吸入噻托溴铵干粉剂联合妥洛特罗贴剂治疗C、D级慢性阻塞性肺疾病稳定期的疗效与安全性被引量：3

Study on the efficacy and safety of tiotropium bromide inhalation agent with tulobuterol patch in the treat- ment of C and D level in patients with chronic obstructive pulmonary disease in stable period

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摘要目的：探讨吸入噻托溴铵干粉剂联合妥洛特罗贴剂治疗C、D级COPD稳定期的有效性和安全性。方法选取255例C、D级COPD稳定期患者按随机数表法分为研究组和对照组，研究组给予吸入噻托溴铵干粉剂（18μg／次），1次／d，并给予妥洛特罗贴剂（2 mg／贴），1次／d。对照组予吸入噻托溴铵干粉剂（18μg／次）1次／d。观察用药前后肺功能、临床症状评分的变化及吸入短效β2受体激动剂的使用、6 min步行实验、急性加重次数情况。结果两组患者治疗后肺功能指标、临床症状评分、吸入短效β2受体激动剂的使用、6 min步行实验、急性加重次数差异均有统计学意义（均P＜0．05）。亚组分析研究组中肺气肿表型可见持续性疗效，慢性支气管炎表型、ACOS表型治疗初期有效，半年后疗效下降。两组药物不良反应发生率分别为19．7％、21．0％，两组不良反应发生率差异无统计学意义（χ2＝0．071，P＞0．05）。结论吸入噻托溴铵干粉剂联合妥洛特罗贴剂能改善部分C、D级COPD稳定期患者的临床症状和肺功能。 Objective To explore the effectiveness and safety of tiotropium bromide inhalation agent with tulobuterol patch in the treatment of C and D level of COPD in stable period .Methods According to the digital table,255 cases of C and D level in patients with stable COPD were randomly divided into the study group and control group,the patients in study group received inhalation of tiotropium bromide dry powder 18μg/times,one time every day,and give tulobuterol patch（2mg/paste）,one time every day.The control group received inhalation of tiotropium bromide dry powder 18μg/times,one time every day.The changes of lung function were observed before and after treatment,the clinical symptom score and inhaled short acting beta 2 agonists used,6min walk test,times of acute exacerbation condition.Results The patients in the two groups after treatment ,pulmonary function ,clinical symptoms score,inhaled short acting beta 2 agonists used,6min walk test,times of acute exacerbation compared with statistical significance（all P〈0.05）.Subgroup analysis in study group ,emphysema phenotype visible persistent effect ,chronic bronchitis phenotype ,ACOS phenotype early effective treatment ,decreased efficacy after half a year .The adverse reac-tion of two groups of drugs were respectively 19.7%and 21.0%,there was no significant difference in the incidence of adverse reaction between the two groups （χ2 =0.071,P〉0.05）.Conclusion Tiotropium bromide inhalation agent with tulobuterol patch can improve clinical symptoms and pulmonary function in patients with C and D level part of the stable phase of COPD .