目的研究噻托溴铵联合丙酸氟替卡松对中重度慢性阻塞性肺疾病(COPD)患者治疗的效果。方法 100例中重度慢性阻塞性肺疾病患者,按入院顺序分为观察组和对照组,各50例。观察组患者使用丙酸氟替卡松(250μg),1次/d,而噻托溴铵(18μg),1次/d吸入;对照组患者使用丙酸氟替卡松,1次/d。记录并分析两组的患者在治疗12、24周后的肺功能状况、COPD的评估测试量表(CAT)评分以及患者血清C反应蛋白的水平变化情况。结果在治疗12周和24周后,两组患者的CAT评分与治疗前都有明显的降低,而且观察组的指标比对照组的指标更低(P<0.05)。治疗12周后,两组患者的血清的水平都比治疗前更低,但差异无统计学意义(P>0.05);在治疗24周后两组患者的CRP水平继续下降,(P<0.05)。但对照组和治疗前相比较差异无统计学意义(P>0.05)。结论噻托溴铵联合丙酸氟替卡松能够有效的改善中重度慢性阻塞性肺疾病患者的肺功能及患者的生活质量,同时还能降低患者的血清C反应蛋白(CRP)水平,这种药物的疗效比单纯的使用噻托溴铵的效果更好。 Objective To study the effect of tiotropium combined with fluticasone propionate on the treatment of patients with moderate-severe chronic obstructive pulmonary disease (COPD). Methods 100 cases of patients with moderate-severe chronic obstructive pulmonary disease were divided into observation group and control group according to admission order, 50 cases each. Patients in the observation group were treated with fluticasone propionate (250 μg) once a day, and tiotropium bromide (18 μg) once a day, while those in the control group were given fluticasone propionate once daily. The pulmonary function status, COPD score, and serum C-reactive protein level were recorded and analyzed in both groups after 12 and 24 weeks of treatment. Results After 12 weeks and 24 weeks of treatment, CAT scores of both groups were significantly lower than those before treatment, and the indexes in the observation group were lower than those in the control group (P <0.05). After 12 weeks of treatment, the serum levels of both groups were lower than those before treatment, but the difference was not statistically significant (P> 0.05). After 24 weeks of treatment, the CRP levels of both groups continued to decline (P <0.05) . However, the difference between the control group and before treatment was not statistically significant (P> 0.05). Conclusion Tiotropium bromide combined with fluticasone propionate can effectively improve lung function and quality of life of patients with moderate-severe chronic obstructive pulmonary disease, while reducing the level of serum C-reactive protein (CRP) in patients with the efficacy of this drug Than the simple effect of using tiotropium bromide.