Clinical trial of salmeterol and fluticasone propionate combined with tiotropium in treatment of elderly patients with stable COPD
Objective To analyze the efficacy of salmeterol rotticasone combined with tiotropium bromide in the treatment of elderly patients with stable chronic obstructive pulmonary disease(COPD)and its influence on serum procalcitonin(PCT),serum amyloid A(SAA)and albumin-to-fibrinogen ratio(AFR)levels.Methods The elderly patients with stable COPD were divided into control group and treatment group.The control group was treated with salmeterol rotticasone inhalation powder(1 inhalation each time,twice a day),while the treatment group was given tiotropium bromide inhaled powder aerosol treatment(1 inhalation each time once a day)on the basis of the control group.Patients in two groups were treated for 3 months.The clinical efficacy and differences in pulmonary function[forced expiratory volume in one second(FEV1),FEV1/forced vital capacity(FEV1/FVC),peak expiratory flow(PEF)],modified British Medical Research Council respiratory questionnaire(mMRC)score,COPD Assessment Test(CAT)score and serum PCT,SAA and AFR levels were compared;and the safety was evaluated.Results Fifty-two patients and fifty-eight patients were included in treatment group and control group,respectively.After treatment,the total effective rates in treatment group and control group were 90.38％(47 cases/52 cases)and 75.86％(44 cases/58 cases)(P＜0.05).The FEV1 values in treatment group and control group were(1.49±0.33)and(1.36±0.29)L;the FEV1/FVC values were(61.28±10.56)％and(57.41±10.03)％;PEF values were(5.32±0.88)and(4.93±0.75)L·s-1;mMRC scores were(0.99±0.24)and(1.21±0.27)points;the CAT scores were(11.58±3.02)and(14.26±3.71)points;PCT levels were(0.76±0.11)and(0.85±0.18)µg·L-1;SAA levels were(34.59±4.15)and(37.66±5.34)mg·L-1;AFR levels were 5.97±1.12 and 5.53±1.06,respectively.Compared with the control group,the above indexes in the treatment group were statistically significant(all P＜0.05).The main adverse drug reactions in treatment group were dry mouth,constipation and dizziness and nausea,and the main adverse drug reactions in control group were dry mouth,constipation,and dizziness and nausea.The total incidence rates of adverse drug reactions in treatment group and control group were 21.15％(11 cases/52 cases)and 13.79％(8 cases/58 cases)respectively,with no statistical significance(P＞0.05).Conclusion Salmeterol ticasone inhalation powder and tiotropium bromide inhaled powder aerosol can effectively enhance the clinical efficacy of elderly patients with stable COPD,improve the pulmonary function,relieve the body's inflammation,and promote the improvement of disease condition,with good safety.
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