摘 要 目的：探讨糖皮质激素类联合长效β2-受体激动剂对稳定期慢性阻塞性肺疾病（COPD）患者的疗效影响。方法：选取2014年2月—2015年8月我院收治的稳定期COPD患者108例，按数字随机表法分为试验组（n=56）和对照组（n=52），对照组患者给予常规治疗，试验组患者在对照组患者治疗的基础上给予沙美特罗、丙酸氟替卡松联合吸入治疗，早晚各1次，疗程均为28 d。分别于治疗前、后检测肺功能、呼吸困难程度、功能性运动能力及血清IL-2、CRP水平。结果：两组患者治疗前FEV1、FEV1/FVC比较，差异无统计学意义（P>0.05），治疗后均明显升高，且试验组患者升高幅度较大（P<0.05）；两组患者治疗前MMRC、6 MWT比较，差异均无统计学意义（P>0.05）；治疗后试验组患者MMRC明显低于对照组患者，6 MWT明显高于对照组患者（P<0.05）；两组患者治疗前血清IL-2、CRP 水平比较，差异无统计学意义（P>0.05），治疗后试验组的IL-6、CRP水平明显低于同期对照组（P<0.05）。结论：沙美特罗、丙酸氟替卡松联合雾化吸入治疗稳定期COPD的疗效确切，可显著改善患者肺功能和炎症反应，值得临床推广。

关键词 慢性阻塞性肺疾病 稳定期 沙美特罗 丙酸氟替卡松 疗效

中图分类号：R977.11； R974.3； R563 文献标识码：A 文章编号：1006-1533（2016）15-0019-03

Effect of glucocorticoid hormones combined with long acting β2 receptor agonist in the treatment of 56 cases of patients with COPD at stable period*

XIA Wu， MEN Li， LIU Hongping

（The Hospital affiliated to Jiujiang University， Jiangxi， Jiujiang 332000， China）

ABSTRACT Objective： To discuss the effect of glucocorticoid hormones combined with long acting b2 receptor agonist in the treatment of patients with COPD at stable period. Methods： One hundred and eight cases of patients with COPD at stable period were selected and randomly divided into an experimental group （n=56） and a control group （n=52）. The control group was given a conventional therapy and the experimental group was additionally given an inhalation therapy of salmeterol plus fluticasone propionate twice a day for 28 days besides the conventional therapy. The clinical efficacy was evaluated and the pulmonary function and the levels of serum IL-2 and CRP were detected before and after treatment. Results： There was no statistical significance in FEV1， FEV1 / FVC between the two groups before treatment， however these indicators were significantly increased after treatment and furthermore higher in the experimental group than the control group （P<0.05）. There was no statistical significance in MMRC and 6 MWT between the two groups before treatment （P>0.05）， and however， the MMRC was significantly lower and 6 MWT was higher in the experimental group than the control group after treatment （P<0.05）. There was no statistical significance in the levels of serum IL-2 and CRP between the two groups before treatment， and the IL-2 and CRP of experimental group were significantly lower than that of control group after treatment （P<0.05）. Conclusion： The inhalation therapy of salmeterol plus fluticasone propionate for the treatment of patients with COPD at stable period has an exact curative effect， can significantly improve the lung function and inflammation reaction of patients and is worthy of promotion.

KEY WORDS chronic obstructive pulmonary disease； stable period； salmeterol； fluticasone propionate； efficacy

慢性阻塞性肺疾病（chronic obstructive pulmonary disease， COPD）是老年群体呼吸系统常见、多发疾病之一，其以持续气流受限为主要特征，并呈进行性发展，是一种可预防和治疗的疾病[1-2]。COPD根据症状表现分为急性发作期和稳定期，稳定期相对于急性发作期，其症状较轻，较稳定，但对其治疗也不可忽视。近年来，局部雾化吸入治疗，已广泛应用于COPD患者治疗中，而针对稳定期COPD患者的雾化吸入药物的应用与发展，一直是国内外学者的研究重点之一[3]。因此，本研究通过观察糖皮质激素类与长效β2-受体激动剂对稳定期COPD患者肺功能、呼吸功能、功能性运动能力及血清炎性因子的影响，以探讨稳定期COPD更好的治疗方案，现报道如下。