目的 探讨氟替美维吸入粉雾剂联合氨茶碱治疗慢性阻塞性肺病稳定期的临床疗效。方法 选取2021年11月—2023年12月河南省胸科医院呼吸内科收治的96例慢性阻塞性肺病稳定期患者，按照随机数字法分为对照组和治疗组，每组各48例。对照组患者口服氨茶碱片，0.1 g/次，2次/d。治疗组在对照组的治疗基础上给予氟替美维吸入粉雾剂，使用配套易纳器干粉吸入装置给患者用药，1吸/次，1次/d。两组均持续治疗2周。观察两组的临床疗效，比较两组治疗前后咳嗽和咳痰评估问卷调查表（CASA-Q）评分、COPD患者自我评估测试问卷（CAT）评分、肺功能指标、血清炎性因子的变化情况。结果 治疗后，治疗组患者总有效率是95.83%，显著高于对照组的77.08%（P＜0.05）。治疗后，两组患者CASA-Q评分咳嗽症状（COUS）、痰液症状（SPUS）、咳嗽影响（COUI）、痰液影响（SPUI）维度评分均较治疗前显著升高，而CAT评分显著降低（P＜0.05）；治疗后，治疗组CASA-Q评分、CAT评分改善优于对照组（P＜0.05）。治疗后，两组患者最大呼气峰流速（PEF）、第1秒用力呼气容积（FEV₁）、第1秒用力呼气容积与用力肺活量的比值（FEV₁/FVC）均较同组治疗前显著升高（P＜0.05）；治疗后，治疗组患者肺功能指标高于对照组（P＜0.05）。治疗后，两组患者转化生长因子-β1（TGF-β1）、白细胞介素-6（IL-6）、可溶性细胞间黏附分子-1（sICAM-1）、肿瘤坏死因子-α（TNF-α）水平显著降低（P＜0.05）；治疗后，治疗组血清炎性因子水平低于对照组（P＜0.05）。结论 氟替美维吸入粉雾剂联合氨茶碱治疗慢性阻塞性肺病稳定期具有较好的临床疗效，能有效改善咳嗽、咳痰等症状，改善肺功能相关指标，减弱机体炎性反应，值得临床借鉴。

Objective To explore the clinical of Fluticasone Furoate, Umeclidinium Bromide and Vilanterol Trifenatate Powder for Inhalation combined with aminophylline in treatment of stationary phase of chronic obstructive pulmonary disease. Methods Ninety-six patients with chronic obstructive pulmonary disease in stable stage admitted to the Respiratory Department of Henan Chest Hospital from November 2021 to December 2023 were selected and divided into control group and treatment group according to random number method, with 48 patients in each group. Patients in the control group were po administered with Aminophylline Tablets, 0.1 g/time, twice daily. Patients in the treatment group were given Fluticasone Furoate, Umeclidinium Bromide and Vilanterol Trifenatate Powder for Inhalation on the basis of the control group, administer medication using a dry powder inhalation device with an accessory readerizer, 1 inhale/time, once daily. Both groups were treated for 2 weeks. The clinical effects of the two groups were observed, and the changes of cough and sputum Evaluation questionnaire (CASA-Q) scores, COPD patient Self-assessment questionnaire (CAT) scores, pulmonary function indexes and serum inflammatory factors before and after treatment were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 95.83%, which was significantly higher than that of the control group (77.08%, P < 0.05). After treatment, CASA-Q scores of cough symptom (COUS), sputum symptom (SPUS), cough influence (COUI) and sputum influence (SPUI) were significantly higher than before treatment, while CAT score was significantly lower in 2 groups (P < 0.05). After treatment, CASA-Q scores and CAT scores in the treatment group were better than those in the control group (P < 0.05). After treatment, the maximum expiratory peak flow rate (PEF), forced expiratory volume in the first second (FEV1) and ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC) in two groups were significantly increased compared with before treatment (P < 0.05). After treatment, the pulmonary function index in the treatment group was higher than that in the control group (P < 0.05). After treatment, the levels of transforming growth factor-β1 (TGF-β1), interleukin-6 (IL-6), soluble intercellular adhesion molecule-1 (sICAM-1) and tumor necrosis factor-α (TNF-α) in two groups were significantly decreased (P < 0.05). After treatment, the level of serum inflammatory factors in the treatment group was lower than that in the control group (P < 0.05). Conclusion Fluticasone Furoate, Umeclidinium Bromide and Vilanterol Trifenatate Powder for Inhalation combined with aminophylline has good clinical efficacy in treatment of stationary phase of chronic obstructive pulmonary disease, and can effectively improve cough, sputum and other symptoms, improve lung function related indicators, weaken the inflammatory response of the body, which is worthy of clinical reference.

R974

河南省科技厅联合共建项目（232102310354）