【摘要】：目的評價聯(lián)合吸入噻托溴銨及舒利迭(沙美特羅/丙酸氟替卡松干粉劑)對穩(wěn)定期重—極重度COPD患者肺過度充氣及運動耐量的影響。 方法42例穩(wěn)定期重—極重度COPD患者隨機分為聯(lián)合吸入噻托溴銨及舒利迭組(聯(lián)合治療組,n=20)和舒利迭組(n=22)。聯(lián)合治療組吸入噻托溴銨干粉膠囊18gg,每天1次及沙美特/丙酸氟替卡松干粉劑(50μg/500μg1吸,每天2次；舒利迭組吸入沙美特羅/丙酸氟替卡松干粉劑(50μg/500μg)1吸,每天2次。在用藥前及用藥1月和3月后測定肺功能(IC、FRC、FEV1、FEV1%預(yù)計值及FEV1/FVC)、COPD評估測試(COPD assessment test, CAT)評分、呼吸困難評分、6分鐘步行距離(6MWD),記錄3月內(nèi)AECOPD的情況,同時記錄藥物不良反應(yīng)。 結(jié)果聯(lián)合治療組及舒利迭組治療1月后IC為(1.72±0.01) Lvs (1.72±0.03) L, FRC為(3.35±0.19) Lvs (3.40±0.17) L;治療3月后IC為(1.87±0.10) Lvs (1.76±0.13) L; FRC為(3.16±0.23) Lvs (3.35±0.16) L;治療1月后IC及FRC兩組比較差異無統(tǒng)計學(xué)意義(P0.05),治療3月后兩組比較差異有統(tǒng)計學(xué)意義(P0.05)。聯(lián)合治療組及舒利迭組治療1月后6MWD為(197.13±15.03) mvs (187.83±16.70) m, CAT評分為(26.83±2.29) vs (29.96±2.29);治療3月后6MWD%(215.43±13.88) mvs (211.17±13.67) m; CAT評分為(24.70±2.55) vs (26.43±2.11);6MWD及CAT評分在治療1月及3月后兩組比較差異均有統(tǒng)計學(xué)意義(P0.05),且隨用藥時間的延長改善作用更加顯著。 結(jié)論聯(lián)合吸入噻托溴銨及舒利迭能減輕穩(wěn)定期重—極重度COPD患者肺過度充氣(提高IC、降低FRC)、減輕呼吸困難、提高運動耐量、改善生活質(zhì)量,較單獨吸入舒利迭療效更好。
[Abstract]:Objective to evaluate the effects of combined inhalation of tiotropium bromide and sulidide (salmeterol / fluticasone propionate dry powder) on pulmonary hyperventilation and exercise tolerance in patients with stable and extremely severe COPD. Methods 42 stable severe COPD patients were randomly divided into two groups: combined inhalation of tiotropium bromide, sulidide group (n = 20) and sulide group (n = 22). The combined treatment group inhaled thiotropium bromide dry powder capsule (18ggg, once a day) and salmete / fluticasone propionate dry powder (50 渭 g / 500 渭 g / day, 2 times a day), and sulidide group inhaled salmeterol / fluticasone propionate powder (50 渭 g / 500 渭 g), twice a day. Pulmonary function (ICFRC / FEV1 / FEV1 / FEV1 / FEV1 / FEV1 / FEV1 / FEV1 / FEV1 / FEV1 / FEV1 / FEV1 / FVC) were measured before and 1 month and 3 months after administration. The scores of assessment test (cat), dyspnea score (6 MWD) and AECOPD within 3 months were recorded, and adverse drug reactions were recorded. Results the IC was (1.72 鹵0.01) L vs (1.72 鹵0.03) L, FRC was (3.35 鹵0.19) L vs (3.40 鹵0.17) L, IC was (1.87 鹵0.10) L vs (1.76 鹵0.13) L, FRC was (3.16 鹵0.23) L vs (3.35 鹵0.16) L in the combined treatment group and the sullide group, and there was no significant difference between the two groups after one month (P0.05). There was significant difference between the two groups after the month (P0.05). 6 MWD (197.13 鹵15.03) mvs (187.83 鹵16.70) m, cat score (26.83 鹵2.29) vs (29.96 鹵2.29), 6MWD% (215.43 鹵13.88) mvs (211.17 鹵13.67) m, cat score (24.70 鹵2.55) vs (26.43 鹵2.11) and cat score (24.70 鹵2.55) vs (26.43 鹵2.11) were significantly different between the two groups after one month and three months after treatment. (P 0.05), and with the prolongation of drug use time, the improvement was more significant. Conclusion combined inhalation of tiotropium bromide and sulipid can reduce lung hyperinflation (increase ICand reduce FRC), relieve dyspnea, improve exercise tolerance and improve quality of life in patients with stable and extremely severe COPD.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R563.9

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1 鄭勁平;康健;蔡柏薔;周新;曹兆龍;白春學(xué);鐘南山;;吸入噻托溴銨干粉與異丙托溴銨定量氣霧劑治療慢性阻塞性肺疾病的療效與安全性比較[J];中華結(jié)核和呼吸雜志;2006年06期

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