布地奈德/福莫特罗联合孟鲁司特钠治疗咳嗽变异型哮喘的疗效观察

目的 观察布地余德/福莫特罗(信必可)联合孟鲁司特钠(顺尔宁)治疗成人咳嗽变异型哮喘的疗效.方法 89例患者随机分成3组,治疗组吸入布地奈德/福莫特罗及服用孟鲁司特钠.对照组2组分别吸入布地奈德/福莫特罗或服用孟鲁司特钠.结果 3组治疗后的症状积分及肺功能较治疗前均有显著改善.且3组治疗后的症状积分及肺功能比较,治疗组...     

布地奈德/福莫特罗干粉吸入剂治疗成人咳嗽变异性哮喘的临床研究

目的:评价联合应用布地奈德/福莫特罗粉吸入剂及孟鲁司特钠口服片剂,治疗成人咳嗽变异性哮喘的疗效。方法:咳嗽变异性哮喘患者42例,随机分为观察组22例(联合应用布地奈德/福莫特罗粉吸入剂及孟鲁司特钠口服片剂治疗),对照组20例(单用孟鲁司特钠口服片剂),连用4w。在治疗前、治疗2w、4w后分别记录患者的咳嗽症状积分及视觉模拟评分(VAS),比较2组的疗效。结果:两组治疗2w及4w后,咳嗽积分及VAS较治疗前均有下降,观察组下降明显,观察组在治疗2w后与对照组咳嗽积分比较P<0.05;4w后显著下降,两组比较P<0.001。结论:联合应用布地奈德/福莫特罗粉吸入剂及孟鲁司特钠口服片剂治疗成人咳嗽变异性哮喘比单用孟鲁司特钠疗效显著。     

吸入布地奈德/福莫特罗干粉剂治疗轻中度支气管哮喘急性发作的疗效观察

目的 评价布地奈德／福莫特罗干粉剂吸入治疗轻中度支气管哮喘急性发作的疗效。方法 96例轻中度支气管哮喘急性发作患者随机分为吸入布地奈德／福莫特罗组和口服强的松／吸入布地奈德组，在治疗前及治疗后第3、6天行肺功能检查，并观察患者的哮喘症状及体征变化。结果 吸入布地奈德／福莫特罗与口服强的松／吸入布地奈德均能明显改善轻中度支气管哮喘急性发作患者的肺功能和症状，但二者疗效相比无明显差异。结论：吸入布地奈德／福莫特罗可以替代口服强的松／吸入布地奈德而作为轻中度支气管哮喘急性发作的治疗用药。     

孟鲁司特钠联合沙美特罗/氟替卡松治疗咳嗽变异性哮喘疗效分析

目的比较孟鲁司特钠联合沙美特罗/氟替卡松、沙美特罗/氟替卡松治疗咳嗽变异性哮喘的疗效。方法选择60名咳嗽变异性哮喘患者,随机分成两组：对照组：吸入沙美特罗/氟替卡松（50 ug/250 ug）早晚各1吸,治疗组：联合孟鲁司特钠10mg每晚口服。每组按需吸入沙丁胺醇气雾剂。观察两组病人的临床疗效、不良反应和复发率。结果治疗组临床疗效明显改善,与对照组相比有显著差异性（P〈0.05）。结论孟鲁司特钠联合沙美特罗/氟替卡松治疗咳嗽变异性哮喘疗效明显,值得推广。     

沙美特罗替卡松粉吸入剂联合孟鲁司特钠咀嚼片治疗中重度咳嗽变异性哮喘患者的临床疗效

目的 观察沙美特罗替卡松粉吸入剂联合孟鲁司特钠咀嚼片治疗中重度咳嗽变异性哮喘患者的临床疗效。方法 选取攀枝花市中心医院2016年1月—2018年1月收治的中重度咳嗽变异性哮喘患者100例,采用随机数字表法分为对照组和观察组,每组50例。在常规治疗及短效氨茶碱片治疗基础上,对照组患者予以布地奈德气雾剂联合孟鲁司特钠咀嚼片治疗,观察组患者予以沙美特罗替卡松粉吸入剂联合孟鲁司特钠咀嚼片治疗;两组患者均连续治疗2个月。比较两组患者临床疗效及治疗前后咳嗽症状积分、肺功能指标、诱导痰炎性递质。结果 (1)观察组患者总有效率高于对照组(P0.05)。(2)两组患者治疗前夜间、日间咳嗽症状积分比较,差异无统计学意义(P0.05);观察组患者治疗后夜间、日间咳嗽症状积分低于对照组(P0.01)。(3)两组患者治疗前第一秒用力呼气容积占预计值的百分比(FEV1%pred)、用力肺活量(FVC)及呼气流速峰值(PEFR)比较,差异无统计学意义(P0.05);观察组患者治疗后FEV1%pred、FVC、PEFR高于对照组(P0.01)。(4)两组患者治疗前诱导痰白介素5(IL-5)、白介素10(IL-10)、嗜酸粒细胞比率(EOS)比较,差异无统计学意义(P0.05);观察组患者治疗后诱导痰IL-5、EOS低于对照组,IL-10高于对照组(P0.01)。结论 沙美特罗替卡松粉吸入剂联合孟鲁司特钠咀嚼片治疗中重度咳嗽变异性哮喘患者的临床疗效确切,可有效改善患者咳嗽症状、肺功能,减轻患者气道炎性反应。     

布地奈德/福莫特罗对咳嗽变异性哮喘患者FeNO及血浆hs-CRP影响的研究

目的 探讨布地奈德/福莫特罗治疗对咳嗽变异性哮喘（CVA）患者呼气一氧化氮（FeNO）及血浆超敏C反应蛋白（hs-CRP）水平的影响,比较FeNO和hs-CRP两种方法在反映CVA患者气道炎症方面的价值.方法 将25例CVA患者作为实验CVA组,24例健康体检者为对照组.所有研究对象均进行肺功能和支气管激发试验.所有CVA患者接受布地奈德/福莫特罗干粉吸入治疗4周（160 μg/4.5 μg,每12小时1次）,比较治疗前后咳嗽症状总积分、FeNO和血浆hs-CRP水平变化,并进行相关性分析.结果 （1）CVA患者治疗前FeNO和hs-CRP水平明显高于正常对照组（P均＜0.01）.FeNO水平与咳嗽症状总积分明显相关（r=0.602,P＜0.01）.（2）布地奈德/福莫特罗吸入治疗4周后患者咳嗽症状总积分、FeNO和hs-CRP较治疗前均明显下降（P＜0.01或P＜0.05）.（3）治疗后咳嗽缓解患者的基线FeNO水平明显高于未缓解者,且FeNO下降的比例与咳嗽总积分下降比例明显相关（r =0.466,P＜0.05）,而hs-CRP下降比例与咳嗽总积分下降比例无明显相关.结论 布地奈德/福莫特罗吸入治疗4周可以有效改善CVA患者症状,同时降低FeNO和血浆hs-CRP水平.相比血浆hs-CRP水平,监测FeNO在评价CVA患者气道炎症及激素治疗反应方面更有优势.     

噻托溴铵联合布地奈德治疗轻中度哮喘的临床疗效评价

目的 观察噻托溴铵联合吸人糖皮质激素对轻中度哮喘患者的临床疗效.方法 60例轻中度哮喘患者随机分为两组:噻托溴铵组给予吸入噻托溴铵干粉剂(18μg,每日1次)与布地奈德干粉剂(200 μg,每日2次);福莫特罗组给予吸入布地奈德福莫特罗干粉剂(160/4.5 μg,每日2次).在治疗前及治疗后8 w测定两组症状体征及肺功能变化.结果 治疗后8w,噻托溴铵组及福莫特罗组患者症状体征评分和肺功能指标明显改善,两组间比较,差异无统计学意义(P＞0.05).结论 在吸入糖皮质激素的基础上加用噻托溴铵,可明显改善轻中度哮喘患者的症状和肺功能,其疗效和加用福莫特罗相当.     

孟鲁斯特钠治疗成人咳嗽变异型哮喘的疗效观察

目的观察孟鲁斯特钠治疗咳嗽变异型哮喘（CVA）的疗效。方法收集我院门诊就诊的咳嗽变异型哮喘患者96例,随机分为A、B、C组。A组给予孟鲁斯特钠10 mg口服,每天1次治疗;B组给予孟鲁斯特钠10 mg口服,每天1次,同时吸入沙美特罗氟替卡松粉吸入剂50μg/250μg早,晚各1次;C组给予沙美特罗氟替卡松粉吸入剂50μg/250μg吸入早,晚各1次;三组疗程均为8周。对比三组治疗前后的临床疗效及肺功能改变。结果三组治疗后的临床疗效及肺功能均较治疗前有不同程度的改善（P〈0.05）;治疗后三组间比较,A组和C组临床疗效及肺功能改善相当,差异无统计学意义。B组的临床疗效及肺功能改善明显优于A、C两组（P〈0.05）。结论孟鲁斯特钠单药治疗可以改善CVA的临床症状及肺功能,孟鲁斯特钠联合沙美特罗氟替卡松疗效更显著。     

布地奈德/福莫特罗、沙美特罗/氟替卡松治疗中重度稳定期慢性阻塞性肺疾病疗效观察

目的比较长期联合吸入布地奈德/福莫特罗和沙美特罗/氟替卡松对中重度稳定期COPD病人的肺功能、生活质量的影响。方法 60例中重度稳定期COPD病人随机分为规律吸入布地奈德/福莫特罗（160μg/4.5μg）20例,规律吸入沙美特罗/氟替卡松（50μg/250μg）20例,按需吸入特布他林组20例（对照组）。测定三组试验前及试验后6个月圣·乔治（St·George）呼吸疾病问卷（SGRQ）的评分、6分钟行走距离（6-MWD）、肺功能。结果布地奈德/福莫特罗组与沙美特罗/氟替卡松组治疗后较对照组生活质量改善、6-MWD增加、肺功能改善,差异有统计学意义（P〈0.05）;布地奈德/福莫特罗组与沙美特罗/氟替卡松组间比较,差异无统计学意义（P〉0.05）。结论与沙美特罗/氟替卡松一样,规律吸入布地奈德/福莫特罗能改善中重度稳定期COPD病人的临床症状、运动耐力和肺功能。     

孟鲁司特钠治疗咳嗽变异性哮喘的临床观察

目的观察口服孟鲁司特钠（顺尔宁）治疗咳嗽变异性哮喘的效果。方法将156例咳嗽变异性哮喘患儿随机分为两组：治疗组84例，给予口服孟鲁司特钠治疗；对照组72例，给予布地奈德（普米克）及沙丁胺醇（万托林）吸入治疗。观察用药后1周、15天、1个月、3个月咳嗽消失的情况。结果对照组显效56例，有效11例，无效5例；治疗组显效68例，有效13例，无效3例，两组比较差异无统计学意义（U=0．2896，P〉0．05）。结论口服孟鲁司特钠与吸入布地奈德治疗咳嗽变异性哮喘效果相当，但使用方便。     

福莫特罗、孟鲁司特和溴醋茶碱治疗支气管哮喘的疗效比较

目的 比较福莫特罗、孟鲁司特和溴醋茶碱联合应用布地奈德治疗支气管哮喘(简称哮喘)的疗效.方法 利用观察、前瞻、对比研究方法,选取2014年5月至2015年2月于延安市人民医院诊断为哮喘患者78例,随机分成3组,分别接受福莫特罗(6 μg/喷)+布地奈德(100 μg/喷)联合吸入剂(2次/d,每次2喷)、口服孟鲁司特(10 mg,1次/d)+布地奈德(100μg/喷,2次/d,每次2喷)和口服溴醋茶碱(100mg,2次/d)+布地奈德(100 μg/喷,2次/d,每次2喷).患者在治疗后随访4周,记录治疗前后的肺量测定值包括FEV1和最大呼气流速(PEFR).利用哮喘生命质量问卷(AQLQ)方法评估患者治疗前后的生命质量情况.结果 与基线期相比,在接受4周药物治疗后3组患者的FEV1、PEFR和生命质量均表现出显著改善.3组每两组间比较结果显示,区域A、C和D无明显差异.但在区域B,福莫特罗组患者与其他2组相比能够更有效地控制哮喘症状(治疗4周后AQLQ评分为0.45±0.02 vs 0.61±0.03,0.83±0.15;t=2.18,2.25;P＜0.05).溴醋茶碱组中3例患者有胃刺激反应,而其他组患者无明显不良反应.结论 福莫特罗、孟鲁司特和溴醋茶碱联合应用布地奈德在治疗哮喘方面疗效类似.     

Improved asthma control with budesonide/formoterol in a single inhaler, compared with budesonide alone.

Budesonide/formoterol in a single inhaler was compared with budesonide alone, and with concurrent administration of budesonide and formoterol from separate inhalers, in patients with asthma, not controlled with inhaled glucocorticosteroids alone. In this 12-week, double-blind, randomized, double-dummy study, 362 adult asthmatics (forced expiratory volume in one second 73.8% of predicted, inhaled glucocorticosteroid dose 960 microg x day(-1)) received single inhaler budesonide/formoterol (Symbicort Turbuhaler) 160/4.5 microg, two inhalations b.i.d., or corresponding treatment with budesonide, or budesonide plus formoterol via separate inhalers. There was a greater increase in morning peak expiratory flow (PEF) with single-inhaler (35.7 L x min(-1)) and separate-inhaler (32.0 L x min(-1)) budesonide and formoterol, compared with budesonide alone (0.2 L x min(-1); p<0.001, both comparisons); the effect was apparent after 1 day (p<0.001 versus budesonide, both comparisons). Similarly, evening PEF, use of rescue medication, total asthma symptom scores and percentage of symptom-free days improved more with both single inhaler and separate inhaler therapy than with budesonide alone, as did asthma control days (approximately 15% more, p<0.001 versus budesonide, both comparisons, with a marked increase in the first week). All treatments were well tolerated and the adverse event profile was similar in all three treatment groups. It is concluded that single inhaler therapy with budesonide and formoterol is a clinically effective and well-tolerated treatment for patients with asthma that is not fully controlled by inhaled glucocorticosteroids alone.     

Budesonide and formoterol in a single inhaler improves asthma control compared with increasing the dose of corticosteroid in adults with mild-to-moderate asthma

BACKGROUND: We evaluated the efficacy and safety of low-dose budesonide/formoterol, 80 micro g/4.5 micro g, bid in a single inhaler (Symbicort Turbuhaler; AstraZeneca; Lund, Sweden) compared with an increased dose of budesonide, 200 micro g bid, in adult patients with mild-to-moderate asthma not fully controlled on low doses of inhaled corticosteroid alone. METHODS: All patients received budesonide, 100 micro g bid, during a 2-week run-in period. At the end of the run-in phase, 467 patients with a mean FEV(1) of 82% predicted received 12 weeks of treatment with budesonide/formoterol in a single inhaler or budesonide alone in a higher dose. Patients kept daily records of their morning and evening peak expiratory flow (PEF), nighttime and daytime symptom scores, and use of reliever medication. RESULTS: The increase in mean morning PEF-the primary efficacy measure-was significantly higher for budesonide/formoterol compared with budesonide alone (16.5 L/min vs 7.3 L/min, p = 0.002). Similarly, evening PEF was significantly greater in the budesonide/formoterol group (p < 0.001). In addition, the percentage of symptom-free days and asthma-control days (p = 0.007 and p = 0.002, respectively) were significantly improved in the budesonide/formoterol group. Budesonide/formoterol decreased the relative risk of an asthma exacerbation by 26% (p = 0.02) compared with budesonide alone. Adverse events were comparable between the two treatment groups. CONCLUSION: This study shows that in adult patients whose mild-to-moderate asthma is not fully controlled on low doses of inhaled corticosteroids, single-inhaler therapy with budesonide and formoterol provides greater improvements in asthma control than increasing the maintenance dose of inhaled corticosteroid.     

布地奈德气雾剂联合孟鲁司特治疗咳嗽变异型哮喘的疗效观察

目的研究布地奈德联合孟鲁司特治疗咳嗽变异型哮喘的疗效。方法回顾性分析我院近年来60例确诊为咳嗽变异型哮喘患者,分为观察组与对照组,各30例。观察组采用布地奈德气雾剂联合孟鲁司特咀嚼,对照组采用地塞米松联合氨茶碱注射液静脉滴注治疗。比较两组治疗前后的有效率。结果观察组有效率与对照组比较,差异无统计学意义(P>0.05)。结论布地奈德联合孟鲁司特治疗咳嗽变异型哮喘与地塞米松联合氨茶碱注射液疗效相当,且治疗更便捷、安全,适宜在临床推广应用。     

苏黄止咳胶囊联合信必可都保治疗CVA的体会

目的观察苏黄止咳胶囊联合信必可都保(布地奈德福莫特罗粉吸入剂)治疗咳嗽变异性哮喘(CVA)的治疗效果。方法将80例诊断为咳嗽变异型哮喘的患者随机分成甲乙两组。甲组:布地奈德福莫特罗粉吸入剂(1吸/次,2次/d);乙组:予以苏黄止咳胶囊(3粒/次,3次/d)联合布地奈德福莫特罗粉吸入剂(1吸/次,2次/d)。观察治疗1周后患者咳嗽症状及治疗1个月后肺功能改善状况。结果与甲组相比,乙组治疗1周后咳嗽症状及治疗1个月后肺功能明显好转(P0.05)。结论采用苏黄止咳胶囊联合布地奈德福莫特罗粉吸入剂治疗咳嗽变异性哮喘的治疗效果更好,值得临床推广。     

Adjustable maintenance dosing with budesonide/formoterol or budesonide: double-blind study

Adjustable maintenance dosing with either budesonide/formoterol or budesonide was compared in asthma patients. This double-blind trial randomized 133 patients (mean forced expiratory volume in 1s 66% predicted) to receive 2 inhalations twice daily of budesonide/formoterol 160/4.5 microg (640/18 microg/day) or budesonide 320 microg (1280 microg/day) for 4 weeks. The study drug was adjusted in both groups according to symptoms to 2-4 inhalations daily during Weeks 5-8 and 1-4 inhalations daily during Weeks 9-20. Asthma was well controlled in both groups, with minimal levels of treatment failure (5 budesonide/formoterol vs. 2 budesonide patients; P=NS) and minimal use of reliever therapy. Clinically important improvements in health-related quality of life (HRQL) occurred in the physical functioning and emotional role functioning domains (both P<0.05) for the budesonide/formoterol group compared with budesonide. Physician and patient treatment satisfaction favored budesonide/formoterol (both P<0.05). Budesonide/formoterol patients used fewer daily inhalations of study drug (P=0.024). The median average daily inhaled corticosteroid dose during the study was 448 microg with budesonide/formoterol and 1152 microg with budesonide. Adjustable maintenance dosing with budesonide/formoterol and budesonide resulted in high levels of asthma control. Adjustable budesonide/formoterol treatment achieved greater HRQL benefits and patient satisfaction, with lower overall drug use.     

One-year safety and efficacy of budesonide/formoterol in a single inhaler (Symbicort Turbuhaler) for the treatment of asthma

BACKGROUND: A budesonide/formoterol single inhaler has been developed for convenient treatment of patients whose asthma is inadequately controlled by inhaled glucocorticosteroids alone. OBJECTIVES: To compare long-term safety and efficacy of budesonide/formoterol single inhaler with budesonide plus formoterol via separate inhalers in adults with asthma. METHODS: In this open, randomized, parallel-group 6-month extension conducted in a subset of centres from a previous 6-month study, patients (n=321) received two inhalations bid of budesonide/formoterol (Symbicort Turbuhaler) 160/4.5 microg delivered dose or corresponding doses of budesonide (Pulmicort Turbuhaler) plus formoterol (Oxis Turbuhaler) via separate inhalers. RESULTS: Significantly fewer patients receiving budesonide/formoterol single inhaler withdrew compared with budesonide plus formoterol (9 vs. 19%, P=0.008). Incidence and severity of AEs were low and similar in both groups. No clinically important differences between groups, or changes, were identified in laboratory measurements, vital signs or ECG. Treatments produced similar improvements in lung function, ACQ scores and Mini AQLQ domains that were maintained throughout 12 months. CONCLUSIONS: Budesonide/formoterol in a single inhaler is as safe and effective in the long-term treatment of asthma as budesonide plus formoterol via separate inhalers. The lower number of withdrawals with budesonide/formoterol may reflect better adherence to treatment compared with budesonide plus formoterol.     

Addition of montelukast versus double dose of inhaled budesonide in moderate persistent asthma

BACKGROUND: Although current guidelines suggest the use of inhaled corticosteroids as the first line therapy in persistent asthma, the concerns about high-dose corticosteroids may limit their usage. We aimed to investigate the efficacy of inhaled budesonide plus oral montelukast versus a double dose of inhaled budesonide. METHODOLOGY: Thirty patients with moderate asthma took part in the study. Following a 2-week run in period, the patients were randomized into two groups to receive 400 microg/day of inhaled budesonide plus 10 mg/day of montelukast (BUD + M group) or 800 microg/day of inhaled budesonide (high BUD group). The patients were evaluated at 2-week intervals (during a total treatment period of 6 weeks) for symptom scores, asthma exacerbations, lung function, use of short-acting beta2 agonist, blood eosinophil counts and adverse events. RESULTS: At the end of the study, morning and daytime symptom scores were significantly reduced within the groups. Although there was a significant decrease in the frequency of short-acting beta2 agonist use in the BUD + M group, the decrease in the high BUD group was not significant. During the study period, no patient in either group experienced an asthma exacerbation. Blood eosinophil levels significantly declined in both the BUD + M (0.87 +/- 0.31%) and high BUD groups (0.67 +/- 0.29%) as compared with baseline levels (BUD + M = 2.60 +/- 0.65%, high BUD group = 2.60 +/- 0.47%; P < 0.05). CONCLUSION: Our results suggest that the addition of montelukast to low-dose inhaled budesonide is as effective as a double dose of inhaled budesonide in asthma control.