%)均显著高于对照组(27.9%,62.8%)(P0.05),治疗后肺功能指标FEV1、FEV1/FVC及动脉血气PaO2均明显升高(P0.05),且治疗组显著高于对照组(P0.05),而动脉血气PaCO2明显降低(P0.05),且治疗组显著低于对照组(P0.05),两组不良反应发生率比较差异无统计学意义(P0.05)。结论舒利迭联合思力华治疗稳定期COPD的临床疗效显著,优于单用舒利迭,可明显改善患者动脉血气及肺功能,是稳定期COPD患者的理想治疗方案。

Observation of curative effect of tiotropium combined with seretide in the treatment of stable chronic obstructive pulmonary disease

Objective To observe the curative effect and safety of tiotropium combined with seretide in the treatment of stable chronic obstructive pulmonary disease （ COPD） . Methods 258 patients with stable COPD were randomly divided into the treatment group and the control group, 129 cases in each group. The treatment group was given seretide （50μg/250μg） twice daily and tiotropium bromide （18μg） once daily, and the control group was giv-en seretide （50μg/250μg） twice daily. The treatment course was 12 weeks. Before and after the treatment, lung function and arterial blood gas of the two groups were examined and compared respectively. Results The effective rate was 65. 9% and the total effective rate was 93. 8% in the treatment group, which were significantly higher than that in the control group （27. 9%, 62. 8%） （P〈0. 05）. After the treatment, the levels of FEV1, FEV1/FVC and PaO2 increased significantly （P〈0. 05）, and the improvement was more pronounced in the treatment group than in the control group （P〈0. 05）. The level of PaCO2 decreased obviously （P〈0. 05）, and the decrease was more pro-nounced in the treatment group than in the control group （P〈0. 05）. There was no statistical difference in the inci-dence of adverse reactions （P〉0. 05）. Conclusion Seretide combined with tiotropium is effective in the treatment of stable COPD, which is better than seretide only and can obviously improve lung function and arterial blood gas.