布地奈德联合硫酸特布他林治疗支气管哮喘急性发作的效果分析

目的探讨布地奈德联合硫酸特布他林治疗支气管哮喘急性发作的临床效果。方法将76例支气管哮喘急性发作患者随机分为两组,对照组给予常规综合治疗,观察组给予布地奈德与硫酸特布他林联合雾化吸入治疗,观察两组患者临床症状消失时间及肺功能改善情况,并评价临床疗效。结果观察组患者气促、憋喘、哮鸣音、咳嗽等临床症状消失时间均明显短于对照组(P0.05);经治疗后,两组患者FEV1/FVC%和PEP均较治疗前明显改善(P0.05),而观察组改善程度明显优于对照组(P0.05),观察组患者疗效优于对照组,差异具有统计学意义(P0.05)。结论布地奈德联合硫酸特布他林雾化吸入治疗支气管哮喘急性发作患者临床疗效显著,能迅速缓解哮喘,明显改善肺通气功能,值得临床推广应用。     

经鼻吸入布地奈德及特布他林治疗支气管哮喘急性发作并变应性鼻炎患者的临床疗效观察

目的观察经鼻吸入布地奈德及特布他林治疗支气管哮喘急性发作并变应性鼻炎患者的临床疗效。方法选取2013年9月—2015年5月淮安市淮阴医院收治的支气管哮喘急性发作并变应性鼻炎患者96例,采用随机数字表法分为对照组和观察组,每组48例。两组患者入院后均给予支气管哮喘常规干预,对照组患者在此基础上经口吸入布地奈德和特布他林,观察组患者在此基础上经鼻吸入布地奈德和特布他林。比较两组患者治疗前、治疗后3 d、出院前视觉模拟量表(VAS)评分、哮喘控制问卷(ACT)评分,住院时间及住院期间糖皮质激素静脉给药量。结果治疗前两组患者VAS、ACT评分比较,差异无统计学意义(P0.05);治疗3 d后、出院前观察组患者VAS评分低于对照组,ACT评分高于对照组(P0.05)。观察组患者住院时间短于对照组,住院期间糖皮质激素静脉给药量少于对照组(P0.05)。结论经鼻吸入布地奈德及特布他林治疗支气管哮喘急性发作并变应性鼻炎患者的临床疗效确切,可有效控制鼻炎及哮喘症状,缩短住院时间并减少糖皮质激素用量。     

布地奈德混悬液联合博利康尼雾化吸入治疗支气管哮喘急性发作期的临床观察

目的观察布地奈德联合博利康尼雾化吸入对支气管哮喘急性发作期的临床疗效。方法选取57例急性发作期支气管哮喘患者随机分为治疗组（30例）和对照组（27例）。两组均常规抗感染、祛痰以及氨茶碱平喘治疗,治疗组在常规治疗的基础上给予普米克令舒4 ml与博利康尼2 ml联合雾化吸入治疗,2次/d。结果两组患者在治疗前观察指标差异无显著性（P〉0.05）,治疗后治疗组哮喘症状体征及肺功能指标明显改善（P〈0.05）。结论雾化吸入布地奈德和博利康尼起效快,有效改善患者的哮喘症状、体征及肺功能指标。     

布地奈德联合特布他林雾化吸入治疗慢性支气管哮喘临床疗效观察

目的分析布地奈德联合特布他林雾化吸入治疗慢性支气管哮喘的临床疗效。方法选取2012年4月—2013年4月我院收治的慢性支气管哮喘患者110例,将其随机分为观察组和对照组,各55例。对照组采取常规基础治疗,观察组在对照组基础上采用布地奈德联合特布他林雾化吸入治疗,观察两组临床疗效。结果观察组总有效率为94.6%(52/55),高于对照组的72.4%(40/55)(P0.05)。两组治疗后复发率比较,差异无统计学意义(P0.05)。结论采用布地奈德联合特布他林雾化吸入治疗慢性支气管哮喘具有较好的疗效,患者治疗后复发率低,值得临床广泛运用。     

布地奈德联合特布他林雾化吸入治疗急性加重期慢性阻塞性肺疾病的疗效观察

目的：探讨布地奈德联合特布他林雾化吸入治疗急性加重期慢性阻塞性肺疾病的临床疗效。方法选取我院2012—2013年收治的急性加重期慢性阻塞性肺疾病患者160例,根据入院日期单双数分为观察组和对照组,每组80例。对照组患者在常规治疗基础上给予氨茶碱治疗,观察组患者在常规治疗基础上给予布地奈德联合特布他林雾化吸入治疗。观察两组患者临床疗效、治疗前后肺功能指标及治疗期间不良反应情况。结果观察组患者总有效率为95.00％,高于对照组的82.50％（ P＜0.01）。两组患者治疗前第1秒用力呼气末容积（ FEV1）、 FEV1占预计值百分比（FEV1％）、 FEV1／用力肺活量（FEV1／FVC）比较,差异均无统计学意义（P ＞0.05）;观察组患者治疗后 FEV1、FEV1％、 FEV1／FVC均高于对照组（ P＜0.05）。两组患者治疗期间均未出现明显不良反应。结论布地奈德联合特布他林雾化吸入治疗急性加重期慢性阻塞性肺疾病安全有效,有利于改善患者肺功能。     

布地奈德联合特布他林雾化吸入治疗急性加重期慢性阻塞性肺疾病的疗效观察

目的：探讨布地奈德联合特布他林雾化吸入治疗急性加重期慢性阻塞性肺疾病的临床疗效。方法选取我院2012—2013年收治的急性加重期慢性阻塞性肺疾病患者160例,根据入院日期单双数分为观察组和对照组,每组80例。对照组患者在常规治疗基础上给予氨茶碱治疗,观察组患者在常规治疗基础上给予布地奈德联合特布他林雾化吸入治疗。观察两组患者临床疗效、治疗前后肺功能指标及治疗期间不良反应情况。结果观察组患者总有效率为95.00％,高于对照组的82.50％（ P＜0.01）。两组患者治疗前第1秒用力呼气末容积（ FEV1）、 FEV1占预计值百分比（FEV1％）、 FEV1／用力肺活量（FEV1／FVC）比较,差异均无统计学意义（P ＞0.05）;观察组患者治疗后 FEV1、FEV1％、 FEV1／FVC均高于对照组（ P＜0.05）。两组患者治疗期间均未出现明显不良反应。结论布地奈德联合特布他林雾化吸入治疗急性加重期慢性阻塞性肺疾病安全有效,有利于改善患者肺功能。     

特布他林雾化剂联合布地奈德混悬液治疗咳嗽变异性哮喘研究

目的探讨特布他林雾化剂联合布地奈德混悬液治疗咳嗽变异性哮喘的临床疗效。方法将符合标准的132例咳嗽变异性哮喘患儿随机分成特布他林组(41例)、布地奈德组(38例)和联合用药组(53例),分别予以特布他林雾化剂、布地奈德混悬液、特布他林雾化剂和布地奈德混悬液联合治疗,比较三组的临床疗效。结果治疗1个疗程后,联合用药组的咳嗽缓解时间、咳嗽消失时间均短于单纯用药组,联合用药组的通气功能改善更好,且显效率和总有效率明显优于单纯用药组,复发率明显低于单纯用药组(P<0.05),单纯用药组的组间比较差异无统计学意义(P>0.05)。结论特布他林雾化剂联合布地奈德混悬液治疗咳嗽变异性哮喘的临床疗效确切,值得临床推广应用。     

盐酸特布他林联合布地奈德对老年COPD患者气道高反应的临床反应性

目的观察盐酸特布他林联合布地奈德雾化吸入治疗对老年慢性阻塞性肺病(COPD)患者气道高反应的临床反应性。方法选择91例明确诊断为COPDⅢ级的患者,随机分成对照组45例(给予常规治疗)和治疗组46例(给予盐酸特布他林联合布地奈德雾化吸入治疗)。观察用药前后两组患者肺功能指标[FEV_1占预计值%,1 s用力呼气容积占用力肺活量的比值(FEV_1/FVC%)]、血气分析(动脉血氧分压、二氧化碳分压和血氧饱和度)的变化,监测出院后两组患者的生活质量。结果经过治疗后治疗组肺功能、血气分析各指标明显改善,优于对照组(P<0.05)。而在出院后生活质量上,治疗组明显优于对照组(P<0.05)。结论盐酸特布他林联合布地奈德雾化吸入治疗老年COPD患者可以在一定程度上改善患者肺功能,减轻气道炎症,防止肺功能的快速下降,提高COPD患者的生活质量。     

布地奈德干粉吸入剂对老年哮喘患者的疗效评价

目的 观察布地奈德干粉吸入剂对老年哮喘患者的临床疗效。方法 将５９例老年哮喘患者分厉三组,分别吸布地奈德干粉吸入剂２次／ｄ,每次２００ｍｇ,倍氯米松气雾剂２次／ｄ,每次２００μｇ,特布他林２次／ｄ,每次０．５μｇ,连续治疗４组。结果 治疗４周后布地奈德组患者肺功能（ＦＥＶ１和ＰＥＦ）的改善和临床疗效均较倍氯米松和特布他林组患者明显。结论 吸入布地奈德干粉吸入剂对哮喘有良好疗效,且吸入方法易于掌握,     

舒利迭治疗支气管哮喘临床效果效果研究

目的 探讨舒利迭治疗支气管哮喘的临床效果.方法 支气管哮喘患者108例,随机分为治疗组和对照组(两组分别为54例),其中治疗组吸入糖皮质激素(倍氯米松)、短效β2受体激动剂(硫酸特布他林),以及使用舒利迭(沙美特罗/氟替卡松)治疗,吸入2次/d.对照组吸入倍氯米松和口服特布他林,观察12周,观察患者哮喘临床控制率、第1秒用力呼气容积(FEV1)、最大呼气流速(PEF)及药物不良反应.结果 治疗组有34例(62.9%)达到临床控制,与对照组20例(37.0%)相比,差异有统计学意义(P＜0.05);两组治疗后FEV1、PEF水平均高于治疗前的水平(P＜0.05).结论 应用舒利迭治疗支气管哮喘能有效改善临床症状和降低复发率,优于单纯吸入糖皮质激素.     

Budesonide Inhalation Suspension Reduces the Need for Emergency Intervention in Pediatric Asthma: A Named‐Patient Case Series

This report describes 15 children aged 10–35 months frequently hospitalized with uncontrolled asthma who were monitored for a mean of 26.9 months to assess the efficacy of budesonide inhalation suspension (AstraZeneca LP, Wilmington, DE) in reducing emergency interventions. Budesonide inhalation suspension was previously shown to relieve asthma symptoms, improve pulmonary function, and reduce rescue medication use in children as young as 6 months with mild to severe persistent asthma. We now show that ≥ 1 year of treatment with Budesonide inhalation suspension at doses between 0.25 and 1.5 mg/d decreased the burden of asthma. The mean number of hospitalizations caused by asthma or respiratory illness decreased from 1.8 ± 1.37 in the period before initiation of treatment with Budesonide inhalation suspension to 0.33 ± 0.62 during treatment. Likewise, the mean number of oral prednisone courses decreased from 8.1 ± 13.7 to 1.8 ± 2.1, and the mean number of acute respiratory illnesses requiring additional therapy decreased from 2.7 ± 2.3 before treatment with Budesonide inhalation suspension to 0.87 ± 0.74 during treatment. Numbers of emergency department visits decreased or remained the same after initiation of Budesonide inhalation suspension treatment in all but two children. There was no effect on growth rate in this group of children with moderate to severe asthma. In this case series, Budesonide inhalation suspension represents a safe, effective treatment option to prevent recurrent emergency intervention for patients < 3 years of age with poorly controlled asthma.     

The impact of budesonide inhalation suspension for asthma hospitalization: In terms of length of stay,recovery time from symptoms,and hospitalization costs

BackgroundHospitalization is a major cause of medical expenditure for asthma. Budesonide inhalation suspension (BIS) may assist in reducing asthma-related symptoms in severe asthma exacerbation. However, its effectiveness for hospitalized patients remains poorly known. The objective of this study is to determine associations of BIS with asthma hospitalization.MethodsWe retrospectively analyzed 98 patients who were admitted to our hospital due to severe asthma exacerbation (24 treated with BIS in combination with procaterol) from April 2014 to January 2019. Length of stay, recovery time from symptoms (wheezes), and hospitalization costs were compared between the 2 groups according to clinical factors including the use of BIS and sings of respiratory infections (i.e. C-reactive protein, the presence of phlegm, and the use of antibiotics). Multivariate logistic regression analysis was performed to determine factors contributing to hospitalization outcomes.ResultsThe use of BIS was associated with shorter length of stay, faster recovery time from symptoms, and more reduced hospitalization costs (6.0 vs 8.5 days, 2.5 vs 5.0 days, and 258,260 vs 343,350 JPY). Signs of respiratory infection were also associated with hospitalization outcomes. On a multivariate regression analysis, the use of BIS was a determinant of shortened length of stay and reduced symptoms and medical costs for asthma hospitalization along with signs of respiratory infection.ConclusionsBIS may contribute to shorten length of hospital stay and to reduce symptoms and medical expenditure irrespective of the presence or absence of respiratory infection.     

布地奈德联合沙丁胺醇雾化吸入对支气管哮喘急性发作的疗效观察

目的观察布地奈德联合沙丁胺醇雾化吸入对支气管哮喘急性发作的效果。方法80例患者随机分为两组,试验组40例予布地奈德联合沙丁胺醇雾化吸入,对照组40例仅予沙丁胺醇雾化吸入,观察用药前及治疗后15min、第3天和第7天症状改善。结果试验组治疗15min后心率、呼吸频率、治疗第3天、第7天症状评分均较治疗前明显改善（P〈0．05）。结论布地奈德联合沙丁胺醇雾化吸入对支气管哮喘急性发作治疗有效。     

Short-term variability of exhaled nitric oxide in young male patients with mild asthma and in healthy subjects

BACKGROUND: Exhaled nitric oxide (NOexp) is an indicator of eosinophilic airways inflammation. This study evaluated short-term variability of NOexp in 13 healthy subjects (19-41 years, eight males) and in 31 patients with asthmatic respiratory symptoms (19-21 years, all male) to obtain data for assessment of short-term changes of NOexp in clinical situations. METHODS: Mild asthma was confirmed in 10 patients (Group = asthma). Twenty-one patients with asthmatic respiratory symptoms did not fulfill the functional criteria of asthma (Group = respiratory symptoms). The procedure to determine NOexp followed the European Respiratory Society (ERS) guidelines; the mean expiratory flow used during sampling was 0.09-0.12 l/s. NOexp for each subject was determined as the mean of at least three successive measurements at the baseline, followed by determinations at 10 min, 6 h and 24 h after the baseline. RESULTS: At the baseline, the mean (SD) value of NOexp was 6.6 (2.3) parts per billion (ppb) in the healthy controls, and significantly higher both in patients with respiratory symptoms (14.6 (11) ppb, P = 0.0076) and in those with asthma (34.2 (43) ppb, P < 0.001). Intraclass correlation coefficient of NOexp measured at baseline and after an interval of 10 min was 0.959 in healthy subjects, 0.986 in patients with respiratory symptoms and 0.936 in asthma patients, respectively. Short-term variability in terms of coefficient of variation (CoV) of repeated measurements of NOexp at 10 min, 6 hand 24 h was 5.1, 10.8 and 11.7% in healthy subjects, 71, 16.4 and 22.2% in patients with respiratory symptoms and 13.5, 19.4 and 26.4% in asthma patients, respectively. CONCLUSIONS: Reproducibility of NOexp using standardized methods was good both in healthy subjects and in asthmatic patients. However, in asthmatics the short-term variation of NOexp was over two times as high as in healthy subjects. The level of NOexp was elevated, except in asthma, also in patients with asthmatic respiratory symptoms who did not fulfill the functional criteria of asthma.     

胃食管反流病与哮喘关系初探

目的探讨胃食管反流与哮喘的关系。方法对15例以哮喘为主要表现的GERD患者进行了食管24hpH值监测及胃镜检查,并分析食管pH值与症状的关系,并以22例无呼吸系统症状的GERD患者作为对照。结果以哮喘为主要表现的GERD患者食管24hpH监测的各项指标与无呼吸系统症状的GERD患者存在显著差异(P<0.001,0.05),胃镜结果无显著差异,提示症状与酸反流密切相关。结论以哮喘为主要表现的GERD患者酸反流比普通GERD患者重,并且哮喘为患者的唯一临床表现,而无食管症状,因此临床上极易误诊。     

Long-term effects of budesonide on airway responsiveness and clinical asthma severity in inhaled steroid-dependent asthmatics

Budesonide 400 micrograms daily, in nonsteroid-dependent asthma, can produce improvements in airway responsiveness and clinical asthma severity, with some patients returning to normal responsiveness and becoming asymptomatic. This study examined whether similar improvements occur when asthmatics, who are dependent upon inhaled steroids, take either a regular maintenance dose of inhaled steroid or twice that amount for a year. Thirty two asthmatics were each stabilized on the minimum amount of inhaled steroid that would keep symptoms non-troublesome. In a double-blind, randomized manner, half were assigned to remain on a maintenance dose (MD) and the rest received twice that dose (MDx2) for one year. Before and monthly throughout the study, airway responsiveness to methacholine was measured and clinical asthma severity assessed by questionnaire, inhaled bronchodilator use and number of asthma exacerbations. There was a significant improvement in airway responsiveness and clinical asthma severity in both treatment groups. Those on MDx2 showed the greatest improvement but the difference between the two groups did not reach significance. This study provides strong evidence that prolonged use of inhaled steroids is associated with improvement in airway responsiveness and clinical asthma severity in inhaled steroid-dependent asthma with a suggestion that the improvements are dose related.     

The realities of clinical asthma diagnosis from questionnaire results

We investigated the basis on which respiratory physicians establish a diagnosis of asthma in clinical practice. A questionnaire survey was conducted on physicians in charge of 1,600 asthma patients receiving outpatient treatment at the Hokkaido University General Hospital or its affiliated hospitals or clinics. The bases for diagnosis were ranked as follows: 1) recurrent paroxysmal dyspnea or symptoms such as wheezing and cough (86%); 2) detection of wheezing on auscultation (78%); 3) improvement in symptoms or auscultation findings after using bronchodilators (56%); 4) improvement in symptoms or auscultation findings after using inhaled corticosteroids (55%); 5) diagnosis of asthma by another physician (46%); and 6) spirometry findings (31%). The performance rates of each examination were as follows. Spirometry at initial visit, 47%; sputum eosinophils, 25%; improvements in FEV1 measured after inhalation of bronchodilator or after treatment as asthma, 12%; measurements of airway responsiveness, 5% and variability in peak expiratory flow, 2%. Asthma is often diagnosed by respiratory physicians based on symptoms, physical examinations and improvement in symptoms or physical findings after treatment for asthma in medical practice. The performance rates of tests used to diagnose asthma were low.     

Asthma survey items as predictors of respiratory problems in children 2 yrs later: a longitudinal study.

The study compared the ability of characteristics defined by an asthma survey (wheeze versus cough and asthma diagnosis versus no diagnosis) to predict later respiratory problems in a cohort of 108 schoolchildren who had reported either recent wheeze or recurrent cough in a 1987 asthma survey. The children recorded daily respiratory symptoms and peak flow from April 1989 until May 1990. The frequency and severity of lower respiratory symptom episodes and peak flow dips were compared in the wheeze and cough groups and in the diagnosed versus nondiagnosed children. The independent effects of initial wheeze, atopy, diagnosis and bronchial hyperresponsiveness (BHR) on the longitudinal outcome measures were assessed using multiple linear regression. Children with initial wheeze had more chronic symptoms and peak flow variability than those with cough alone, but wheeze had only a weak effect on frequency and severity of acute lower respiratory episodes. Children with both wheeze and atopy had more acute symptomatic episodes and more chronic symptoms than did the other children. Children with diagnosed asthma (versus no diagnosis) had significantly more frequent and severe lower respiratory exacerbations, more days symptomatic and greater peak flow variability. The predictive effects of diagnosis were independent of (and stronger than the effects of) wheeze, atopy and BHR, or combinations of these variables. The results suggest that among children who report respiratory symptoms, survey-reported wheeze on its own is a weaker marker of significant respiratory disease than is a doctor's diagnosis of asthma.     

Induced sputum eosinophils in the assessment of asthma and chronic cough

OBJECTIVE: To evaluate induced sputum eosinophils in asthma and chronic cough. DESIGN: This was an analytical, cross-sectional study set in an ambulatory respiratory clinic. SUBJECTS: Subjects (n=75) referred for evaluation of symptomatic asthma or episodic respiratory symptoms had a clinical assessment, spirometry, hypertonic saline challenge and induced sputum. Two diagnostic groups were identified. The first group comprised subjects with symptomatic asthma and variable airway obstruction (VAO) (n=32). The second group included subjects with episodic respiratory symptoms and no VAO (n=43). RESULTS: The prevalence of eosinophilic bronchitis (eosinophils >2.75%) was greatest in asthma (n=14, 44%), compared to the episodic respiratory symptoms group (n=9, 21%, P = 0.02). Clinical variables did not predict increased eosinophils (P > 0.05). Sputum eosinophils were highest in asthmatics not using inhaled corticosteroids (6.5% vs 0.5%, P = 0.02). Sputum neutrophils were higher in subjects using inhaled corticosteroid (53% vs 25%, P = 0.04). CONCLUSION: Airway inflammation with eosinophilia was common among patients presenting to a respiratory clinic, especially those with asthma who were not using inhaled corticosteroids. Induced sputum also identified eosinophilic bronchitis in those without asthma. It was not possible to detect the presence or absence of airway eosinophilia by routine clinical assessment. The results in this study imply that the assessment of induced sputum eosinophils may be a useful guide to therapy, especially in the assessment of persistent symptoms in asthmatics on corticosteroids, and in the assessment of non-asthmatic subjects with symptoms.     

Budesonide turbuhaler delivered once daily improves health-related quality of life in adult patients with non-steroid-dependent asthma.

Budesonide inhalation powder via the dry-powder multidose inhaler Turbuhaler (budesonide Turbuhaler) has been shown to improve lung function and symptoms in adults with asthma. In this double-blind, placebo-controlled, multicenter trial, we evaluated the effects of once-daily budesonide Turbuhaler on health-related quality of life (HRQL) in 177 adults (aged 18-70 years) with non-steroid-dependent asthma. Patients were randomized to receive budesonide Turbuhaler (400 micrograms) once daily or placebo for 12 weeks. HRQL was assessed at baseline and weeks 4 and 12 using the Asthma Quality of Life Questionnaire (AQLQ). In addition to assessment based on the four AQLQ domains (activity limitations, asthma symptoms, emotional function, and response to exposure to environmental stimuli), AQLQ overall scores were analyzed for both treatment groups. Compared with placebo, patients using budesonide Turbuhaler once daily had statistically significant (p < 0.001) improvements from baseline to weeks 4 and 12 in AQLQ overall scores. Statistically significant improvements from baseline to weeks 4 and 12 in all four individual domains also were observed in the budesonide Turbuhaler group compared with placebo. Differences between the two treatment groups in mean changes from baseline in AQLQ overall, asthma symptoms, and emotional function reached the level required for patients to achieve a minimal important difference of change (> or = 0.5 U) at week 12. A retrospective analysis of the data showed that approximately 70% of patients treated with budesonide Turbuhaler experienced a minimal important difference of change in AQLQ overall scores. Overall, improvements in AQLQ correlated significantly (p < or = 0.04) with improvements in forced expiratory volume in 1 second, morning peak expiratory flow measurements, asthma symptoms, and breakthrough bronchodilator use at the study end. Thus, patients with corticosteroid-na?ve asthma can experience improved HRQL when using budesonide Turbuhaler.