陈改英

[摘要] 目的 探讨噻托溴铵联合沙美特罗替卡松治疗对稳定期COPD患者肺功能的治疗效果及对生活质量的影响。方法 将2013年1月～2014年1月期间来我院就诊的稳定期COPD患者119例分为两组，对照组60例患者采用沙美特罗替卡松治疗，观察组59例患者采用噻托溴铵联合沙美特罗替卡松治疗，连续治疗6个月后比较两组的临床效果。 结果 （1）观察组急性加重次数与对照组比较明显较低，两组比较有显著性差异（P<0.05）。（2）治疗后观察组和对照组FEV1、FEV1/FVC、FEV1/预计值均明显高于治疗前，观察组治疗后与对照组治疗后比较均明显较高，两组有显著性差异（P<0.05）。（3）治疗后观察组和对照组SGRQ量表症状、活动能力、对日常生活影响及总分均明显低于治疗前，观察组治疗后与对照组治疗后比较均明显较低，两组比较有显著性差异（P<0.05）。 结论 稳定期COPD患者采用噻托溴铵联合沙美特罗替卡松治疗疗效显著，有较高的安全性，可以在临床推广应用。

[关键词] COPD；稳定期；噻托溴铵；沙美特罗替卡松；肺功能；生活质量

[中图分类号] R563.9 [文献标识码] B [文章编号] 1673-9701（2014）32-0129-03

The effects on lung function and quality of life of Tiotropium combined salmeterol and fluticasone propionate in treatment of patients with stable COPD

CHEN Gaiying

The Second Medicine Department，Shandong Province Dezhou City Traditional Chinese Medicine Hospital，Dezhou 253000，China

[Abstract] Objective To investigate the effect on the lung function and quality of life in COPD patients with stable therapeutic treated with tiotropium combined salmeterol fluticasone propionate. Methods A total of 119 cases with stable COPD patients collected from January 2013 to January 2014 in our hospital were retrospective analyzed，all of them were divided into two groups， the control group had 60 patients and used salmeterol fluticasone treatment， the observation group had 59 cases and used tiotropium combined salmeterol and fluticasone propionate therapy，patients of two groups were treated 6 months and the effect of two groups were compared. Results （1）the frequency of acute exacerbation of the observation group was significantly lower than the control group，there was a significant difference between two groups （P<0.05）. （2）FEV1， FEV1/FVC， FEV1/expected values of the observation group and the control group post-treatment were significantly higher than before treatment， the observation group after treatment were significantly higher than the control group， there was a significant difference between two groups （P<0.05）. （3）SGRQ symptom， activity， impact on daily life and total scores of the observation group and control group post-treatment were significantly lower than before treatment， the observation group after treatment were significantly lower than the control group， there was a significant difference between two groups（P<0.05）. Conclusion Stable COPD patients with tiotropium combined salmeterol and fluticasone propionate therapy significantly， with higher security， can clinical applications.

[Key words] COPD； Stable； Tiotropium； Salmeterol and fluticasone propionate； Lung function； Quality of lifeendprint

慢性阻塞性肺疾病（COPD）是临床常见的一种疾病，其患病率占我国40岁以上人群的8.2%[1]。根据COPD患者的症状及体征可分为急性加重期和稳定期，稳定期COPD是指患者的咳嗽、咳痰和（或）喘息症状处于稳定状态或较为轻微，治疗的主要目标为预防急性发作，使患者的肺功能有效改善，促进患者生活质量提高[2]。有报道表明，稳定期COPD患者采用沙美特罗替卡松粉吸入及M受体阻断剂噻托溴铵治疗可使患者的症状得到显著改善，减少疾病发作，生活质量也得到明显提高，从而在临床上广泛应用[3]。笔者收集2013年1月～2014年1月期间来我院就诊的稳定期COPD患者119例，分别单独采用沙美特罗替卡松治疗、噻托溴铵联合沙美特罗替卡松治疗，比较两种方法的效果，现报道如下。

1 资料与方法

1.1 一般资料

回顾性分析2013年1月～2014年1月期间来我院就诊的稳定期COPD患者119例，符合《慢性阻塞性肺疾病诊治指南》的诊断标准[4]。……