简亚梅　张少兴　彭永林

[摘要] 目的 探讨沙美特罗/丙酸氟替卡松联合盐酸氨溴索对慢性阻塞性肺疾病（COPD）患者肺功能和血气指标的影响。 方法 选取2011年1月～2014年6月在本院就诊的确诊为COPD的患者200例，根据治疗方法不同分为观察组和对照组，对照组给予沙美特罗/丙酸氟替卡松（沙美特罗50 μg/丙酸氟替卡松250 μg）每次1吸，2次/d。观察组在对照组治疗的基础上给予盐酸氨溴索30 mg，口服，2次/d。观察两组肺功能和血气指标的变化。 结果 治疗前两组患者的FEV1，FVC、FEV1/FVC，FEV1%比较，差异无统计学意义（P>0.05）；治疗后3个月观察组的FEV1、FVC、FEV1/FVC、FEV1%高于对照组，差异有统计学意义（P<0.05）。治疗前两组患者的PaO2、PaCO2比较，差异无统计学意义（P>0.05）；治疗后3个月观察组的PaO2高于对照组，PaCO2低于对照组，差异有统计学意义（P<0.05）。治疗后3个月，观察组急性发作0次者90例（90%），对照组急性发作0次者73例（73%），两组急性发作0次者比率差异有统计学意义（P<0.05）。 结论 沙美特罗/丙酸氟替卡松联合盐酸氨溴索治疗COPD效果明显，可有效改善患者肺功能及血气指标，提高患者的生活质量。

[关键词] 沙美特罗/丙酸氟替卡松；盐酸氨溴索；慢性阻塞性肺疾病；肺功能；血气分析；影响

[中图分类号] R974 [文献标识码] A [文章编号] 1674-4721（2015）01（b）-0088-03

Effect of salmeterol/fluticasone propionate combined with ambroxol on pulmonary function and blood gas in patients with chronic obstructive pulmonary disease

JIAN Ya-mei ZHANG Shao-xing FENG Yong-lin

Department of Respiration，Xingang Central Hospital of Xinyu City in Jiangxi Province，Xinyu 338001，China

[Abstract] Objective To investigate the effect of salmeterol/fluticasone propionate combined with ambroxol on pulmonary function and blood gas in patients with chronic obstructive pulmonary disease （COPD）. Methods 200 cases of patients with COPD in our hospital from January 2011 to June 2014 were selected，according to the different treatment methods，they were divided into observation group and control group，the control group were treated with salmeterol/fluticasone propionate （salmeterol 50 μg/ fluticasone propionate 250 μg） every time 1 suction，2 times a day；ambroxol was added to the observation group on the basis of control group，30 mg orally 2 times a day.The pulmonary function and blood gas index of the two groups was observed. Results Before treatment，the FEV1，FVC，FEV1/FVC，FEV1% of two groups had no significant （P>0.05）；after 3 months treatment，the FEV1，FVC，FEV1/FVC，FEV1% of observation group was higher than that of control group，the difference was significant （P<0.05）.Before treatment，the PaO2 and PaCO2 of two groups had no significant （P>0.05）；after 3 months treatment，PaO2 of the observation group was higher than that of the control group，PaCO2 was lower than that of the control group （P<0.05）.After 3 months treatment，the acute attack of 0 time rate of observation group was 90%，the control group was 73%，there was significant difference （P<0.05）. Conclusion The clinical curative efficacy of salmeterol/fluticasone propionate combined with ambroxol in the treatment of COPD is apparent，it can effectively improve the patients′ pulmonary function and blood gas index，and improve the life quality of patients.

[Key words] Salmeterol/fluticasone propionate；Ambroxol；Chronic obstructive pulmonary disease；Pulmonary function；Blood gas analysis；Influence

慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）是呼吸系统最常见的疾病之一，发病率和死亡率均较高，呈逐年上升的趋势。反复的急性发作对个人、家庭及社会均造成很大的经济负担，肺功能差，患者生活质量差。COPD患者稳定期仍有不同程度的咳嗽、咳痰、胸闷、气急症状。故COPD稳定期的治疗，目的是改善患者肺功能，减少急性发作的次数，而上述两方面的控制是本病治疗的重点，也是评估治疗手段有效程度的重要依据[1-3]。本文探讨沙美特罗/丙酸氟替卡松联合盐酸氨溴索对COPD患者肺功能和血气指标的影响，以了解两药联合应用的价值。

1 资料与方法

1.1 一般资料

选取2011年1月～2014年6月在本院进行治疗的COPD患者200例，均符合《慢性阻塞性肺疾病诊治指南》中对COPD的诊断方法，主要包括以下几点[4-5]。①……