丁剑

[摘要] 目的 探究M胆碱受体阻断剂联合沙美特罗丙酸氟替卡松干粉吸入剂治疗慢性阻塞性肺疾病（COPD）稳定期患者的疗效及肺功能。方法 方便选取该院2018年2月—2019年2月收治的COPD稳定期患者60例，根据治疗方案不同分为观察组（n=30，M胆碱受体阻断剂联合沙美特罗丙酸氟替卡松干粉吸入剂治疗）与对照组（n=30，沙美特罗丙酸氟替卡松干粉吸入剂治疗），持续治疗3个月后，观察两组临床疗效、治疗前后肺功能[FEV1占预计值百分比（FEV1%）、呼吸峰流量（PEF）]、运动耐力、生活质量（SGRQ）评分。 结果 观察组总有效率96.67%高于对照组73.33%（χ2=4.706，P=0.030）;治疗3个月后观察组FEV1%高于对照组（t=6.062，P=0.000），PEF高于对照组（t=5.050，P=0.000）;治疗3个月后观察组SGRQ评分低于对照组（t=11.977，P=0.000），6 min步行距离（6MWT）高于对照组（t=3.323，P=0.002）。 结论 M胆碱受体阻断剂联合沙美特罗丙酸氟替卡松干粉吸入剂可有效提高COPD稳定期患者肺功能，增强运动耐力，改善生活质量，疗效显著。

[关键词] 慢性阻塞性肺疾病;M胆碱受体阻断剂;沙美特罗丙酸氟替卡松干粉吸入剂;肺功能

[Abstract] Objective To investigate the efficacy and lung function of M choline receptor blocker combined with fluticasone propionate dry powder inhalation for the treatment of patients with chronic obstructive pulmonary disease （COPD） stable stage. Methods Sixty patients with stable COPD who were treated in the hospital from February 2018 to February 2019 were convenient selected and divided into observation group （n=30， M-choline receptor blocker combined with fluticasone propionate salmonate propionate dry powder inhalation treatment according to different treatment regimens） and the control group （n=30， fluticasone propionate dry powder inhalation treatment）， after 3 months of continuous treatment， observe the clinical efficacy and lung function of both groups before and after treatment [FEV1 as a percentage of expected value （FEV1 %）， Peak respiratory flow （PEF）]， exercise endurance， quality of life （SGRQ） scores. Results The total effective rate in the observation group was 96.67% higher than that in the control group 73.33% （χ2=4.706， P=0.030）. After 3 months of treatment， the FEV1% in the observation group was higher than the control group （t=6.062， P=0.000）， and the PEF was higher than the control group（t=5.050， P=0.000）; the SGRQ score of the observation group was lower than the control group （t=11.977， P=0.000） after 3 months of treatment， and the 6-minute walking distance （6MWT） was higher than the control group（t=3.323，P=0.002）. Conclusion M-choline receptor blocker combined with salmeterol and fluticasone propionate dry powder inhaler can effectively improve the lung function， enhance exercise endurance， improve the quality of life， and the effect is significant.

[Key words] Chronic obstructive pulmonary disease; M choline receptor blocker; Salmeterol fluticasone propionate dry powder inhaler; Lung function

慢性阻塞性肺疾病（COPD）是臨床常见呼吸系统疾病，气流受限呈持续性进展，主要分为急性加重期与稳定期，患者通常在急性加重期注重药物治疗，而稳定期忽视治疗重要性，造成肺功能持续恶化、疾病反复发作、运动耐力不断降低、生活质量持续下降[1]。因此，COPD稳定期治疗尤为重要，对阻滞疾病进展，改善肺功能、增强运动耐力具有重要意义。沙美特罗丙酸氟替卡松干粉吸入剂主要用于可逆性阻塞性气道疾病规则治疗，具有改善肺功能、抗炎、平喘等作用[2]。……