Effects Of Tiotropium Combined Seretide On Lung Hyperinflation And Exercise Tolerance In Patients With COPD

Objective To evaluate the effects of tiotropium bromide combined seretide (salmeterol/fluticasone propionate,SFC) on lung hyperinflation and exercise tolerance in patients with stable severe to very severe chronic obstructive pulmonary disease(COPD).Methods42patients with stable severe to very severe COPD were randomly divided into two groups, which were the combination group and seretide group. The combination group (n=20) was given tiotropium bromide inhalation (18μg) once a day combined with seretide (50μg/500μg) twice a day,while the seretide group (n=22) was given seretide (50μg/500μg) twice a day alone.Pulmonary function test(IC、FRC、FEV1、FEV1%pred and FEV1/FVC)、COPD assessment test(CAT) score、dyspnea score and6-minute walking distance (6MWD) were conducted before treatment、1and3monthes after treatment.At the same time,the time of AECOPD and adverse reactions were recorded.Results1month after treatment, IC of the combination group and seretide group were (1.72±0.01) Lvs (1.72±0.03) L, FRC were (3.35±0.19) Lvs (3.40±0.17) L;3monthes after treatment, IC of the combination group and seretide group were(1.87±0.10)Lvs((1.76±0.13) L, FRC were (3.16±0.23) Lvs (3.35±0.16) L; there were no significant difference in IC and FRC between two groups at1month after treatment (P>0.05),while there were significant difference in IC and FRC between two groups at3monthes after treatment (P<0.05).1month after treatment,6MWD of the combination group and seretide group were (197.13±15.03) m vs (187.83±16.70) m, CAT score were (26.83±2.29) vs (29.96±2.29);3monthes after treatment,6MWD of the combination group and seretide group were (215.43±13.88) m vs (211.17±13.67) m,CAT score were (24.70±2.55) vs (26.43±2.11);there were significant difference in6MWD and CAT score between two groups at1month and3monthes after treatment (both P<0.05).There was no significant difference in the time of AECOPD between two groups,and no obvious adverse reactions in both groups were found.Conclusions This study confirmed that tiotropium bromide combined seretide could obviously decrease the lung hyperinflation、relieve dyspnea、improve exercise tolerance and quality of life. Tiotropium bromide combined with seretide in the treatment of stable severe to very severe COPD was more effective than seretide inhalation alone.