i use reason live and it works a charm.
i have a reason live set file with just one combinator within it. the combinator is mapped to my controller and i assign 2 buttons to the up/down patch select buttons using 'edit remote override mapping'. all of the buttons and knobs on the combi are assigned also.
i make one combi patch for each song. these patches are typically multiple instrument based with effect chains etc. some of them are mapped to different parts of the keyboard. if i need to change sounds mid song and cant afford the combi patch load time, then i assign one button on the combi to multiple mutes on the mixer within the combi...one button press on my controller mutes one channel and unmutes the other etc.
all of those combi patches are put into a seperate folder called "live set".
before the set i just load in the first patch within the "live set" folder and use the up/down arrows afterwards (one press). if i have a pre defined set list then i also number the patches ie "1_trackname.cmb". that way i can just hit the down button and know i've got the correct patch selected without even looking at the screen.
i used to do this with live racks and although live racks have their advantages i just prefer doing this in reason. somehow it feels a bit more robust.