目的 探討氟替美維吸入粉霧劑聯(lián)合氨茶堿治療慢性阻塞性肺病穩(wěn)定期的臨床療效。方法 選取2021年11月—2023年12月河南省胸科醫(yī)院呼吸內(nèi)科收治的96例慢性阻塞性肺病穩(wěn)定期患者，按照隨機(jī)數(shù)字法分為對(duì)照組和治療組，每組各48例。對(duì)照組患者口服氨茶堿片，0.1 g/次，2次/d。治療組在對(duì)照組的治療基礎(chǔ)上給予氟替美維吸入粉霧劑，使用配套易納器干粉吸入裝置給患者用藥，1吸/次，1次/d。兩組均持續(xù)治療2周。觀察兩組的臨床療效，比較兩組治療前后咳嗽和咳痰評(píng)估問卷調(diào)查表（CASA-Q）評(píng)分、COPD患者自我評(píng)估測(cè)試問卷（CAT）評(píng)分、肺功能指標(biāo)、血清炎性因子的變化情況。結(jié)果 治療后，治療組患者總有效率是95.83%，顯著高于對(duì)照組的77.08%（P＜0.05）。治療后，兩組患者CASA-Q評(píng)分咳嗽癥狀（COUS）、痰液癥狀（SPUS）、咳嗽影響（COUI）、痰液影響（SPUI）維度評(píng)分均較治療前顯著升高，而CAT評(píng)分顯著降低（P＜0.05）；治療后，治療組CASA-Q評(píng)分、CAT評(píng)分改善優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組患者最大呼氣峰流速（PEF）、第1秒用力呼氣容積（FEV₁）、第1秒用力呼氣容積與用力肺活量的比值（FEV₁/FVC）均較同組治療前顯著升高（P＜0.05）；治療后，治療組患者肺功能指標(biāo)高于對(duì)照組（P＜0.05）。治療后，兩組患者轉(zhuǎn)化生長(zhǎng)因子-β1（TGF-β1）、白細(xì)胞介素-6（IL-6）、可溶性細(xì)胞間黏附分子-1（sICAM-1）、腫瘤壞死因子-α（TNF-α）水平顯著降低（P＜0.05）；治療后，治療組血清炎性因子水平低于對(duì)照組（P＜0.05）。結(jié)論 氟替美維吸入粉霧劑聯(lián)合氨茶堿治療慢性阻塞性肺病穩(wěn)定期具有較好的臨床療效，能有效改善咳嗽、咳痰等癥狀，改善肺功能相關(guān)指標(biāo)，減弱機(jī)體炎性反應(yīng)，值得臨床借鑒。

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

河南省科技廳聯(lián)合共建項(xiàng)目（232102310354）