Division of Respiratory Medicine, Department of Internal Medicine, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, Japan.
Pulm Pharmacol Ther. 2011 Oct;24(5):617-24. doi: 10.1016/j.pupt.2011.06.002. Epub 2011 Jun 13.
The addition of transdermal tulobuterol (Tulo) to inhaled tiotropium bromide (Tio) produced beneficial effects on spirometry-assessed parameters of respiratory function, disease-related symptoms and quality of life in patients with chronic obstructive pulmonary disease (COPD).
To compare the effects of Tio plus Tulo versus Tio alone on peripheral airway obstruction and quality of life in Japanese patients with COPD using impulse oscillation system (IOS)-assessed measures.
Patients aged 50-80 years with clinically stable COPD and a forced expiratory volume in 1 s (FEV(1)) that was 30-80% of the predicted value were randomized to receive Tio 18 μg once daily, or combination therapy with Tio 18 μg once daily plus Tulo 2 mg once daily for 4 weeks. Patients then switched treatments for a further 4 weeks.
Sixteen patients completed the study. Tio plus Tulo was associated with significantly greater improvements than Tio in IOS-assessed markers of resistance (R5 and R5-R20), reactance and reactance area, from baseline to week 4. Both treatments significantly improved these markers over the 4-week treatment period, with the exception of R20 for which improvements were not significant. Tio plus Tulo improved symptoms of dyspnea to a significantly greater extent than Tio alone. St. George's Respiratory Questionnaire Score-Total was not significantly different between the two groups, but improvement from baseline in the 'impact' component was significantly greater with Tio plus Tulo than with Tio alone.
Coadministration of transdermal Tulo with inhaled Tio, as well as Tio alone, is associated with beneficial effects on IOS-assessed measures of peripheral airway obstruction in patients with COPD.
在吸入噻托溴铵（Tio）的基础上添加透皮贴剂妥洛特罗（Tulo），可改善慢性阻塞性肺疾病（COPD）患者的肺功能呼吸参数、疾病相关症状和生活质量。
使用脉冲震荡系统（IOS）评估的指标，比较 Tio 加 Tulo 与 Tio 单药治疗对日本 COPD 患者的周边气道阻塞和生活质量的影响。
年龄在 50-80 岁之间、有临床稳定 COPD 和用力呼气量（FEV1）占预计值的 30-80%的患者，随机分为每日接受 Tio 18μg 治疗组或 Tio 18μg 联合 Tulo 2mg 每日一次治疗组，疗程 4 周。然后两组患者交换治疗，疗程 4 周。
16 例患者完成了研究。与 Tio 相比，Tio 加 Tulo 在 IOS 评估的阻力（R5 和 R5-R20）、电抗和电抗面积等指标方面，从基线到第 4 周的改善更为显著。两种治疗方法在 4 周的治疗期间均显著改善了这些指标，除了 R20 以外，其改善无统计学意义。与 Tio 单药治疗相比，Tio 加 Tulo 显著改善了呼吸困难症状。圣乔治呼吸问卷总分（St. George's Respiratory Questionnaire Score-Total）在两组间无显著差异，但 Tio 加 Tulo 组在“影响”方面的改善显著大于 Tio 单药治疗组。
与单独使用 Tio 相比，Tio 加 Tulo 可改善 COPD 患者 IOS 评估的周边气道阻塞指标，且 Tio 单药治疗也有获益。
