Comparison of the efficacy of tiotropium combined with salmeterol and fluticasone propionate on different specifications of elderly patients with stable chronic obstructive pulmonary disease / 中国基层医药

ABSTRACT

Objective To compare the curative effect of tiotropium bromide combined with salmeterol flutica-sone of different specifications in treatment of chronic obstructive pulmonary disease(COPD)at stable stage in senile patients.Methods 84 senile patients of COPD were selected.All the patients were divided into observation group (42 cases)and control group(42 cases).And both groups were provided with basic treatment of tiotropium bromide, on the basic treatment,the patients in the observation group were provided with 50μg/250μg salmeterol fluticasone, and the control group with 50μg/500μg salmeterol fluticasone.The course of treatment in the two groups was 12 months.The arterial blood gas,lung function,motor function and clinical efficacy were compared between the two groups after treatment.Results 12 months after treatment,the arterial oxygen partial pressure(PaO2 ),arterial carbon dioxide partial pressure(PaCO2 ),forced expiratory volume in one second(FEV1 ),forced vital capacity(FVC),1 second forced expiratory volume accounted for the percentage of forced vital capacity(FEV1 /FVC)of the control group were (51.66 ±3.96)mmHg,(66.58 ±4.90)mmHg,(1.39 ±0.09)L,(2.41 ±0.09)L,(60.40 ±4.25)%,(366.01 ± 17.21)m respectively,which of the observation group were (46.29 ±3.38)mmHg,(75.83 ±5.09)mmHg,(1.59 ± 0.12)L,(2.65 ±0.10)L,(67.33 ±485)%,(325.69 ±15.62)m respectively.The arterial blood gas,lung function and exercise capacity of the two groups were significantly improved,among them,PaO2 of the control group was significantly better than that of the observation group,the difference was statistically significant (t =6.684,P <0.001).PaCO2 of the control group was significantly better than that of the observation group,the difference was statistically significant(t =-8.485,P <0.001).FEV1 of the control group was significantly better than that of the observation group,the difference was statistically significant(t =-8.641,P <0.001).FVC of the control group was significantly better than that of the observation group,the difference was statistically significant(t =-11.561,P <0.001).FEV1 /FVC of the control group was significantly better than that of the observation group,the difference was statistically significant(t =-6.964,P <0.001).6MWD of the control group was significantly better than that of the observation group,the difference was statistically significant(t =-11.243,P <0.001).After 12 months of treatment, the total effective rate of the observation group was 97.62%,which was significantly higher than that of the control group 85.71%(χ2 =3.896,P =0.048).Conclusion The comprehensive effect of tiotropium bromide combined with 50μg/500μg salmeterol fluticasone is better than that of tiotropium bromide combined with 50μg/250μg salmeterol fluticasone.