慢性阻塞性肺疾病(COPD)的发病率和病死率在全球范围内仍呈升高趋势。吸烟是COPD最重要的发病危险因素。由于我国的吸烟人群高达3.5亿，而且缺乏有效的控烟措施，所以可以预计在未来相当长的时间内，我国的COPD发病率和病死率仍会持续升高，继续成为一个严重的公共卫生问题。近年来的多项临床试验证实噻托溴铵、沙美特罗／氟替卡松等药物的应用可以改善COPD患者的症状及生活质量，甚至短期内改善一些肺功能指标。2006年新版的“慢性阻塞性肺疾病全球创议”(GOLD)将COPD定义为“可治疗”的疾病，比过去GOLD 的定义增加了“乐观”的成分。但是目前的这些药物还不能改变COPD的自然病程，能否降低COPD的病死率也没有明确的答案。因此，葛兰素史克(GSK)公司发起了全球性的多中心临床试验——“迈向COPD患者健康的变革(TORCH)”研究[1]，研究的目的是验证这样的假设，即通过沙美特罗／氟替卡松3年的治疗能降低所有原因导致的COPD死亡率，包括作者单位在内的44个国家444个医学临床研究中心参加了该研究。
Citation：
WANG Changzheng. What do we know form The TORCH study about the treatment of chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2007, 6(4): 241-242. doi:
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- 1. Vestbo J, TORCH Study Group. The TORCH (TOwards a Revolution in COPD Health) survival study protocol. Eur Respir J,2004,24:206-210.
- 2. Calverley PM, Anderson JA, Celli B, et al. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med, 2007,356: 775-789.
- 3. La Vecchia C, Fabbri LM. Prevention of death in COPD. N Engl J Med, 2007,356;2211-2212.
- 4. Nelson HS, Weiss ST, Bleecker ER, et al. The Salmeterol Multicenter Asthma Research Trial: a comparison of usual pharmacotherapy for asthma or usual pharmacotherapy plus salmeterol.Chest,2006,129:15-26.
- 5. Rabe KF. Treating COPD--the TORCH trial, P values, and the Dodo. Engl J Med,356,851-854.
- 6. Siva R, Green RH, Brightling CE, et al. Eosinophilic airway inflammation and exacerbations of COPD: a randomized controlled trial. Eur Respir J,2007,29:906-913.
