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[摘要]
目的 探讨羧甲司坦联合沙美特罗替卡松气雾剂治疗稳定期D组慢性阻塞性肺疾病(COPD)患者的临床疗效.方法 选取2011年8月—2013年6月就诊于天津市第四中心医院处于稳定期D组COPD患者96例,随机分为治疗组(50例)和对照组(46例).对照组在常规治疗基础上吸入沙美特罗替卡松气雾剂,1揿/次,2次/d.治疗组在对照组治疗的基础上口服羧甲司坦口服溶液10 mL/次,3次/d.两组均连续治疗48周.观察两组患者治疗前,治疗8、24、48周运动耐量、呼吸困难指数(mMRC)及肺功能的变化,同时观察两组患者治疗过程中急性加重次数.结果 两组患者6 min步行距离(6MWD)在治疗8、24、48周后均较治疗前显著增加,mMRC均较治疗前有所降低,治疗前后差异有统计学意义(P<0.05);治疗24、48周治疗组6MWD显著长于对照组,mMRC显著低于对照组,两组比较差异有统计学意义(P<0.05).两组患者在治疗24、48周第1秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1/pred%)均较治疗前有所增加,治疗前后差异有统计学意义(P<0.05);治疗24、48周治疗组患者FEV1、FEV1/pred%显著高于对照组,两组比较差异有统计学意义(P<0.05).结论 羧甲司坦联合沙美特罗替卡松气雾剂治疗稳定期D组COPD患者具有较好的临床疗效,可增加患者的运动耐力,改善呼吸困难症状和肺功能,值得临床推广应用.
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[Abstract]
Objective To investigate the clinical effect of carbocisteine combined with Salmeterol Xinafoate and Fluticasone Propionate Aerosol in treatment of stable chronic obstructive pulmonary disease (COPD) of group D. Methods The patients with stable COPD of group D (96 cases) of Tianjin Fourth Center Hospital from August 2011 to June 2013 were randomly divided into treatment (n = 50) and control (n = 46) groups. The patients in the treatment group were administered with Salmeterol Xinafoate and Fluticasone Propionate Aerosol on the basis of conventional treatment, 1 press/time, twice daily. The patients in the treatment group were po administered with Carbocisteine Oral Solution at the basis of the control group, 10 mL/time, three times daily. The patients in two groups were treated for 48 weeks. The changes of exercise tolerance, dyspnea index (mMRC), and pulmonary function in two groups before treatment, and treated for 8, 24, and 48 weeks were observed. At the same time, the number of exacerbation were observed in the process of treatment. Results 6MWDS in two groups was significant increased, the mMRC was reduced in 8, 24, and 48 weeks of treatment, and the difference was statistically significant in the same group before and after treatment (P < 0.05). 6MWDS of the treatment group was longer and mMRC was significantly lower than that in the control group in 24 and 48 weeks of treatment, and there were differences between the two groups (P < 0.05). FEV1 and FEV1/pred% in two groups were increased in 24 and 48 weeks of treatment, and the difference was statistically significant in the same group before and after treatment (P < 0.05). FEV1 and FEV1/pred% in treatment group were higher than those in the control group in 24 and 48 weeks of treatment, and there were differences between the two groups (P < 0.05). Conclusion Carbocisteine combined with Salmeterol Xinafoate and Fluticasone Propionate Aerosol has the good clinical effect in treatment of stable COPD of group D, and can increase exercise endurance, while can improve the symptoms of dyspnea and lung function, which is worth clinical promotion.
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