目的:研究分析噻托溴铵联合大剂量沙美特罗氟替卡松治疗重度支气管哮喘(BA)合并慢性阻塞性肺疾病(COPD)稳定期的疗效.方法:选取重度BA 合并COPD患者158例进行研究.依据数字随机表法将158例患者分成观察组以及对照组各79例,为两组患者均常规予以祛痰平喘和吸氧止咳,及解痉和抗感染等治疗.对照组予以噻托溴铵及中等剂量的沙美特罗氟替卡松进行治疗,观察组则予以噻托溴铵以及大剂量的沙美特罗氟替卡松进行治疗,1年后评价两组疗效.结果:观察组的哮喘完全控制率45.57% 及总控制率98.73% 均分别明显高于对照组的21. 52% 及88.61%,差异有统计学意义(P＜0.05).治疗后观察组的FEV1% 预计值和FEV1增加量均明显高于对照组,△PEF水平明显低于对照组,差异有统计学意义( P＜0.05).治疗后观察组的发作时间明显少于对照组,发作间隔时间明显大于对照组,差异有统计学意义(P＜0.05).观察组不良反应的总发生率是5.06%,与对照组的7.59% 相比,差异无统计学意义( P＞0.05).结论:应用噻托溴铵以及大剂量的沙美特罗氟替卡松对重度BA合并COPD患者治疗的疗效较好,且能有效改善患者的肺功能和临床症状,安全性也较高.%Objective:To study and analyze the curative effect of tiotropium combined with high dose of salmeterol fluticasone in the treatment of patients with severe bronchial asthma combined with COPD in stable phase.Methods:The treatment of severe bronchial asthma combined with COPD patients of 158 cases were studied.On the basis of the digital random table method,158 patients were divided into observation group and control group each with 79 cases in each,the control group was given tiotropium bromide and moderate dose salmeterol fluticasone,the observation group was given tiotropium bromide and high-dose salmeterol fluticasone,evaluated the efficacy of the two groups after 1 years.Results:The control rate of asthma in the observation group was 45.57% and the total control rate was 98.73%,which were signif-icantly higher than the control group of 21.52% and 88.61%,the difference was statistically significant (P ＜ 0.05).Af-ter treatment,the observation group of FEV1% was expected to increase and FEV1 values were significantly higher than those of the control group.PEF level was significantly lower than that of the control group,the difference was statistically significant (P ＜ 0.05).After treatment,the onset time of the observation group was significantly less than the control group,onset interval was significantly higher than the control group,the difference was statistically significant (P ＜ 0. 05).The observation group’s the total incidence of adverse reaction was 5.06%,compared with 7.59% in the control group,the difference was not statistically significant (P ＞ 0.05).Conclusion:The application of Tiotropium bromide and large doses of salmeterol fluticasone propionate on severe asthma combined efficacy in the treatment of patients with chronic obstructive pulmonary disease (COPD) better,and can effectively improve the patient's lung function and clinical symptoms, safety is high,it is worth to give recommendation.
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