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目的探讨噻托溴铵联合丙酸氟替卡松治疗稳定期D组慢性阻塞性肺疾病(COPD)患者的临床疗效。方法选取2014年6月至2015年6月大连市第二人民医院收治的101例稳定期D组COPD患者作为研究对象,按随机数字表法将其分为Ⅰ组(34例)、Ⅱ组(34例)及Ⅲ组(33例)。Ⅰ组患者采用噻托溴铵粉吸入剂进行治疗,Ⅱ组患者给予丙酸氟替卡松治疗,Ⅲ组患者采用噻托溴铵联合丙酸氟替卡松治疗。比较3组患者治疗前后的肺功能、6 min步行距离(6 MWT)及呼吸困难情况。结果治疗后,Ⅲ组患者的用力肺活量(FVC)、第1秒钟用力呼气容积(FEV1)、第1秒钟用力呼气容积占预计值百分比(FEV1%)及6MWT均明显高于Ⅰ组、Ⅱ组,呼吸困难评分明显低于Ⅰ组、Ⅱ组,差异均有统计学意义(均P<0.05)。结论噻托溴铵联合丙酸氟替卡松治疗稳定期D组COPD患者的临床疗效明显优于单用噻托溴铵或丙酸氟替卡松,可明显提高患者肺功能,改善呼吸困难症状。
Objective To investigate the clinical efficacy of tiotropium combined with fluticasone propionate in patients with stable chronic obstructive pulmonary disease (COPD) in group D. Methods A total of 101 patients with stable COPD in Group D admitted to Dalian Second People ’s Hospital from June 2014 to June 2015 were selected and randomly divided into group Ⅰ (34 cases), group Ⅱ ( 34 cases) and group Ⅲ (33 cases). Patients in group I were treated with tiotropium bromide inhalers, patients in group II were given fluticasone propionate, and patients in group III were treated with tiotropium in combination with fluticasone propionate. The lung function, 6-minute walking distance (6 MWT) and dyspnea before and after treatment were compared between the three groups. Results After treatment, the FVC, FEV1, FEV1% and 6MWT in group 1 were significantly higher than those in group Ⅰ , Group Ⅱ, dyspnea scores were significantly lower than those in group Ⅰ and group Ⅱ (all P <0.05). Conclusion The clinical efficacy of tiotropium combined with fluticasone propionate in stable COPD patients in group D is better than that of tiotropium alone or fluticasone propionate alone. It can significantly improve pulmonary function and improve the symptoms of dyspnea.