Clinical Observation Of Tiotropium Bromide Combined With Salmeterol / Fluticasone In The Treatment Of Chronic Obstructive Pulmonary Disease

BackgroundChronic obstructive pulmonary disease(COPD)is a common chronic airway disease in clinical practice.In recent years,the disease has developed rapidly and the incidence rate is increasing.The total incidence rate of chronic obstructive pulmonary disease is 8.6% in China,and 13.6% in people over 40 years old.At present,a variety of effective methods have been formed in clinical treatment of COPD,among which the observation of the clinical efficacy of tiotropium combined with salmeterol / fluticasone is helpful to further explore the clinical treatment of COPD and the improvement of the academic theoretical system of tiotropium combined with salmeterol / fluticasone.ObjectiveTo explore the clinical effect of tiotropium bromide combined with salmeterol / fluticasone in the treatment of chronic obstructive pulmonary disease.MethodsFrom August 2018 to may 2019,60 patients with severe(grade III)and extremely severe(grade IV)COPD were collected from Anyang People's hospital.Randomly divided into the experimental group(30 cases)and the control group(30 cases).In the process,2 patients were separated from the study,2 patients lost their visit during the course.Finally,56 patients completed the study,27 in the experimental group and 29 in the control group.On the basis of the same routine and symptomatic treatment of the two groups,the experimental group used tiotropium bromide combined with salmeterol / fluticasone,while the control group used salmeterol / fluticasone for 180 days to observe the differences in lung function,arterial blood gas,times of acute exacerbation,score of dyspnea between the two groups before and after treatment.The paired sample t test was used in the group,and the independent sample t test was used between the groups To compare the clinical effect before and after treatment and the difference between the two groups.Results1.There was no significant difference between the two groups in FEV1 and FEV1% PRED before treatment(P>0.05).After treatment,FEV1 and FEV1% PRED in the two groups increased significantly compared with before treatment(P<0.05),and the increase in the experimental group after treatment was more significant than that in the control group,and the difference was statistically significant(P<0.05).2.Two There was no significant difference in PaO2 and PaCO2 between the two groups before treatment(P>0.05).PaO2 in the two groups increased after treatment,which was significantly different from that before treatment(P<0.05).After treatment,the PaO2 in the experimental group increased more significantly than that in the control group,and the difference was statistically significant(P<0.05).At the same time,PaCO2 in the two groups decreased,which was significantly different from that before treatment(P<0.05),and after treatment The difference was statistically significant(P<0.05).3.There was no significant difference between the two groups in the score of dyspnea before treatment(P>0.05).After treatment,the score of dyspnea in the two groups decreased significantly compared with that before treatment(P<0.05).4.During the 180 day treatment,the number of acute exacerbations in the experimental group was significantly lower than that in the control group(P<0.05).And readmission rate were significantly lower than the control group(P<0.05).5.The re-entry rate of the experimental group was 3.70%,and that of the control group was 24.14%,the difference was statistically significant(P<0.05).6.There was no significant difference in the incidence of adverse reactions between the experimental group(11.11%)and the control group(3.45%)(P>0.05).ConclusionThe combination of tiotropium bromide with salmeterol / fluticasone and salmeterol / fluticasone alone can improve the clinical symptoms and parameters related to pulmonary function and arterial blood gas analysis in patients with COPD,but the effect of combination is better.At the same time,the combination of drugs can significantly reduce the number of patients with acute exacerbations and the rate of re-entry,and no significant adverse reactions..