普米克令舒联合博利康尼雾化吸入治疗毛细支气管炎疗效观察

目的观察普米克令舒联合博利康尼雾化吸入治疗毛细支气管炎的效果。方法两组在吸氧、抗感染、止咳、平喘、化痰等对症治疗的基础上,治疗组给予氧气驱动雾化吸入普米克令舒、博利康尼、普米克令舒1次0.5mg,博利康尼雾化液1次2.5mg,加生理盐水2mL吸入,1日3次,5d为1疗程;对照组给予生理盐水2mL吸入,1日3次,5d为1疗程。结果治疗1疗程后,治疗组显效率83.3%明显高于对照组显效率41.7%,P<0.05。结论普米克令舒、博利康尼氧气驱动雾化吸入治疗婴幼儿毛细支气管炎疗效确切、简单,依从性好。     

沙丁胺醇、溴化异丙托品雾化吸入治疗毛细支气管炎疗效观察

目的观察雾化吸入沙丁胺醇、溴化异丙托品治疗毛细支气管炎的疗效。方法将110例患儿随机分为治疗组56例及对照组54例,两组均予抗病毒、抗感染、糖皮质激素及止咳化痰等治疗,治疗组加用沙丁胺醇、溴化异丙托品雾化吸入;对两组治疗后的临床症状和体征改善情况进行比较。结果治疗组总有效率为98．2％,对照组总有效率为77．8％,2组比较差异有统计学意义（P〈0．01）。结论沙丁胺醇、溴化异丙托品雾化吸入治疗毛细支气管炎显效迅速,疗效显著。     

普米克令舒、爱全乐雾化治疗小儿毛细支气管炎临床观察

目的观察普米克令舒和爱全乐联合氧气雾化吸入治疗毛细支气管炎的疗效。方法将63例毛细支气管炎随机分为2组,对照组31例,在综合治疗基础上单用爱全乐;治疗组32例,联合爱全乐、普米克令舒。观察2组疗效及临床症状、体征改善时间。结果治疗组在缓解临床症状及体征改善时间方面优于对照组,差异有显著性。结论普米克令舒和爱全乐联合氧气驱动雾化吸入具有协同作用,可提高治愈率,缩短住院时间,值得临床推广。     

普米克令舒联合博利康尼氧气雾化吸入治疗小儿毛细支气管炎临床研究

目的:对普米克令舒联合博利康尼氧气雾化吸入治疗小儿毛细支气管炎的临床效果进行研究.方法:选取我院在2016年10月～2017年3月收治的小儿毛细支气管炎患者60例,随机分为对照组与研究组,每组30例.对照组静滴地塞米松磷酸钠,研究组使用普米克令舒联合博利康尼氧气雾化吸入治疗,对比两组肺湿啰音消失时间、住院时间、临床疗效、不良反应.结果:研究组肺湿啰音消失时间、住院时间明显少于对照组(P<0.05),总有效率明显高于对照组(P<0.05),两组不良反应发生率不存在明显差异(P>0.05).结论:普米克令舒联合博利康尼氧气雾化吸入治疗小儿毛细支气管炎能够起到显著的临床效果,能够在临床广泛使用.     

硫酸镁与普米克令舒、博利康尼联合吸入治疗小儿毛细支气管炎疗效观察

目的观察硫酸铗和普米克令舒、博利康尼联合吸入治疗小儿毛细支气管炎的疗效。方法将100例毛细支气管炎患儿随机分为对照组及治疗组。对照组采用常规综合治疗，治疗组在对照组治疗的基础上采用空气压缩泵吸入等渗硫酸铗和普米克令舒、博利康尼治疗，比较两组治疗前后临床症状及体征改善时间。结果治疗组喘憋、双肺哮呜音及咳嗽、气促消失时间均明显短于对照组（均为P〈0．05），治疗组治愈率为90％，对照组治愈率为68％（P〈0．05）。结论硫酸铗和普米克令舒、博利康尼吸入治疗毛细支气管炎可迅速缓解症状，抗炎、平喘效果确切，且方法简单。无副作用，可作为治疗小儿毛细支气炎的主要药物。     

普米克令舒及博利康尼雾化吸入治疗毛细支气管炎的疗效观察

目的为探讨普米克令舒及博利康尼雾化吸入治疗毛细支气管炎疗效。方法对照组在常规治疗基础上加用普米克令舒及博利康尼雾化吸入,每12h1次,采用氧气泵驱动装置,每次雾化吸入15min,共给药物5～7d。结果两组疗程差异有显著性（P＜0.05）。结论普米克令舒及博利康尼雾化吸入疗效确切,可作为治疗毛细支气管炎的常规药物。     

普米克令舒联合异丙托溴铵雾化吸入治疗小儿毛细支气管炎临床疗效观察

目的观察吸入用布地奈德混悬液(普米克令舒)联合异丙托溴铵雾化吸入治疗小儿毛细支气管炎的临床疗效。方法小儿毛细支气管炎患儿119例,随机分为观察组(60例)和对照组(59例),两组均给予常规对症治疗,在此基础上对照组采用异丙托溴铵雾化吸入治疗,观察组在对照组的基础上加用普米克令舒联合治疗,比较两组患儿的临床治疗效果。结果观察组治疗总有效率及临床症状改善时间均显著优于对照组,差异有统计学意义(P<0.05)。结论普米克令舒联合异丙托溴铵雾化吸入治疗小儿毛细支气管炎安全可靠,可明显提高治愈率,患儿耐受,值得在临床推广应用。     

溴化异丙托品治疗毛细支气管炎108例疗效考察

目的:观察溴化异丙托品治疗毛细支气管炎的疗效。方法:240例毛细支气管炎的患儿随机分为治疗组108例,对照组132例,对照组给于抗感染、吸氧、止咳化痰,口服β2激动剂等综合治疗,治疗组在上述治疗基础上加用溴化异丙托品0.5 ml雾化吸入,每日二次,连用3-7 d,观察两组患者在症状、体征改善方面的差异.结果:治疗组喘憋症状缓解、哮鸣音消失及总住院时间均短于对照组,差别有极显著意义(P<0.01)。结论:溴化异丙托品治疗毛细支气管炎疗效明显。     

普米克令舒联合万托林及爱全乐压缩雾化吸入治疗毛细支气管炎疗效观察

目的观察普米克令舒、万托林、爱全乐压缩雾化吸入治疗毛细支气管炎的疗效。方法将确诊的116例毛细支气管炎患儿随机分为2组,2组患儿均采用抗感染、吸氧、止咳、吸痰等综合治疗。在此基础上,对照组加用地塞米松、万托林压缩雾化吸入治疗;观察组加用普米克令舒、万托林、爱全乐吸入治疗。结果观察组患儿显效率65.00%,总有效率91.67%;对照组患儿显效率35.7%,总有效率67.86%,差异有显著性（P〈0.05）。结论普米克令舒、万托林、爱全乐吸入治疗毛细支气管炎效果好,副作用小。     

溴化异丙托品、特布他林、布地奈德联合气雾吸入治疗婴幼儿喘息性疾病临床观察

目的：观察溴化异丙托品、特布他林、布地奈德联合气雾吸入治疗婴幼儿喘息性疾病的疗效。方法：将58例患儿随机分为两组。在综合治疗的基础上，观察组给予溴化异丙托品、特布他林、布地奈德联合气雾吸入治疗．对照组静脉滴注地塞米松和氨茶碱，观察两组疗效及临床症状、体征持续时间。结果：观察组的咳嗽、喘憋及肺部哮鸣音、湿罗音消失天数均小于对照组。结论：溴化异丙托品、特布他林、布地奈德联合气雾吸入治疗婴幼儿喘息性疾病具有协同作用，起效快，副作用少，可缩短病程，提高治愈率。     

布地奈德联合硫酸特布他林和异丙托溴铵治疗小儿毛细支气管炎的效果观察

目的探讨布地奈德联合硫酸特布他林和异丙托溴铵治疗小儿毛细支气管炎的临床效果。方法选取2008年3月-2013年11月到本院进行治疗的120例毛细支气管炎患儿,将其随机分为观察组和对照组各60例,对照组患儿进行常规抗感染、平喘、止咳等治疗,观察组在常规治疗的基础上加用布地奈德联合硫酸特布他林和异丙托溴铵雾化吸入,对治疗后患儿的症状和体征消失时间以及治疗效果进行统计分析。结果治疗后观察组咳嗽、喘憋、肺部哮鸣音消失时间短于对照组,差异有统计学意义（P〈0.01）。观察组总有效率为100.0%,高于对照组的93.3%,差异有统计学意义（P〈0.05）。结论布地奈德联合硫酸特布他林和异丙托溴铵治疗小儿毛细支气管炎,能有效改善患儿气喘和咳嗽等症状,值得临床推广应用。     

雾化吸入复方异丙托溴铵与硫酸特布他林治疗小儿喘憋性肺炎的效果对比

目的研究雾化吸入复方异丙托溴铵与硫酸特布他林治疗小儿喘憋性肺炎的效果。方法将我院2017年8月~2018年8月收治的82例喘憋性肺炎患儿纳入研究,根据治疗方式的不同分为两组,均41例,其中对照组实施硫酸特布他林,研究组实施复方异丙托溴铵,比较两组患儿各项炎症因子与症状消失时间。结果治疗前两组患儿的各项炎症因子水平差异无统计学意义(P 0.05),治疗后研究组患儿各项炎症因子水平均优于对照组,对照组咳嗽消失时间、肺啰音消失时间等各项均长于研究组,两组患者治疗后均优于治疗前,研究组治疗总有效率(92.68%)明显高于对照组(78.05%),差异有统计学意义(P 0.05)。结论通过对喘憋性肺炎患儿实施雾化复方异丙托溴铵治疗,各项症状有效得到改善,炎症因子能够及时好转,值得应用。     

苏顺注射液联合爱全乐氧气雾化吸入对降低腹部术后肺部感染的临床研究

目的探讨苏顺注射液联合爱全乐氧气雾化吸入对预防腹部术后肺部感染的临床疗效。方法2013年12月至2014年12月在我科行开腹手术的患者80例,随机分为2组,对照组42例,试验组38例。对照组:庆大霉素4万U+0.9%生理盐水4 m L;试验组:爱全乐8 m L+苏顺1 mg;疗程:两组均给药1周,2次/d。治疗前后分别比较各组Pa O2、Pa CO2及肺部感染的情况。结果治疗前,对照组与试验组患者的Pa O2[(76.3±6.98)、(76.70±6.6)mm Hg]和Pa CO2[(35.47±6.34)、(36.4±8.30)mm Hg]比较差异均无统计学意义(P>0.05);治疗后,对照组与试验组患者的Pa O2[(78.30±3.23)、(81.30±4.34)mm Hg]和Pa CO2[(39.51±9.32)、(32.40±8.31)mm Hg]比较差异有统计学意义,试验组患者Pa O2高于对照组(P<0.05),Pa CO2低于对照组(P<0.05)。试验组咳嗽、咳痰、呼吸困难及术后肺部并发症发生率、有效率均高于对照组(P<0.05)。结论苏顺注射液联合爱全乐雾化吸入对于术后预防肺部并发症有效率高,治疗效果更为明显。     

Actions of theophylline, terbutaline, and ipratropium bromide alone and in combinations on the methacholine induced bronchoconstriction in rats

Rats under pentobarbitone anaesthesia, pancuronium relaxation and artificial ventilation with constant volume, were given methacholine (MeCh) 4, 6, and 9 micrograms intravenously at 2 min. intervals; the rise in intratracheal pressure indicated bronchoconstriction. The heights of peak responses (PIPR), response areas (RA), and blood pressure and heart rate were recorded, and theophylline (THEO) concentrations in plasma and lung tissue were measured. THEO (5, 10, or 20 mg/kg intravenously) proved a weak bronchodilator agent with pronounced effects on circulation. Terbutaline (TER) (10, 20, or 40 microgram/kg intravenously) shifted dose dependently the airways MeCh dose-response curves to the right, with minor stimulation of the heart. THEO 5+TER 20, and THEO 20+TER 20 enhanced the bronchodilator action of each other in an additive manner. Ipratropium bromide (IPRA) (5 micrograms/kg intravenously) eliminated MeCh bronchoconstriction without any inhibition of MeCh bradycardia and with partial inhibition of MeCh hypotonia. THEO 20+IPRA 0.5 provided a supra-additive bronchodilation. Injection of TER 20 promoted the penetration of THEO into the lungs thus increasing THEO concentrations in the lung tissue. The present results suggest that in this animal model combinations of low doses of THEO with TER/IPRA provide enhanced bronchodilation but reduced cardiovascular effects, in comparison with single therapy. Further, a pharmacokinetic interaction between THEO and a beta 2-agonist was evident within certain doses.     

Tobacco dependence treatment for hospitalized smokers: a randomized, controlled, pilot trial using varenicline

Objective

The hospital can be an important opportunity for smoking cessation interventions. This is the first randomized, double-blinded, placebo-controlled pilot trial utilizing varenicline and post-discharge, in-person behavioral treatment for hospitalized smokers.

Method

Seventy-nine smokers admitted to a university-based hospital with various diagnoses were enrolled from 2007 to 2009. The primary outcome was biochemically confirmed abstinence at 24 weeks following discharge. Secondary outcomes included withdrawal symptoms, motivation, utilization of treatment, and medical events.

Results

Overall abstinence at 24 weeks was 27% with no difference between varenicline and placebo treatment groups (23% vs. 31%). There were no significant differences in motivation to stop smoking or withdrawal symptoms. Over 40% of all subjects utilized post-discharge behavioral treatment with significantly higher abstinence rates compared with those who did not (53.1% vs. 8.5%, p < 0.01). Overall adverse events were similar in both treatment groups with the only significant difference being more nausea in the varenicline group (25% vs. 5%; p < 0.01). Twenty-three subjects were re-hospitalized with no significant differences between treatment groups (13 varenicline vs. 10 placebo).

Conclusion

This pilot trial of varenicline in hospitalized smokers demonstrated feasibility of implementation, produced some hypothesis-generating findings, and suggested the potential benefit of face-to-face treatment following discharge.     

A randomized, controlled trial validates a peripheral supra-additive antihyperalgesic effect of a paracetamol-ketorolac combination

The combination of paracetamol with non-steroidal anti-inflammatory drugs (NSAIDs) is widely used; however, the nature and mechanism of their interaction are still debated. A double-blind, pharmacokinetic/pharmacodynamic, randomized, cross-over, placebo-controlled study was carried out in human healthy volunteers. The aim was to explore the existence of a positive interaction between paracetamol 1 g and ketorolac 20 mg administered intravenously on experimental pain models in human beings. The effects of the paracetamol-ketotolac combination were compared with similar doses of respective single analgesic and to placebo on the sunburn model (UVB-induced inflammation), cold pain tolerance and the nociceptive flexion reflex. The kinetics of the plasma concentrations of paracetamol and ketorolac were measured using 2D-liquid chromatography-mass spectrometry. Thirteen volunteers were screened, and 11 completed the study. Ketorolac significantly decreased primary hyperalgesia to heat stimuli compared with paracetamol (p < 0.014). The combination performed better than paracetamol (p < 0.001) and placebo (p < 0.042), increasing heat pain threshold by 1.5°C. The combination radically reduced primary hyperalgesia to mechanical stimulation (39%) compared with placebo (p < 0.002) and single agents (paracetamol p < 0.024 and ketorolac p < 0.032). The combination also reduced, slightly although significantly, the intensity of pain (10%) for the cold pressor test (versus placebo: p < 0.012, paracetamol: p < 0.019 and ketorolac p < 0.004). None of the treatments significantly affected the central models of pain at this dosage level. No pharmacokinetic interactions were observed. These results suggest a supra-additive pharmacodynamic interaction between paracetamol and ketorolac in an inflammatory pain model. The mechanism of this interaction could mainly rely on a peripheral contribution of paracetamol to the effect of NSAIDs.     

Clinical effectiveness and safety of escitalopram and desvenlafaxine in patients of depression with anxiety: A randomized,open-label controlled trial

Aim:

Selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRI) are effective in treating anxiety disorders associated with major depressive disorder (MDD). This randomized, controlled, parallel-group, open-label, phase 4 trial (CTRI/2012/08/002895) was undertaken to compare the effectiveness and safety of desvenlafaxine versus escitalopram, a standard antidepressant.

Materials and Methods:

Effectiveness was assessed using the Hamilton Depression Rating Scale (HAM-D₁₇) and Hamilton Anxiety Rating Scale (HAM-A). Response to treatment was assessed by ≥50% decrease of baseline scores (responder rate). Safety and tolerability was evaluated by changes in routine laboratory parameters, vital signs, and adverse events reported by the subject and/or observed by the clinician.

Results:

Responder rates for both HAM-A and HAM-D scores at 8 weeks were better in the escitalopram group compared to the desvenlafaxine group (HAM-A 76.92% vs. 71.05%; HAM-D 79.48% vs 73.68%) but the differences were not statistically significant (P = 0.59 and P = 0.61). Within group changes of both scores, from baseline to subsequent visits in both treatment arms were statistically significant (P < 0.01).

Conclusion:

The effectiveness of desvenlafaxine was comparable to escitalopram, but escitalopram was better tolerated.KEY WORDS: Anxiety, clinical trial, desvenlafaxine, escitalopram, major depressive disorder     

A randomized,controlled, dose-ranging trial of sertindole in patients with schizophrenia

Sertindole is a novel antipsychotic agent with high selectivity for the mesolimbic dopaminergic pathway and nanomolar affinities for dopamine D₂, serotonin 5-HT₂, and norepinephrine NE₁ receptors. This 40-day randomized, placebo-controlled, dose-ranging multicenter study was designed to assess the effect of sertindole on previously neuroleptic-responsive, hospitalized schizophrenic patients (n=205). Sertindole doses began at 4 mg/day and were increased to 8, 12, or 20 mg/day, depending on randomization. Efficacy measures included the Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale (BPRS), and Clinical Global Impression (CGI). Extrapyramidal symptoms (EPS) were assessed by movement rating scales, EPS-related adverse events, and use of anti-EPS medications. A dose-related improvement was observed for PANSS, BPRS, and CGI, with statistically significant mean differences (P<0.05) between placebo and 20-mg/day sertindole (decreases from baseline of –5.8 versus –16.9 for PANSS, –4.8 versus –10.4 for BPRS, respectively). The differences in CGI final improvement score between placebo and 20-mg/day sertindole were 3.8 versus 2.9, respectively. EPS-related events were comparable in the placebo and sertindole groups. In conclusion, sertindole 20 mg/day was effective, well tolerated, and not associated with significant motor system abnormalities.This study was presented as a podium presentation at the 23rd Annual Meeting of the American College of Neuropsychopharmacology, Honolulu, Hawaii, December 13–17, 1993. Members of the Sertindole Study Group are listed under Acknowledgements