氨溴特罗联合复方异丙托溴铵治疗小儿毛细支气管炎的疗效观察简

目的 观察氨溴特罗口服液联合复方异丙托溴铵氧气雾化吸入治疗小儿毛细支气管炎的临床疗效.方法 选取2010年3月~2013年2月我院收治的90例毛细支气管患儿随机分为治疗组与对照组各45例,分别给予氨溴特罗口服液联合复方异丙托溴铵氧气雾化吸入和常规治疗,比较两组患儿的临床疗效.结果 治疗组总有效率明显高于对照组（P〈0.05）,喘憋、湿啰音、咳嗽及哮鸣音消失时间均明显短于对照组（P〈0.05）,具有统计学意义.两组患儿均未见明显不良反应.结论 氨溴特罗口服液联合复方异丙托溴铵氧气雾化吸入治疗小儿毛细支气管炎效果理想.     

氨溴特罗联合复方异丙托溴铵治疗小儿毛细支气管炎的疗效观察

目的观察氨溴特罗口服液联合复方异丙托溴铵氧气雾化吸入治疗小儿毛细支气管炎的临床疗效。方法选取2010年3月~2013年2月我院收治的90例毛细支气管患儿随机分为治疗组与对照组各45例,分别给予氨溴特罗口服液联合复方异丙托溴铵氧气雾化吸入和常规治疗,比较两组患儿的临床疗效。结果治疗组总有效率明显高于对照组(P0.05),喘憋、湿啰音、咳嗽及哮鸣音消失时间均明显短于对照组(P0.05),具有统计学意义。两组患儿均未见明显不良反应。结论氨溴特罗口服液联合复方异丙托溴铵氧气雾化吸入治疗小儿毛细支气管炎效果理想。     

两药联合雾化吸入治疗 AECOPD 临床疗效观察简

目的 观察复方异丙托溴胺溶液联合布地奈德混悬液雾化治疗AECOPD的疗效.方法 将70例AECOPD患者随机分为治疗组（n=35例）和对照组（n=35例）.治疗组在常规治疗基础上加用复方异丙托溴胺溶液2.5 ml（含异丙托溴胺0.5 mg沙丁胺醇3.0 mg）联合布地奈德混悬液2 ml（含布地奈德1 mg）进行高流量氧气驱动雾化吸入（即射流式雾化吸入）; 对照组为常规治疗方案.对两组治疗前后FEV1、FEV1/FVC、FEV1占预计值百分比及临床症状改善情况进行比较.结果 治疗组患者在治疗期肺功能有明显改善,随着使用时间延长,肺功能改善持续提高.对照组患者治疗初期临床症状、肺功能有所改善,随着使用时间延长,肺功能改善不明显.结论 复方异丙托溴胺溶液联合布地奈德混悬液雾化吸入治疗AECOPD疗效肯定.     

高流量氧驱动吸入复方异丙托溴铵溶液治疗支气管哮喘急性发作20例

为探讨高流量氧驱动吸入用复方异丙托溴铵溶液对支气管哮喘急性发作FEV1的影响，我们从2006年4月～2007年2月对20例高流量氧驱动吸入用复方异丙托溴铵溶液治疗支气管哮喘急性发作患者，进行了随机对照的临床研究，现报道如下。     

两药联合雾化吸入治疗AECOPD临床疗效观察

目的观察复方异丙托溴胺溶液联合布地奈德混悬液雾化治疗AECOPD的疗效。方法将70例AECOPD患者随机分为治疗组(n=35例)和对照组(n=35例)。治疗组在常规治疗基础上加用复方异丙托溴胺溶液2.5 ml(含异丙托溴胺0.5 mg沙丁胺醇3.0 mg)联合布地奈德混悬液2 ml(含布地奈德1 mg)进行高流量氧气驱动雾化吸入(即射流式雾化吸入);对照组为常规治疗方案。对两组治疗前后FEV1、FEV1/FVC、FEV1占预计值百分比及临床症状改善情况进行比较。结果治疗组患者在治疗期肺功能有明显改善,随着使用时间延长,肺功能改善持续提高。对照组患者治疗初期临床症状、肺功能有所改善,随着使用时间延长,肺功能改善不明显。结论复方异丙托溴胺溶液联合布地奈德混悬液雾化吸入治疗AECOPD疗效肯定。     

孟鲁司特联合氟替卡松吸入治疗支气管哮喘的效果观察

目的观察孟鲁司特联合氟替卡松吸入对支气管哮喘的治疗效果。方法共有200例支气管哮喘患者参加研究。患者随机分为观察组(100例)和对照组(100例),除基本治疗外,观察组给予孟鲁司特联合氟替卡松吸入,对照组给予异丙托溴铵联合氟替卡松吸入,主要终点为哮喘恶化,次要终点为因症状加重增加皮质激素治疗、症状恶化及FEV1减低。结果观察组治愈率、症状缓解率优于对照组,哮鸣音持续时间明显缩短(P<0.05)。哮喘恶化无显著差异,治疗后FEV1显著改善(P<0.05)。结论孟鲁司特联合氟替卡松吸入治疗支气管哮喘有显著效果,不亚于异丙托溴铵联合氟替卡松吸入效果。     

孟鲁司特联合吸入异丙托溴铵治疗重度慢性阻塞性肺疾病稳定期的临床观察

孟鲁司特及异丙托溴铵在治疗支气管哮喘方面已得到肯定,而慢性阻塞性肺疾病(COPD)与支气管哮喘又有很多相似之处,许多慢性阻塞性肺疾病患者的气道阻塞可以具有明显的可逆成分[1].故我们对本院2006年12月～2007年12月66例重度COPD稳定期患者中35例应用孟鲁司特(杭州默沙东制药公司生产,商品名顺尔宁)联合吸入异丙托溴铵(北京海德润制药有限公司生产)治疗3月后,取得了较好疗效,现报道如下.     

稳定期慢性阻塞性肺疾病病人吸入支气管舒张剂后深吸气量与运动耐量的关系

目的探讨稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)病人吸入支气管舒张剂后深吸气量(inspiratory capacity,IC)与运动耐量的关系。方法对42例稳定期COPD病人进行常规肺功能检测和6 min步行试验(six-minute walk test,6MWT),以6 min步行距离(6MWD)和Borg评分来评价病人的运动耐量和呼吸困难程度;病人吸入复方异丙托溴胺2.5 ml(沙丁胺醇3 mg/异丙托溴胺500μg)后复查肺功能和6MWT,探讨IC与运动耐量的关系。结果吸入复方异丙托溴胺后,第1秒用力呼气量(FEV1)、用力肺活量(FVC)、IC、残气量(RV)、功能残气量(FRC)和肺总量(TLC)及6MWD均有显著的改善,但仅IC的增加(△IC%)与6MWD的增加(△6MWD)和运动后Borg呼吸困难评分的改善(△Borg步行后)之间存在显著相关性。结论支气管舒张剂治疗后IC的增加与病人运动耐量和呼吸困难的改善密切相关。     

噻托溴铵联合大剂量沙美特罗/氟替卡松治疗重度支气管哮喘合并COPD稳定期的临床观察

目的 为了探讨更好的治疗重度支气管哮喘(简称哮喘)合并慢性阻塞性肺疾病(COPD)的方法,提高重度哮喘合并COPD患者的生活质量.为重度哮喘合并COPD防治积累更多临床经验.方法对于临床确诊的重度哮喘合并COPD的患者,随机分为两组,一组为对照组,给予复方异丙托溴铵气雾剂(可必特)联合中等剂量沙美特罗/氟替卡松(舒利迭...     

孟鲁司特联合吸人异丙托溴铵治疗重度慢性阻塞性肺疾病稳定期的临床观察

孟鲁司特及异丙托溴铵在治疗支气管哮喘方面已得到肯定，而慢性阻塞性肺疾病（COPD）与支气管哮喘又有很多相似之处，许多慢性阻塞性肺疾病患者的气道阻塞可以具有明显的可逆成分。     

Ipratropium bromide, salbutamol and prednisolone in bronchial asthma and chronic bronchitis.

Eleven patients with bronchial asthma and 10 with chronic bronchitis were treated over four consecutive 3-day periods, firstly with aerosols either of ipratropium bromide (40 microgram four times a day) or of salbutamol (200 microgram four times daily) by random allocation, then the alternate drug, next by both drugs together, and finally with prednisolone (10 mg three times daily) in addition to both drugs. The effects of these four treatment periods were assessed both clinically and by measuring ventilatory capacity, nitrogen slope and progressive exercise testing. Ipratropium bromide and salbutamol produced approximately equal improvements in both diseases, with salbutamol showing a marginal advantage in patients with asthma. The combination of both drugs together more than doubled the FEV1 change in both groups of patients. The addition of prednisolone to both drugs produced a marginal advantage only in those with asthma.     

Bronchodilator action of the anticholinergic drug, ipratropium bromide (Sch 1000), as an aerosol in chronic bronchitis and asthma.

Ipratropium bromide (also known as Sch 1000) is a new atropine-like bronchodilator drug whose mechanism of action is via an anticholinergic pathway and may decrease cyclic guanosine monophosphate. Although of established efficacy in asthma, there are no studies of the use of ipratropium in patients with chronic bronchitis. The single metered aerosol doses of 10 mug, 20 mug, 40 mug and 80 mug of ipratropium bromide, 75 mug and 150 mug of isoproterenol, and placebo were studied in 20 adult patients, half with asthma and half with chronic bronchitis. To qualify, all patients demonstrated at least 20% improvement in the forced expiratory volume in one second while in the drug-free state when tested with isoproterenol. All subjects were tested for six hours with each agent in a double-blind crossover design. The dose-response aspects of the study indicate that in bronchial asthma the optimal range of dosage is 40 mug to 80 mug of ipratropium bromide. These doses are superior to isoproterenol in duration of action. In chronic bronchitis, all doses of ipratropium showed prolonged efficacy, but 80 mug was superior. Isoproterenol lacked this sustained efficacy. No significant alteration in pulse or blood pressure was observed. Ipratropium appears to be an important addition to the bronchodilator agents used in isoproterenol-responsive obstructive pulmonary disease.     

孟鲁司特联合复方异丙托溴铵及布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期的疗效研究

目的观察孟鲁司特联合复方异丙托溴铵及布地奈德雾化吸入治疗慢性阻塞性肺疾病(COPD)急性加重期的临床疗效。方法选择我科2013年1—10月收治的COPD急性加重期患者84例,采用随机数字表法将所有患者分为对照组和治疗组,每组42例。对照组患者采用吸氧、抗感染、止咳化痰、维持水电解质平衡等综合治疗,治疗组患者在对照组基础上加用孟鲁司特10 mg口服,1次/晚;雾化吸入复方异丙托溴铵2.5 ml和布地奈德混悬液2 ml,2次/d,连用1周。观察两组患者临床疗效及肺功能改善情况。结果治疗组患者总有效率为95.24%(40/42),高于对照组的80.95%(34/42)(P0.01)。治疗组患者治疗前后第1秒用力呼气容积(FEV1)占预计值百分比(FEV1%)、用力肺活量(FVC)、FEV1/FVC、最大呼气流量(PEF)、残气量(RV)、RV/肺总量(TLC)差值均大于对照组(P0.05)。结论孟鲁司特联合复方异丙托溴铵及布地奈德雾化吸入能明显提高COPD急性加重期患者的临床疗效,改善患者肺功能。     

The effect of altering airway tone on the sensitivity of the cough reflex in normal volunteers.

Cough is frequently the presenting symptom of bronchial asthma, although cough can result from a wide variety of other respiratory disease. Treatment of chronic cough has proved extremely difficult. It has been suggested that treatment with bronchodilators may reduce the symptom of cough. In this study the effect of altering airway tone on the sensitivity of the cough reflex was determined. Twelve normal, healthy volunteers took part. The number of coughs following inhalations of single breaths of doubling concentrations of capsaicin (1.95-500 microM) was recorded before and after doses of salbutamol, methacholine and saline which altered forced expiratory volume in one second (FEV1) by 6.2 +/- 2.6%, -8.8 +/- 3.2% and -0.18 +/- 1.38%, respectively. In a further study the cough response was recorded before and after doses of salbutamol and ipratropium bromide, both of which reduced baseline respiratory resistance and resistance measured after capsaicin. Ipratropium bromide, salbutamol and methacholine, despite having significant effects on airway tone, did not change the sensitivity of capsaicin-induced cough. Thus, if bronchodilator drugs are antitussive in non-asthmatic patients, then this is unlikely to be due to an effect on the sensitivity of the cough reflex.     

Airways responses to ipratropium bromide do not vary with time in asthmatic subjects. Studies of interindividual and intraindividual variation of bronchodilatation and protection against histamine-induced bronchoconstriction

Bronchial histamine provocation tests were performed in nine patients with nonallergic asthma on four consecutive days 45 minutes after inhalation of placebo or ipratropium bromide in a dose-response manner (40 micrograms, 200 micrograms, and 800 micrograms). The drugs were administered double-blind, one dose on each day. This procedure was repeated identically after three to nine months to investigate whether the bronchial responses to ipratropium bromide are constant or change with time. Ipratropium bromide induced a significantly better bronchodilation and protection against histamine-induced bronchoconstriction than placebo with no differences between the three doses. No correlation between bronchodilatation and protection was found. In six asthmatic patients ("responders") ipratropium bromide induced a significant protective effect against histamine-induced bronchoconstriction but no dose-response relationship was found. In three patients none or a very poor protective effect was found at all dose levels ("nonresponders"). The protective effect of ipratropium bromide against histamine-induced bronchoconstriction did not differ between the first and second occasion. Thus, the bronchoprotection differed between different asthmatic subjects but did not vary with time (three to nine months) within the same subject. This finding seems to be of clinical importance since it implicates that the effect of anticholinergic agents on the airways is predictable.     

噻托溴铵联合沙美特罗氟替卡松对重度支气管哮喘疗效观察

目的探讨噻托溴铵联合沙美特罗氟替卡松对重度支气管哮喘的临床疗效,提高患者的生活质量。方法对照组给予大剂量沙美特罗氟替卡松粉吸入剂,观察组给予吸人噻托溴铵粉吸入剂联合中等剂量沙美特罗氟替卡松粉吸入剂。结果观察组治疗总有效率为88.0%,对照组治疗总有效率为62.0%,两组对比差异显著,P<0.05。治疗后两组的肺功能较治疗前均有改善,差异有统计学意义,P<0.05;且观察组较对照组改善更明显,差异有统计学意义,P<0.05。结论噻托溴铵联合沙美特罗氟替卡松改善患者生活质量,减少急性加重发作的次数,值得临床推广。     

A comparison of ipratropium bromide, deptropine citrate and placebo in asthma and chronic bronchitis.

A new anticholinergic aerosol, ipratropium bromide, was compared in a double-blind cross-over trial with an established preparation, deptropine citrate, and placebo in 16 patients with defined asthma or chronic bronchitis. Ipratropium bromide produced a significantly greater and more rapid bronchodilation than did deptropine citrate or placebo in the doses used, and its effect was slightly greater in the asthmatic than in the chronic bronchitic group. No unwanted effects on secretion were seen with ipratropium bromide.     

噻托溴铵、布地奈德联合孟鲁司特治疗支气管哮喘合并过敏性鼻炎疗效及对患者肺功能影响的研究

目的 探讨噻托溴铵、布地奈德联合孟鲁司特治疗支气管哮喘(简称哮喘)合并过敏性鼻炎疗效及其对患者肺功能的影响.方法 将98例我院于2013年1月至2015年1月收治哮喘合并过敏性鼻炎的患者作为研究对象,随机分为对照组和观察组,每组49例.对照组采用布地奈德雾化吸入及孟鲁司特口服治疗,观察组在对照组基础上另给予噻托溴铵粉雾剂吸入治疗,2组治疗周期为10周.观察2组患者临床疗效,检测治疗前后肺功能指标(PEF、FEV1、PEFR及FEV1/FVC),血气指标(PaO2、PaCO2及pH)和炎性因子水平(TNF-α、IFN-γ、IL-13、IL-8及IL-4).结果 观察组显著有效率为57.1％,总有效率为98.0％,均明显高于对照组;观察组无效率为2.0％,明显低于对照组;2组患者治疗后的肺功能指标、血气指标和炎性因子水平较治疗前均得到明显改善.结论 噻托溴铵、布地奈德联合孟鲁司特治疗哮喘合并过敏性鼻炎不仅疗效显著,还能能改善患者肺功能,值得深入研究.     

成人支气管哮喘患者吸入糖皮质激素治疗的依从状况及其影响因素

目的探讨成人支气管哮喘患者应用糖皮质激素治疗的治疗依从性,并分析与其相关的影响因素。方法选取2014年3月至2015年6月我院收治的成人支气管哮喘患者160例,应用哮喘用药依从性量表对患者吸入糖皮质激素治疗依从性进行测评,并应用Logistic回归分析对于吸入糖皮质激素治疗相关的影响因素进行分析。结果 160例患者中,吸入糖皮质激素治疗依从性好的患者有60例,依从率为37.5%,治疗依从性较差的患者有100例;经影响吸入皮质激素治疗依从性的单因素分析显示,患者病情严重程度及吸入技术掌握程度及哮喘知识掌握程度与患者吸入糖皮质激素治疗依从性存在相关性,差异有统计学意义(P0.05);经Logistic多因素分析显示,哮喘知识的掌握程度、疾病严重程度及吸入技术掌握程度是影响支气管哮喘患者吸入糖皮质激素治疗依从性的影响因素。结论成人支气管哮喘患者应用糖皮质激素吸入治疗的依从性不高,应加强患者吸入技术及哮喘知识的宣教,以提高治疗依从性。     

Two cases of Kimura's disease associated with bronchial asthma]

We encountered two rare cases of Kimura's disease associated with bronchial asthma presenting eosinophilia and hyperimmunoglobulinemia E. Patient 1 was a 26-year-old man who had been admitted to our hospital with recurrent increase in left parotid mass in May 1997. He had previously undergone surgery for local excision at another hospital in September 1987; the excised specimens were re-evaluated and the diagnosis of Kimura's disease was confirmed. Because the patient was suffering from an acute asthma attack on admission, prednisolone (PSL) 30 mg/day was administered orally. PSL reduced the parotid mass and improved control of the asthma. Patient 2 was an 18 year-old man who had been given a diagnosis of Kimura's disease on the basis of histologic findings from a biopsy specimen of a subcutaneous tumor in the left cheek in 1988. Following the diagnosis, the patient was treated with methotrexate for the first several months, and then with loxioprofen for 9 years, but the size of the mass remained unchanged. Bronchial asthma developed in this patient in 1995 and had been treated with theophylline. However, because this therapy caused a deterioration of asthma control, the patient was admitted to our hospital in October 1997 for the treatment of bronchial asthma. Inhaled corticosteroids (beclometasone 0.8 mg/day) in addition to theophylline alleviated the patient's asthma symptoms and yielded improved lung function. Because few cases of Kimura's disease associated with bronchial asthma have been reported, patients with eosinophilia and hyperimmunoglobulinemia E were not necessarily considered at high risk for the onset of bronchial asthma.