目的 探討沙美特羅替卡松聯(lián)合噻托溴銨對慢性阻塞性肺疾?。璺危┘毙约又仄诘闹委熜Ч?。方法 選取2018年12月-2019年12月榆林市第二醫(yī)院收治的200例慢阻肺急性加重期患者作為研究對象，應用隨機數(shù)字分組法將患者隨機分為對照組（n=66）、觀察1組（n=67）、觀察2組（n=67）。對照組患者在常規(guī)治療基礎上吸入18 μg的噻托溴銨粉吸入劑；觀察1組患者在對照組治療基礎上給予1 mL沙丁胺醇氣霧劑和2 mL生理鹽水配比霧化吸入治療，2次/d；觀察2組患者在對照組治療基礎上應用沙美特羅替卡松粉吸入劑治療，1吸/次，2次/d。3組患者均連續(xù)治療14 d后評定治療效果。觀察3組患者的臨床療效，同時比較3組治療前后的肺功能指標與炎性因子水平。結(jié)果 治療后，對照組治療總有效率為71.21%，觀察1組為85.07%，觀察2組為94.03%，觀察2組顯著高于對照組（P<0.05）。治療后，3組患者呼氣峰流速（PEF）、第一秒用力呼氣量（FEV₁）水平均上升（P<0.05），且觀察2組高于觀察1組及對照組（P<0.05）。治療后，3組患者超敏C反應蛋白（hs-CRP）、白細胞介素-6（IL-6）水平顯著降低，白細胞介素-10（IL-10）顯著升高（P<0.05）；且觀察2組優(yōu)于觀察1組及對照組（P<0.05）。結(jié)論 對慢阻肺急性加重期患者應用沙美特羅替卡松聯(lián)合噻托溴銨治療，能夠提升治療效果、改善肺功能，減少患者炎癥反應，安全性好。

Objective To investigate the therapeutic effect of salmeterol xinafoate and fluticasone propionate combined with tiotropium bromide in treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods A total of 200 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to Yulin Second Hospital from December 2018 to December 2019 were selected as the research subjects, and the patients were randomly divided into control group (n=66), observation group 1 (n=67) and observation group 2 (n=67) by random number grouping method. Patients in the control group were given Tiotropium Bromide Powder for Inhalation 18 μg on the basis of conventional treatment. Patients in the observation group 1 were given 1 mL Salbutamol Aerosol and 2 mL normal saline on the basis of control group, twice daily. Patients in the observation 2 groups were treated with Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation on the basis of control group, 1 inhalation/time, twice daily. All patients in the 3 groups were evaluated after continuous treatment for 14 d. Clinical efficacy of three groups was observed, and lung function indexes and inflammatory factors before and after treatment in the three groups were compared. Results After treatment, the total effective rate of control group was 71.21%, observation group 1 was 85.07%, observation group 2 was 94.03%, observation group 2 was significantly higher than control group (P<0.05). After treatment, the levels of PEF and FEV 1 in three groups were increased (P<0.05), and the levels of PEF and FEV₁ in the observation group 2 was higher than observation group 1 was and higher than control group (P<0.05). After treatment, the levels of hs-CRP and IL-6 in three groups were significantly decreased, and IL-10 was significantly increased (P<0.05). And the levels of hs-CRP, IL-6, and IL-10 in the observation group 2 was better than observation group 1, and better than control group (P<0.05). Conclusion The application of salmeterol xinafoate and fluticasone propionate combined with tiotropium bromide in treatment of patients with acute exacerbation of chronic obstructive pulmonary disease can improve the treatment effect, lung function, reduce the inflammatory response of patients, and have good safety.

R974