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目的:观察胸腺肽a1联合吸入沙美特罗替卡松治疗中重度慢性阻塞性肺疾病(COPD)稳定期患者的临床疗效。方法:将63例中重度慢性阻塞性肺疾病稳定期患者随机分为对照组28例和试验组35例,两组均给予常规化痰和平喘对症治疗,按需使用沙丁胺醇气雾剂。对照组给予吸入沙美特罗替卡松(舒利迭50/500)治疗,试验组同时接受胸腺肽1.6mg皮下注射,每周两次,共注射12次;两组患者均观察6个月,每2周经门诊随访1次,进行临床情况评价,并于治疗前、治疗后6个月检查患者肺功能、外周血CD3、CD4和CD8水平。结果:试验组患者发生急性加重再次住院人数和住院天数均明显低于对照组(P<0.05),而且试验组患者在治疗后血CD4及CD4/CD8比值明显升高(P<0.05)。两组较治疗前肺功能有显著改善作用,但试验组肺功能与对照组无明显差别。结论:胸腺肽a1联合舒利迭治疗对COPD患者肺功能有显著改善作用,能够增强患者细胞免疫功能,有效地减少再次急性加重次数。
Objective: To observe the clinical efficacy of thymosin a1 combined with salmeterol and fluticasone in the treatment of patients with stable chronic obstructive pulmonary disease (COPD). Methods: Sixty-three patients with stable chronic obstructive pulmonary disease (COPD) were randomly divided into control group (n = 28) and experimental group (n = 35). Both groups were given conventional symptomatic treatment of phlegm and asthma and salbutamol aerosol. The control group was given inhaled salmeterol / fluticasone (Seretide 50/500) treatment, the experimental group also received thymosin 1.6mg subcutaneously twice a week for a total of 12 times; two groups of patients were observed for 6 months, each Two weeks after the outpatient clinic was followed up for clinical evaluation. Before the treatment and 6 months after treatment, the pulmonary function, peripheral blood CD3, CD4 and CD8 levels were examined. Results: The number of rehospitalization and hospital stay in patients with acute exacerbation in the experimental group were significantly lower than those in the control group (P <0.05), and the ratio of CD4 and CD4 / CD8 in the experimental group was significantly increased after treatment (P <0.05). The two groups had a significant improvement in lung function before treatment, but there was no significant difference between the two groups in lung function and the control group. Conclusion: Thymosin a1 combined with seretide therapy can significantly improve pulmonary function in patients with COPD, which can enhance cellular immune function and reduce the number of acute exacerbations again.