硫酸沙丁胺醇治疗支气管哮喘疗效观察

目的探讨硫酸沙丁胺醇治疗支气管哮喘的临床疗效。方法选择支气管哮喘患者60例,随机分为观察组和对照组各30例,观察组给予硫酸沙丁胺醇治疗,对照组给予布地奈德治疗,比较两组患者的治疗效果。结果观察组和对照组的总有效率分别为100%和83.33%,观察组疗效明显优于对照组,差异有统计学意义(P<0.05)。结论硫酸沙丁胺醇治疗支气管哮喘,能显著改善哮喘症状,改善肺功能,临床疗效较好,且无明显不良反应,值得临床推广。     

沙丁胺醇雾化溶液治疗支气管哮喘的疗效观察

支气管哮喘是临床上常见病。其临床特点是病程长，反复发作，有明显的季节性，起病急，急性发作时须尽快缓解气道阻塞，纠正低氧血症，使肺功能尽可能接近正常水平，防止并发症，尽最大能力提高哮喘患者的生活质量。我院从2002年1月至2002年8月共收治支气管哮喘患者50人，其中24例应用沙丁胺醇雾化溶液(商品名为：全乐宁)雾化治疗，收到良好效果，现报道如下：     

加长喷头吸入硫酸沙丁胺醇气雾剂治疗建立人工气道支气管哮喘患者的疗效

目的 观察加长喷头吸入硫酸沙丁胺醇气雾剂对建立人工气道支气管哮喘患者的效果.方法 将80例患者按住院日期分组,单日为观察组,双日为对照组.比较两组患者用药后1、5、10 min缓解率及平均缓解时间,监测用药10 min后两组患者的心率及呼吸和血液中PaO2、SaO2、PaCO2、pH、Lac的变化.结果 两组患者的1、5、10 min缓解率差异明显(P＜0.05),观察组平均缓解时间明显短于对照组(P＜0.05),而对照组无效例数较多(P＜0.01).药物干预10 min后,观察组患者的PaO2较对照组明显增高(P＜0.05),PaCO2、pH和呼吸次数较对照组下降(P＜0.05),两组患者的心率、SaO2及Lac水平变化不大(P＞0.05).结论 加长喷头提高了人工气道患者使用硫酸沙丁胺醇气雾剂的效果.     

平喘四号气雾剂与沙丁胺醇气雾剂治疗支气管哮喘疗效比较

目的观察平喘四号气雾剂(由盐酸克仑特罗、异丙托溴铵、丙酸倍氯米松组成)治疗支气管哮喘中度发作的疗效及安全性。方法选取支气管哮喘中度发作的患者60例,随机分为平喘四号气雾剂治疗组和沙丁胺醇气雾剂对照组。二组各30例,进行双盲对比观察。平喘四号组用平喘四号气雾剂,每日三次,每次2吸。沙丁胺醇组用沙丁胺醇气雾剂,每日三次,每次2吸。两组第一次用药后先观察6小时,疗程均为10天。观察两组起效时间、达效高峰时间、药效维持时间、肺功能改善状况及疗程结束后的综合疗效,同时观察不良反应。两组进行对比分析。结果两组在起效时间、达效高峰时间上差异无显著性(P>0.05);在维持时间、肺功能改善及综合疗效判断上,平喘四号气雾剂明显优于沙丁胺醇气雾剂,两组有非常显著的差异(P<0.01);不良反应发生率两组无显著差异(P>0.05)。结论平喘四号气雾剂是一个安全的、疗效卓越的平喘药物;对支气管哮喘的治疗,明显优于沙丁胺醇气雾剂。     

支气管哮喘发病相关因素的病例对照研究

目的探讨支气管哮喘发病的相关因素。方法使用成组的病例对照研究方法,采用问卷调查方式,对调查数据进行单因素和多因素非条件Logistic回归分析。结果单因素Logistic回归分析结果显示,有10个因素与支气管哮喘有关联;多因素Logistic回归分析显示,6个因素被选入,家庭人均拥有轿车量越多(OR为2.901)、最近10年至少染过一次头发(OR为2.620)、父母兄弟姐妹子女及父系或母系亲属患有过敏性疾病(OR为1.225)、使用化学洗涤剂清洁蔬菜水果和餐具的频率越高(OR为1.163)等4个因素为哮喘发病的危险因素,而儿时接种过疫苗(OR为0.886)及儿时母乳喂养超过6个月(OR为0.858)是哮喘的保护因素。结论支气管哮喘可能是生活方式、生活环境和遗传因素共同作用而导致的一种疾病。     

布地耐德混悬液联合沙丁胺醇液雾化吸入治疗支气管哮喘急性发作的临床观察

目的观察雾化吸入布地耐德混悬液及沙丁胺醇液对中重度支气管哮喘中～重度急性发作的疗效。方法将86例患者随机分为两组,治疗组在常规治疗的基础上联合雾化吸入布地耐德及沙丁胺醇治疗7天,观察两组患者哮喘症状体征及肺功能指标的变化。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）。结论联合布地耐德及沙丁胺醇雾化吸入治疗哮喘中～重度急性发作能有效改善患者的哮喘症状体征及肺功能指标。     

平喘四号气雾剂与沙丁胺醇气雾剂治疗支气管哮喘疗效比较

目的观察平喘四号气雾剂（由盐酸克仑特罗、异丙托溴铵、丙酸倍氯米松组成）治疗支气管哮喘中度发作的疗效及安全性.方法选取支气管哮喘中度发作的患者60例,随机分为平喘四号气雾剂治疗组和沙丁胺醇气雾剂对照组.二组各30例,进行双盲对比观察.平喘四号组用平喘四号气雾剂,每日三次,每次2吸.沙丁胺醇组用沙丁胺醇气雾剂,每日三次,每次2吸.两组第一次用药后先观察6小时,疗程均为10天.观察两组起效时间、达效高峰时间、药效维持时间、肺功能改善状况及疗程结束后的综合疗效,同时观察不良反应.两组进行对比分析.结果两组在起效时间、达效高峰时间上差异无显著性（P＞0.05）;在维持时间、肺功能改善及综合疗效判断上,平喘四号气雾剂明显优于沙丁胺醇气雾剂,两组有非常显著的差异（P＜0.01）;不良反应发生率两组无显著差异（P＞0.05）.结论平喘四号气雾剂是一个安全的、疗效卓越的平喘药物;对支气管哮喘的治疗,明显优于沙丁胺醇气雾剂.     

匹多莫德口服液治疗小儿支气管哮喘的临床疗效

目的观察临床应用匹多莫德口服液治疗小儿支气管哮喘的效果及对机体免疫功能的影响。方法选取2010年2月~2012年6月我院收治的138例支气管哮喘患儿,按随机数字表法随机分为对照组和观察组各69例,对照组患儿进行常规治疗,观察组患儿常规治疗联合匹多莫德口服液口服,观察两组患者的临床疗效及免疫功能改变。结果用药后观察组患儿的治疗总有效率较对照组明显升高(P0.05);患儿的抗体水平提高幅度明显高于对照组(P0.05)。结论临床应用匹多莫德口服液治疗小儿支气管哮喘可明显提高机体抗体水平,临床疗效显著。     

雾化吸入布地奈德与沙丁胺醇治疗支气管哮喘急性发作对HMGB1的影响及治疗效果评价

目的探究布地奈德联合沙丁胺醇雾化吸入对支气管哮喘急性发作患者血清中HMGB1的影响,并评价临床治疗效果。方法分析2013年1月~2014年12月我院收治的支气管哮喘急性发作期患者的临床资料,随机分为两组,观察组患者在采用常规治疗方案外,增加布地奈德联合沙丁胺醇雾化吸入治疗,对照组患者采用常规方法治疗。结果两组研究对象治疗后肺功能指标FEV_1、FVC、PEF水平明显高于治疗前指标水平,差异具有统计学意义(P0.05);治疗后观察组患者FEV_1、FVC、PEF水平高于对照组患者治疗后的指标水平,差异具有统计学意义(P0.05);治疗后观察组患者血清中血清中TNF-α、CRP、HMGB1水平明显低于对照组,差异具有统计学意义(P0.05);观察组患者HMGB1与FEV_1(r=-0.522,P0.001)呈显著负相关,与CRP(r=0.365,P=0.009)呈现正相关关系;观察组患者治疗总有效率为94%,对照组总有效率为79.55%,观察组治疗总有效率明显高于对照组,差异具有统计学意义(P0.05)。结论通过布地奈德联合沙丁胺醇联合雾化吸入治疗支气管哮喘急性发作的患者治疗效果较好,临床上可以大力推广。     

沙丁胺醇联合布地奈德雾化吸入治疗对支气管哮喘患者肺功能及炎症水平的影响

目的 分析沙丁胺醇联合布地奈德雾雾化吸入治疗对支气管哮喘患者肺功能及炎症水平的影响.方法 选取2018年1月-2018年12月我院收治的80例支气管哮喘患者为研究对象,按分层随机法分为观察组和对照组,各40例.对照组以布地奈德雾化吸入治疗,观察组在其基础上联合使用沙丁胺醇治疗,对比两组疗效及患者肺功能和炎症水平变化.结果 治疗后两组CRP、IL-6和TNF-α明显降低其观察组水平低于对照组(P<0.05);治疗后两组PEF较治疗前降低而FEV1和FEV1/FVC水平升高(P<0.05),观察组治疗后PEF低于对照组而FEV1和FEV1/FVC水平高于对照组(P<0.05);观察组治疗总有效率高于对照组(P<0.05);两组不良反应发生率比较无显著差异(P>0.05).结论 在支气管哮喘治疗中应用沙丁胺醇联合布地奈德雾化效果良好,可改善患者肺功能,缓解炎症反应,安全性高,值得应用.     

Mouthpiece Versus Facemask for Delivery of Nebulized Salbutamol in Exacerbated Childhood Asthma

We compared the bronchodilator response to salbutamol (albuterol) delivered by a compressed air nebulizer through a mouthpiece and via a facemask in 18 asthmatic children, to determine the most appropriate delivery method. Patients using a mouthpiece had significantly better mean percent increases in forced expiratory volume in 1 sec (FEV₁) and in forced vital capacity (FVC) than those using a facemask 30 min after inhalation (FEV₁: 56.4 ± 32.6 % vs. 28.9 ± 19.1%, FVC: 34.4 ± 26.4% vs. 7.5 ± 14.9%, respectively). Nebulized therapy plays an important role in the management of bronchial asthma in children and should be delivered by a mouthpiece whenever possible in cases of exacerbated asthma.     

Recruitment of Participants in the Childhood Asthma Management Program (CAMP). I. Description of Methods

The Childhood Asthma Management Program (CAMP), a multicenter clinical trial sponsored by the Division of Lung Diseases of the National Heart, Lung, and Blood Institute (NHLBI), is the largest outcome study of mild to moderate asthma in children to be undertaken, with eight clinical centers in the United States and Canada participating. The initial recruitment goal was 960 children within an 18-month recruitment period. Recruitment was extended to 23 months, with 1041 children randomized from late December, 1993, to early September, 1995. In this time interval each of the eight centers met the recruitment goal of 120 using a variety of self-selected recruitment strategies. The goal for minority recruiting was 33%, or 320 of the planned 960 children to be recruited. CAMP achieved the overall goal for the number of minorities, with 330 patients. Three centers recruited at or above the expected rate from the beginning. The other five centers had significant delays in recruitment. Examination of the recruitment experiences of the centers with and without delays did not indicate any single recruitment strategy that was certain to be successful. The most commonly cited factors for success were a cohesive staff, endorsement of participation by the child's primary care provider, and ability of the staff to be flexible and honest in assessing progress and the value of recruiting methods being used.     

布地奈德联合沙丁胺醇雾化吸入对急性哮喘发作患儿诱导痰液炎性细胞和细胞因子的影响

目的 布地奈德（普米克令舒）联合沙丁胺醇雾化吸入治疗儿童哮喘急性发作前后气道炎性细胞、白介素6（IL-6）、IL-8、肿瘤坏死因子α（TNF-α）的变化，探讨其影响机制。方法 对急性哮喘发作患儿采用上述联合治疗1周，共对34例急性发作期、24例缓解期患儿和15例正常儿童的诱导痰液进行炎性细胞计数和分类，测定其中IL-6、IL-8、TNF-α水平。结果 急性组的总白细胞数，嗜酸粒细胞、中性粒细胞单核细胞比例及IL-6、IL-8、TNF-α水平均高于正常对照组。缓解组除嗜酸粒细胞及淋巴细胞比例明显高于正常对照组外，其余上述炎性细胞比例及细胞因子水平均降至正常。结论 普米克令舒联合沙丁胺醇雾化吸入可显著降低急性哮喘发作患儿气道分泌物内嗜酸粒细胞、中性粒细胞和单核细胞数量及IL-6、IL-8、TNF-α水平。     

Asthma education taught by physical education teachers at grade schools: A randomised cluster trial

ObjectiveAssess whether the Asthma, Sport and Health (ASAH) programme taught by teachers improves asthmatics’ quality of life, asthma knowledge, and reduces school absenteeism.DesignRandomised cluster trial parallel group.Participants2293 students (203 asthmatic) in the Intervention School group (IS) and 2214 in the Comparison School (CS) (224 asthmatic) belonging to primary school.InterventionImplementation of the educational programme “Asthma, Sport and Health” at grade schools, taught by physical education teachers.Main outcomeQuality of life according to the Pediatric Asthma Quality of Life Questionnaire (PAQLQ).Secondary outcomesAsthma knowledge, asthma control, school absenteeism.ResultsAfter implementing the programme in the IS group, global quality of life improved significantly (p < 0.001) as did their domains, symptoms (p < 0.001), emotional function (p < 0.001) and activity limitations (p < 0.01), while in the CS group improvement was seen in global life quality (p < 0.01) without any significant changes in the domains for emotional function and activity limitations. Asthma knowledge only increased in IS, among asthmatic students from 16.51 (CI 95% 16.04–16.98) to 18.16 (CI 95% 17.69–18.62) (p < 0.001) and students without asthma from 15.49 (CI95% 15.36–15.63) to 17.50 (CI95% 17.36–17.64) (p < 0.001). The multiple regression analysis showed that quality of life and its domains depend on asthma knowledge and above all, having well-controlled asthma. We found no decrease in school absenteeism.ConclusionsThe ASAH programme improved certain quality of life aspects regarding asthma (emotional function and limitation of activities) and asthma knowledge, but it failed to reduce school absenteeism NCT01607749.     

Inhaled Corticosteroids and Bone Density of Children with Asthma

In this cross-sectional study we aimed to compare anteroposterior (AP) spine and total body bone mineral density (BMD) measurements of children with asthma treated with long-term inhaled budesonide (n = 52, mean age 6.4 ± 2.2 yr, M/F = 22/30) (Group I) with those of asthmatic children who had never received treatment with inhaled corticosteroids (Group II) (n = 22, mean age 6.8 ± 2.2, M/F = 10/12). Boys and girls were comparable for age, weight, height, cumulative corticosteroid (CS) dosage, duration of disease and inhaled corticosteroid (ICS) treatment within each group. The mean total accumulated dosage of budesonide for children in Group I was 154.0 ± 135.3 mg (mean daily dosage = 419 ± 154 µg) and the mean treatment duration was 13.0 ± 9.8 months. The two groups were comparable with respect to age, gender, weight, height, Tanner's stage and duration of disease. There was no significant difference between subjects in the two groups for total (p = 0.214) and (AP) spine BMD results (p = 0.661), respectively. Our results provide additional support for the safety of ICS therapy on bone density of asthmatic children.     

Psychosocial Functioning and Stress-Processing of Children with Asthma in the School Context: Differences and Similarities with Children without Asthma

Objective.?To characterize children with asthma by their stress processing at school and their psychosocial functioning. To establish similarities and differences between children with and without asthma. Methods.?Participants were 79 children with asthma and 359 children without asthma (ages 8–12). Children completed questionnaires on stress processing and their well-being at school. Parents filled in a questionnaire on behavior problems, and teachers provided data on school performance and absence rate. Results.?Children with asthma had higher scores on absence rates, teacher-rated well-being, internalizing behavior problems, occurrence of “rejection by peers,” and use of aggression when coping with “problems with school work.” However, using discriminant analyses, the groups could not reliably be distinguished from one another by these variables. Conclusions.?Children with asthma are similar to other children with regard to their stress processing at school and their psychosocial functioning. The value of conducting multivariate analysis over several univariate tests is underscored.     

Psychosocial Functioning and Stress-Processing of Children with Asthma in the School Context: Differences and Similarities with Children without Asthma

Objective. To characterize children with asthma by their stress processing at school and their psychosocial functioning. To establish similarities and differences between children with and without asthma. Methods. Participants were 79 children with asthma and 359 children without asthma (ages 8-12). Children completed questionnaires on stress processing and their well-being at school. Parents filled in a questionnaire on behavior problems, and teachers provided data on school performance and absence rate. Results. Children with asthma had higher scores on absence rates, teacher-rated well-being, internalizing behavior problems, occurrence of “rejection by peers,” and use of aggression when coping with “problems with school work.” However, using discriminant analyses, the groups could not reliably be distinguished from one another by these variables. Conclusions. Children with asthma are similar to other children with regard to their stress processing at school and their psychosocial functioning. The value of conducting multivariate analysis over several univariate tests is underscored.