特布他林雾化与气雾吸入对小儿急性哮喘的疗效比较

目的：观察比较特布他林雾化吸入剂与气雾剂治疗小儿急性哮喘的疗效。方法：将急性哮喘患儿88例随机抽样分为两组，采用记分法观察，用药后20min,40min,60min病情变化。结果：两组间治疗后各时间段症状及体征记分下降，实验组明显优于对照组（P＜0．05），用药20min后，两组差异尤为明显（P＜0．001）。结论：雾化吸入疗法较气雾剂吸入使用便捷，起效迅速，更适用于小儿特别是婴幼儿的急性哮喘。     

特布他林对支气管哮喘吸入激素患者气道炎症的影响

目的 :探讨特布他林对支气管哮喘吸入激素患者气道炎症的影响。方法 :将 2 7例轻、中度支气管哮喘患者随机分成2组 ,A组 14例 ,予吸入特布他林气雾剂 5 0 0 μg ,tid ,吸入布地奈德气雾剂 4 0 0 μg ,bid ;B组 13例 ,只予吸入布地奈德气雾剂 4 0 0μg ,bid ,疗程均为 4wk ,治疗前后分别查痰嗜酸性粒细胞比例、痰白细胞介素 5 (IL 5 )、肺功能。结果 :治疗结束后嗜酸性粒细胞比例A组为 ( 0 0 4 8± 0 0 1) ,显著高于B组 ( 0 0 35± 0 0 0 5 ) ,P <0 0 1;痰中IL 5含量A组为 ( 71± 4 2 )pg·mL-1,显著高于B组 ( 38± 2 0 )pg·mL-1,P <0 0 5。结论 :长期 ( 4wk)规则吸入特布他林对激素的气道抗炎作用有不利影响 ,应注意合理使用该药     

特布他林雾化与气雾吸入对小儿急性哮喘的疗效比较

目的 :观察比较特布他林雾化吸入剂与气雾剂治疗小儿急性哮喘的疗效。方法 :将急性哮喘患儿 88例随机抽样分为两组 ,采用记分法观察 ,用药后 2 0min、40min、6 0min病情变化。结果 :两组间治疗后各时间段症状及体征记分下降 ,实验组明显优于对照组 (P <0 0 5 ) ,用药 2 0min后 ,两组差异尤为明显 (P <0 0 0 1)。结论 :雾化吸入疗法较气雾剂吸入使用便捷 ,起效迅速 ,更适用于小儿特别是婴幼儿的急性哮喘     

特布他林溶液气雾吸入治疗哮喘发作的临床疗效

哮喘是临床常见疾病之一。近年来 ,专家们推荐气雾吸入法作为哮喘急性发作的首选治疗。最近我院以微型气雾泵产生的压缩空气为动力 ,气雾吸入特布他林液 (喘康速 )治疗哮喘发作 ,其中儿科 90例、呼吸内科 10例 ,疗效满意。报道如下。1　临床资料治疗组 10 0例哮喘患者 ,均符合第三届全国小儿呼吸道疾病学术会议制订的儿童哮喘诊断标准及成人哮喘的诊断标准。儿科 90例 :男 5 0例 ,女 4 0例 ,平均年龄 6 ( 1～ 12 )岁。平均病程3年半 ( 1～ 10年 )。内科 10例 :女 7例 ,男 3例 ,平均年龄 2 8( 18～ 4 8)岁 ,平均病程 6年 ( 1～ 2 0年 )。对照…     

特布他林对哮喘急性期疗效及细胞因子的影响观察

目的:观察布特布他林对哮喘急性期及免疫指标的影响。方法:将某科室2014年32月~2015年3月收治的急性期哮喘患者75例按随机、双盲原则分为观察组38例和对照组37例,所有纳入病例均符合《支气管哮喘防治指南》。对照组给予布地奈德单独用药,观察组给予特布他林联合布地奈德治疗,观察两组患者白细胞介素-6(IL-6)、白细胞介素-1(IL-1)、超敏-C反应蛋白(hsCRP)、肿瘤坏死因子-α(TNF-α)等炎症因子变化及临床疗效情况。结果:两组治疗后白细胞介素-6、白细胞介素-1、超敏-C反应蛋白、肿瘤坏死因子-α均有所下降,但是观察组下降更为显著,两组相比,差异有显著性(P0.05);观察组患者治疗后的总有效率为89.47%,明显高于对照组72.97%,差异有显著性(P0.05)。结论:特布他林可有效降低血清炎症因子的水平,改善哮喘患者症状,值得临床推广和应用。     

特布他林和布地奈德雾化吸入治疗支气管哮喘

<正>支气管哮喘是由多种细胞包括气道的炎性细胞、结构细胞和细胞组分参与的气道慢性炎症性疾病。近年来,哮喘患病率呈上升趋势,部分患者病情反复发作,严重影响患者的生命质量。本溪市铁路医院用特布他林和布地奈德治疗支气管哮喘,疗效显著,现报道如下。1对象与方法1.1对象2009年9月至2010年9月在本溪市铁路医院住院的患者103例,均     

特布他林加地塞米松吸入治疗中重度哮喘的疗效观察

支气管哮喘是一种慢性气道炎症,气道痉挛、炎症及气道上皮下组织增生引起的气道重塑是其发病机制.对哮喘患者联合应用皮质激素和肾上腺素β2受体激动剂,抗炎和解痉兼而有之,同时可以减少皮质激素的剂量.     

以等渗硫酸镁溶液为溶媒吸入特布他林对哮喘发作期患者肺功能的影响

目前临床上对中、重度发作的哮喘患者雾化吸入β2受体激动剂均以生理盐水为溶媒。本研究以等渗硫酸镁溶液为溶媒，观察吸入特布他林(terbumline)对哮喘中、重度发作期患者肺通气功能的影响。     

雾化吸入布地奈德联合特布他林对哮喘患儿肺功能的影响

目的 观察雾化吸入布地奈德联合特布他林对哮喘患儿肺功能及卵泡抑素样蛋白1(FSTL1)表达的影响.方法 将90例哮喘患儿按照随机数字表法分为试验组与对照组,各45例.对照组给予雾化吸入布地奈德,每次1 mg,每次15 min,每天2次,连续治疗7 d;试验组在对照组的基础上使用空气压缩泵雾化吸入硫酸特布他林吸入粉雾剂,...     

特布他林雾化与硝普钠静滴对肺心病患者心肺功能的影响

对12例肺心病患者比较研究机械通气时特布他林5mg雾化与硝普钠25mg在5％葡萄糖液500mL静滴后的心肺功能变化。静滴硝普钠后肺动脉平均压(PAP)和肺血管阻力(PVR)均降低,但伴动脉血氧分压(PO_2)下降。特布他林雾化后,虽然PAP和PVR降低较少,但PO_2无明显改变且伴P_VO_2升高。提示特布他林雾化可较好地改善肺心病患者心肺功能。     

Increased theophylline clearance in asthmatic patients due to terbutaline

Summary The pharmacokinetic mechanism of the theophylline-terbutaline interaction has been studied. Sustained release theophylline 200–400 mg b.d. was given with placebo or terbutaline 2.5 mg t.d.s. to six adult asthmatic patients.Terbutaline decreased the serum trough theophylline levels from 8.1 to 7.3 µg/ml, improved daily the clinical score from 1.51 to 1.26 and increased the peak expiratory flow rate from 316 to 370 l/min. In a single dose study following the chronic therapy, it was shown that there was no change in the peak theophylline concentration or in the timing of the peak, but the t_1/2 was reduced from 9.0 to 7.5 h, and the systemic clearance was increased from 20.2 to 24.8 ml·h^–1·kg^–1.Thus, terbutaline reduced the serum theophylline concentration by increasing its systemic clearance.     

Comparison of conventional metered dose inhaler and breath actuated inhaler in elderly patients

Elderly patients frequently fail to achieve or to retain a competent inhaler technique using a conventional metered dose inhaler. In a prospective, randomised, crossover study of 44 subjects aged 64–94 (mean 78) years, we compared a metered dose inhaler (MDI) with a breath actuated inhaler (BAI) in terms of inhaler technique, ease of teaching and patient acceptability. Patients were stratified according to physical, functional or cognitive impairment before randomisation. Structured tuition was provided at the start of treatments, and technique was graded weekly and retaught if deficient. At the start of the treatment periods satisfactory technique was observed in 14 of 35 patients (six impaired, eight unimpaired) using the MDI and in 14 of 35 patients (three impaired, 11 unimpaired) using the BAI (P = 1.0). At the end of the four-week treatment periods satisfactory technique was observed in 19 of 30 patients (seven impaired, 12 unimpaired) using the MDI and in 27 patients (11 impaired, 16 unimpaired) using the BAI (P = 0.01). Mean weekly teaching times (minutes) were similar (MDI 7.0, BAI 6.5, P = 0.41) and there was no difference in terms of patient acceptability (P = 0.38). A breath actuated inhaler may be the preferred device for elderly patients as a greater proportion were able to retain satisfactory inhaler technique.     

β2受体激动剂联合抗胆碱能药物雾化治疗哮喘发作

目的 :观察β2 受体激动剂硫酸特布他林和抗胆碱能药物溴化异丙托品联合雾化吸入治疗哮喘急性发作的作用。方法 :用溴化异丙托品联合硫酸特布他林雾化吸入治疗急性发作期哮喘患者 (治疗组 )并与单用硫酸特布他林 (对照组 )进行比较 ,监测患者呼气峰流速 (PEFR)的变化。结果 :所有患者治疗前PEFR均小于70 %预计值。用药后两组的PEFR均有提高 ,治疗组更为明显 ,两组有显著性差异 (P<0.01)。结论 :溴化异丙托品与硫酸特布他林联合应用 ,肺功能改善程度较单用硫酸特布他林更明显 ,扩张支气管作用时间更长 ,副作用并不增加     

A comparative study of the efficacy of beclomethasone dipropionate delivered from a breath activated and conventional metered dose inhaler in asthmatic patients

Summary

In order to overcome the problem of poor co-ordination with the use of the conventional press and breathe metered dose inhaler, a breath-activated inhaler (‘Autohaler’ inhalation device) has been developed. The clinical response to equal doses of beclomethasone dipropionate administered from the ‘Autohaler’ device and the conventional metered dose inhaler was compared in 36 stable asthmatic patients receiving regular inhaled beclomethasone dipropionate. The study was performed using a double-blind, double-dummy crossover design. Each treatment was given for 4 weeks. Objective and subjective measures of asthma severity were compared in the second 14 days of each treatment period, with clinical equivalence defined as a difference of 20% or less in the adjusted mean values for the 30 patients with data from both treatment periods. Equivalence at the ± 5% level was found in the objective measures of pre-bronchodilator FEV₁, (p≤0.001); post-bronchodilator FEV₁ (p<0.001); morning and evening peak expiratory flow rate (both p≤0.001). Patient diary cards established there was equivalent usage of inhaled bronchodilator, and equivalent symptom scores for daytime disability and daytime and night-time breathlessness. The results show that, in stable asthmatics, treatment with beclomethasone dipropionate is clinically equivalent when delivered by the ‘Autohaler’ device or the conventional metered dose inhaler used efficiently.     

Terbutaline aerosol from a metered dose inhaler via a 750 ml spacer

Summary The effect on large and small airways of a pressurized terbutaline aerosol delivered via a 750 ml spacer, or via an ordinary actuator, was investigated in a double-blind study of 15 patients with reversible obstructive airflow disease. There was significant bronchodilatation with both devices as measured byRaw, FEV_1.0, PEFR, MEF₇₅, MEF₅₀, and MEF₂₅.Raw showed, a significant difference in favour of the 750 ml spacer. Measurement of Closing Volume (CV) revealed a significant decrease with the spacer, but with the ordinary actuator there was a slight increase in CV; the difference between the devices was significant. The quotient Closing Volume/Vital Capacity (CV/VC%) was significantly decreased with the 750 ml spacer but not with the ordinary actuator. The decrease in volume of isoflow (Viso ) was more pronounced with the spacer but not significantly so. The results suggest that use of a 750 ml spacer may promote more extensive peripheral deposition of the drug in the bronchial tract.     

国产与进口特布他林注射液的平喘疗效比较

目的 :比较国产与进口特布他林注射液对支气管哮喘 (哮喘 )和喘息性支气管炎 (喘支炎 )的平喘效果。方法 :10 0例中度喘息发作的哮喘和喘支炎病人 ,采用非盲法序贯随机对照法分为国产组和进口组各 4 0例 ,开放组 2 0例分别给予国产与进口特布他林注射液 0 .2 5mg +氯化钠注射液 10 0mL静脉滴注 10 0min ,tid× 3d。治疗前后分别观察临床症状和测定肺功能FEV1,FVC ,PEF。结果 :国产组与进口组总有效率分别为 90 %和 85 % (P >0 .0 5 ) ;FEV1,FVC ,PEF改善率分别为 (45± 4 2 ) % ,(47± 5 0 ) % ,(2 9± 4 1) %和 (41± 36 ) % ,(45±4 2 ) % ,(2 9± 33) % (P >0 .0 5 )。副作用发生少 ,均为轻度 ,不影响治疗。结论 :国产与进口特布他林注射液疗效相仿 ,均能有效地改善哮喘和喘支炎病人的临床症状和肺通气功能     

Drug delivery from the Turbuhaler and Nebuhaler pressurized metered dose inhaler to various age groups of children with asthma.

A total of 198 children aged 3 to 15 years inhaled a single dose of 200 micrograms budesonide from a Nebuhaler pressurized metered dose inhaler (pMDI) and a Turbuhaler dry powder inhaler in a randomized crossover study. The budesonide dose delivered to a patient was assessed by measuring the amount of drug deposited on a filter inserted between the inhaler outlet and the patient's mouth. The dose of budesonide deposited on the filter and the estimated dose of particles with a mass median aerodynamic diameter (MMAD) of 5 microns or less after inhalation from the Turbuhaler were both approximately twice the values inhaled from the pMDI Nebuhaler in children less than 5 years of age (P < 0.01). The variation in the dose delivered to the patient was similar for the two inhalers in children over 5 years old. In 3- to 4-year-old children, dose delivery to the patient was higher and/or more consistent from the pMDI Nebuhaler than from the Turbuhaler. Filter dose after Turbuhaler treatment varied significantly from peak inspiratory flow rate through the Turbuhaler (PIFTbh) (P < 0.01). The percentage of children producing a PIFTbh greater than 50 L/min decreased with age (89%, 45%, and 14% in 5-, 4-, and 3-year-old children, respectively). It is concluded that drug delivery to a child with asthma varies with age and inhalation device. Further studies are needed to assess the clinical importance of this finding.     

影响慢性阻塞性肺疾病患者正确使用定量型气雾剂的因素分析及对策

目的 探讨慢性阻塞性肺疾病（COPD）患者正确使用定量型气雾剂的必要性和可行性. 方法 对120例COPD患者使用定量型气雾剂,按使用的7个步骤进行初试记录.出院前复试,出院后2周再次复试.比较患者在初、复试中的正确使用率. 结果 初始时,120例COPD患者中能正确使用定量型气雾剂者18例（15%）,常见的错误为：先按压后吸气（90例次）、连喷几次后再吸气（30例次）、吸气后无屏气（28例次）、吸人激素后无漱口（20例次）、使用前无摇匀（18例次）、先吸入糖皮质激素后再吸入β2受体激动剂（80例次）.出院前复试时总的正确使用率增至88例（73%）.出院2周第二次复试时总的正确使用率降至56%（68例）. 结论 定量型气雾剂在COPD患者中使用的正确率低影响疗效.建立规范化的指导和定期培训才能保证使用的正确性和有效性.     

Clinical trial of a modified inhaler for pressurized aerosols

Summary Using spirometry, the effects on lung function of interposing a tube extension between a bronchodilator aerosol (terbutaline sulphate 0.25 mg) and the mouth and an ordinary aerosol have been compared. Both devices were administered with a delay of 2 s from actuating the aerosol to inhalation, thus simulating inability to coordinate properly. In 12 stable asthmatics it was found that attachment of the tube extension to the aerosol gave significantly better results for one-second forced vital capacity (FEV_1.0) and forced vital capacity (FVC). The tube extension seems to be beneficial in patients with hand-lung dyscoordination.