目的 分析噻托溴銨聯(lián)合布地奈德福莫特羅吸入劑治療穩(wěn)定期慢性阻塞性肺疾?。–OPD）的臨床療效。方法 以2014年5月-2016年5月中航工業(yè)西安醫(yī)院收治的穩(wěn)定期COPD患者80例為研究對(duì)象，根據(jù)隨機(jī)數(shù)字表法分為觀察組和對(duì)照組，每組40例。對(duì)照組給予布地奈德福莫特羅吸入劑，觀察組在此基礎(chǔ)上加用噻托溴銨粉吸入劑。兩組均連續(xù)治療2個(gè)月。比較兩組治療前后的肺功能，包括第1秒用力呼氣容積（FEV1）、用力肺活量（FVC）、FEV1占預(yù)計(jì)值百分比（FEV1%），并計(jì)算FEV1/FVC的值，以及生活質(zhì)量、血清基質(zhì)金屬蛋白酶-9（MMP-9）和白介素-6（IL-6）水平，用藥期間不良反應(yīng)及治療后半年內(nèi)的急性加重發(fā)作次數(shù)。結(jié)果 治療后，兩組的FEV1、FEV1/FVC、FEV1%均較治療前顯著升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組的以上指標(biāo)均顯著高于對(duì)照組，組間比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組治療后的SGRQ評(píng)分、血清MMP-9、IL-6水平均較治療前顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組的顯著低于對(duì)照組，組間比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組的總不良反應(yīng)發(fā)生率比較，差異均無統(tǒng)計(jì)學(xué)意義；觀察組發(fā)生急性加重1次及以上的人數(shù)顯著少于對(duì)照組，且平均急性加重次數(shù)亦顯著低于對(duì)照組，組間比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 噻托溴銨聯(lián)合布地奈德福莫特羅吸入劑治療穩(wěn)定期慢性阻塞性肺疾病的臨床療效顯著，可有效改善患者的肺功能、生活質(zhì)量，降低急性加重的發(fā)生次數(shù)，且可顯著降低患者血清中MMP-9、IL-6水平。

Objective To investigate the clinical effect of budesonide/formoterol single inhaler combined with tiotropium bromide in stable chronic obstructive pulmonary disease (COPD). Methods 80 cases of patients with stable COPD in China Aviation Industrial Xi'an Hospital from May 2014 to May 2016 were divided into observation group and control group, 40 cases in each group. Patients in the control group were treated with budesonide/formoterol single inhaler, and in the observation group were treated with budesonide/formoterol single inhaler combined with tiotropium bromide. Compared the pulmonary function, life quality, serum levels of matrix metalloproteinases 9 (MMP-9) and interleukin 6 (IL-6), drug adverse reaction during the treatment and exacerbations episodes within the next six months. Results After treatment, the FEV1, FEV1/FVC, FEV1% of two groups were significantly higher than before treatment (P < 0.05), and in the observation group were significantly higher than that in control group (P < 0.05). SGRQ scores, serum levels of MMP-9 and IL-6 of two groups were significantly lower than before treatment (P < 0.05), and these indexes in the observation group were significantly lower than that in control group (P < 0.05). The differences in the adverse reaction rate of two groups has no significant, the number of acute exacerbation in observation group were significantly lower than that of control group (P < 0.05). Conclusion Budesonide/formoterol single inhaler combined with tiotropium bromide has remarkable clinical effect in stable COPD, and can effectively improve the pulmonary function, life quality, reduce the number of acute exacerbation, and reduce the serum levels of MMP-9, IL-6.