A single dose comparison of a combination of fenoterol and ipratropium aerosols in bronchial asthma

Nine patients with reversible obstructive airways disease were studied to compare the bronchodilator response to a combination of fenoterol and ipratropium aerosols with two dose levels of fenoterol alone. Using a double-blind, cross-over, single dose regime, 200 micrograms fenoterol hydrobromide and 80 micrograms ipratropium bromide was compared to 400 micrograms fenoterol + placebo, and to 200 micrograms fenoterol + placebo. There was no significant difference between the combination and either dose of fenoterol in terms of peak or duration of response as determined by absolute or percent change in forced expiratory volume in one second, or forced vital capacity, over baseline.     

A cumulative dose comparison between salbutamol and fenoterol metered dose aerosols in asthmatic patients

The potency and side effects of salbutamol and fenoterol inhalers have been compared in 8 asthmatic patients using a dose response curve. There was no significant difference in the absolute or percentage increase in FEV1 with the two treatments, but fenoterol caused a significantly greater (P less than 0.01) increase in heart rate than did salbutamol. A greater degree of bronchodilatation was observed with increased doses and we suggest that regular higher doses may provide better bronchodilatation and control of asthma in selected patients.     

Efficacy of salbutamol by nebulizer versus metered dose inhaler with home-made non-valved spacer in acute exacerbation of childhood asthma

This study was done to evaluate and to compare the efficacy of jet nebulizer and metered dose inhaler (MDI) with home-made non-valved spacer (HM NVS) to deliver aerosolized salbutamol in acute exacerbation of asthma in children. HM NVS was made by 500ml plastic mineral water bottle. It was perforated at the bottom for the insertion of MDI and proximal end was cut for placing the mouth. This prospective randomized study was conducted in the department of Pediatrics, Dhaka Medical College Hospital, during April 2007 to March 2008 with 50 known cases (2-12 years) of bronchial asthma with acute exacerbation. After randomized enrollment, each patient received three doses of salbutamol either through a jet nebulizer or through a HM NVS. Oxygen saturation (SaO2), wheeze, heart rate, respiratory rate were recorded throughout the treatment period. Data were analyzed with SPSS for Windows 10.0 at p value <0.05 was considered significant. The mean age of patients was 59.8 months in nebulizer group versus 69.4 months in MDI with HM NVS group. Baseline clinical characteristics in nebulizer group were SaO2 87.7±2.5 versus 89.0±1.8 percent, RR 59.2±7.3 vs. 63.2±4.8 per minute, HR 155.4±11.8 versus 149.0±10.8 per minute and wheeze in 22(88.0%) cases versus 21(84.0%) cases respectively (p>0.05). After therapy improvement was noted among the nebulizer group (SaO2 87.7±2.5 vs. 94.3±2.8 percent; RR 59.2±7.3 vs. 39.3±4.9 per minute; HR 155.4±11.8 vs. 151.60±17.3 per minute; wheeze 88% vs. 8%) as well as in the MDI with HM NVS group (SaO2 89.0±1.8 vs. 94.8±1.8 percent; RR 63.2±4.8 vs. 38.7±6.4 per minute; HR 149.0±10.8 vs. 144.5±13.5 per minute; wheeze 84% vs. 16%) [p<0.001; CI:95%]. However, these improvements did not differ significantly between the nebulizer group and HM NVS group (SaO2 94.3±2.8 vs. 94.8±1.8 percent, RR 39.3±4.9 vs. 38.7±6.4 per minute, HR 151.60±17.3 vs. 144.5±13.5 per minute and wheeze persisted in 2(8.0%) cases versus 4(16.0%) cases respectively) [p>0.05]. The overall response to these modalities of treatment was satisfactory in nebulizer (19/25) and HM NVS (17/25). Salbutamol delivered through both nebulizer as well as MDI with HM NVS is equally effective in the treatment of acute asthma in children.     

儿童支气管哮喘急性发作治疗方法的临床对比研究

目的 评价3种常用治疗儿童哮喘急性发作治疗方式的临床疗效.方法 将113例哮喘急性发作的患儿随机分为3组.A组53例采用布地奈德雾化悬浊液联合沙丁胺醇和异丙托溴胺混合溶液雾化吸入治疗,每日2次;B组41例采用布地奈德气雾剂联合沙丁胺醇和异丙托溴胺混合气雾剂吸入治疗;C组29例采用静脉地塞米松联合氨茶碱,每日1次,疗程5 d.入选患儿均采用综合治疗如补液、抗生素及抗病毒药物等.结果 布地奈德雾化悬浊液联合沙丁胺醇和异丙托溴胺混合溶液雾化吸入和静脉使用地塞米松联合氨茶碱均能有效控制儿童哮喘急性发作,两组疗效比较差异无显著性(p0.05).相对前两者,布地奈德气雾剂联合沙丁胺醇和异丙托溴胺混合气雾剂吸入不能有效治疗儿童哮喘急性发作.结论 经空气压缩泵雾化吸入是治疗儿童哮喘急性发作的最佳给药途径,布地奈德雾化悬浊液联合沙丁胺醇和异丙托溴胺混合溶液治疗儿童哮喘发作的疗效与静脉使用地塞米松联合氨茶碱相当,依从性好,简便可行.     

噻托溴铵与异丙托溴铵联合舒利迭治疗中重度COPD患者疗效比较

目的：研究噻托溴铵干粉制剂及异丙托溴铵气雾制剂联合舒利迭治疗中重度COPD患者的疗效及安全性。方法：48名确诊为稳定期的中重度COPD患者随机分为噻托溴铵＋舒利迭组、异丙托溴铵＋舒利迭组及舒利迭组。治疗前及经治疗1、3个月后分别观察临床症状、生活质量评分、FEV1及6min步行距离（6MWD）。结果：三组COPD患者在吸入治疗后临床症状、生活质量、FEV1及6MWD明显改善,而联合M受体阻断剂时其改善作用更显著（P〈0.05）,且噻托溴铵干粉制剂优于异丙托溴铵气雾剂。结论：老年中重度COPD患者可考虑噻托溴铵及舒利迭联合吸入,提高疗效及安全性。     

布地奈德雾化悬浊液联合复方异丙托溴铵治疗儿童哮喘发作的疗效观察

目的 评价布地奈德雾化悬浊液联合复方异丙托溴铵溶液治疗儿童哮喘急性发作的临床疗效.方法 76例哮喘急性发作的患儿随机分为治疗组42例和对照组34例,治疗组采用布地奈德雾化悬浊液联合复方异丙托溴铵溶液雾化吸入治疗,每日2次;对照组静脉使用地塞米松联合氨茶碱,每日1次,疗程5 d.治疗组和对照组患儿均采用综合治疗如补液、抗生素及抗病毒药物等.结果 布地奈德雾化悬浊液联合复方异丙托溴铵溶液雾化吸入和静脉使用地塞米松联合氨茶碱均能有效控制儿童哮喘急性发作,治疗组和对照组疗效比较差异无显著性 (P＞0.05).结论 布地奈德雾化悬浊液联合复方异丙托溴铵溶液治疗儿童哮喘发作的疗效与静脉使用地塞米松联合氨茶碱相当,依从性好,值得临床推广应用.     

不同剂量复方异丙托溴铵雾化吸入对支气管哮喘患儿疗效及心率的影响

目的 探讨不同复方异丙托溴铵雾化吸入对支气管哮喘患儿疗效及心率的影响.方法 选择我院儿科于2014年6月至2016年6月期间收治的84例支气管哮喘患儿,根据随机数字表法分为A、B、C三组,每组28例,所有患儿均接受雾化吸入复方异丙托溴铵治疗,剂量分别为每次1 mL、1.25 mL、2.5 mL,疗程7 d;比较三组患儿的临床疗效及首次用药后的心率情况.结果 A组患儿的治疗总有效率为71.43%,明显低于B组的89.29%和C组的96.43%,差异均有统计学意义(P<0.05),而B组和C组的疗效比较差异无统计学意义(P>0.05);在治疗后5 min、20 min,心率在三组均较治疗前显著加快,且在A组、B组、C组间分别为(108.5±9.6)次/min和(104.8±7.5)次/min、(117.2±8.9)次/min和(110.5±8.1)次/min、(124.8±9.2)次/min和(126.6±9.7)次/min,两两比较均依次上升,差异有统计学意义(P<0.05);A组与B组心率恢复正常时间分别为(21.6±6.2)min、(24.4±6.8)min,差异无统计学意义(P>0.05).结论 复方异丙托溴铵雾化吸入治疗儿童支气管哮喘急性发作具有较好的临床疗效,选择1.25 mL的中剂量复方异丙托溴铵雾化吸入治疗可以在保证疗效的前提下减少对患儿心率的影响.     

爱喘乐、喘乐宁雾化吸入治疗小儿喘息性疾病31例疗效观察

目的:探讨雾化吸入治疗在喘息性疾病的应用价值。方法:设氨茶碱对照组,爱喘乐、喘乐宁雾化吸入治疗组。结果:治疗组在缓解急性发作肺部罗音吸收住院时间等方面明显优于对照组。结论:爱喘乐、喘乐宁雾化吸入治疗小儿喘息性疾病有显著疗效。     

联用溴化异丙托品及沙丁胺醇雾化吸入在成人支气管哮喘急性发作期治疗中的应用效果

目的:观察治疗成人支气管哮喘急性发作期联用溴化异丙托品及沙丁胺醇雾化吸入的临床治疗效果。方法:回顾性分析2019年3月至2020年1月辽宁省健康产业集团铁煤总医院收治的78例支气管哮喘急性发作期成人患者,依据治疗方法将其分为对照组和观察组,每组各39例。对照组采用溴化异丙托品雾化吸入治疗,观察组患者在对照组基础上联合沙丁胺醇雾化吸入疗法,比较两组的疗效、症状缓解时间、动脉血气指标变化情况及哮喘症状控制(ACT)评分。结果:观察组的总有效率为94.87%,高于对照组的79.49%,差异有统计学意义(P<0.05);观察组的胸闷、气促、咳嗽、喘鸣症状缓解时间均短于对照组,差异有统计学意义(P<0.05);治疗后,观察组的动脉血气指标水平均高于对照组,ACT症状评分低于对照组,差异有统计学意义(P<0.05)。结论:溴化异丙托品联合沙丁胺醇雾化吸入治疗成人支气管哮喘急性发作期,疗效理想,可以缩短症状改善时间,值得推广应用。     

护理干预对哮喘患儿定量气雾剂吸入的依从性及对血IgE的影响

目的探讨护理干预对哮喘患儿使用定量气雾剂(MDI)治疗依从性及治疗前后血清学IgE水平的影响。方法 260例哮喘患儿,随机分为两组,ICS组135例,采取专项护理措施,对照组125例,采用常规的用药指导方法,评价护理干预的依从性及检测治疗前及治疗后3个月血清IgE水平。结果 ICS组依从性较对照组好(P0.01)。对照组及ICS组治疗3个月较治疗前IgE水平均下降(P0.05)。ICS组治疗后3个月IgE水平较对照组明显降低(P0.05)。结论积极的护理干预,能提高哮喘患儿使用MDI的依从性,提高疗效。ICS糖皮质激素可使哮喘儿童血清IgE水平降低。     

布地奈德等与异丙托溴铵联合治疗儿童哮喘急性发作观察

目的观察布地奈德、硫酸特布他林与异丙托溴铵联合吸入治疗支气管哮喘急性发作的效果。方法将106例中、重度哮喘患儿随机分为治疗组与对照组，对照组采用布地奈德、硫酸特布他林吸入治疗，治疗组采用布地奈德、硫酸特布他林与异丙托溴铵联合吸入治疗，观察临床症状和体征的变化，测定吸入前10min、吸入后24h、吸入后72h最大呼气流量（PEF）。结果治疗后两组患儿临床症状及体征均有不同程度改善，治疗组发绀、憋气、呼吸困难缓解时间及肺部听诊喘鸣音消失时间快于对照组，两组患儿吸入治疗后PEF均明显增加，与对照组比较，治疗组PEF值改善更为明显，有统计学意义（P〈0．01）。两组患儿采用吸入治疗依从性好，未出现不良反应。结论哮喘急性发作采用吸入治疗疗效满意，在布地奈德、硫酸特布他林吸入治疗的基础上加用异丙托溴铵吸入起效快，疗效更明显，可缩短病程。     

小剂量茶碱联合溴化异丙托品治疗COPD急性加重期23例疗效观察

目的探讨小剂量茶碱与溴化异丙托品联合治疗COPD急性加重期的临床疗效及安全性。方法将46例COPD急性加重期患者随机分为观察组和对照组,各23例。观察组给予小剂量茶碱联合溴化异丙托品治疗,对照组给予溴化异丙托品联合沙丁胺醇治疗,观察两组患者肺功能改善情况及不良反应情况,并进行疗效评定。结果两组患者治疗后FEVI、FVC、FEVI百分比及FEVI/FVC水平均较治疗前有明显改善(P<0.05);观察组治疗后FEVI、FVC、FEVI百分比及FEVI/FVC水平均明显高于对照组(P<0.05);观察组治疗总有效率为91.30%,明显高于对照组的73.91%(P<0.05);两组不良反应均较轻微,且发生率比较差异无统计学意义(P>0.05)。结论小剂量茶碱联合溴化异丙托品治疗COPD急性加重期具有疗效好、见效快、症状缓解明显等优点,且不会增加不良反应,对改善COPD患者肺功能、提高其生活质量均有积极意义。     

布地奈德异丙托溴铵与沙丁胺醇联合氧气雾化治疗小儿喘息性肺炎的临床疗效分析

【摘要】 目的 研究布地奈德（BUN）、异丙托溴铵（YBTXA）和沙丁胺醇（STL）联合氧气雾化对喘息性肺炎患儿的疗效。方法 收集90例喘息性肺炎患儿按照完全随机化方法分成对照和观察组各45例,对照组使用雾化吸入BUN治疗,观察组使用BUN、YBTXA、STL联合氧气雾化治疗,治疗1周后分别比较两组患儿前后肺功能各项指标及其主要症状消失时间。结果 ①观察组的总有效率显著高于对照组（P＜0.05）;②观察组的FEV1、FEV1%以及SaO2三项肺功能指标都显著优于对照组（P＜0.05）;③观察组肺部湿罗音、咳嗽和肺部哮鸣音三种主要症状消失时间少于对照组（P＜0.05）。结论 使用BUN、YBTXA、STL联合氧气雾化对喘息性肺炎患儿进行相应的治疗能够快速减轻其原有症状,改善肺功能,具有较好的临床疗效。     

雾化吸入布地奈德对哮喘儿童肺功能的影响

目的：探讨雾化吸入布地奈德福莫特罗粉加沙丁胺醇治疗儿童哮喘急性发作的疗效.方法：2006-01/2007-12我院儿科门诊哮喘患儿130例,随机分为3组：①A组（n=60）,用雾化器吸入布地奈德福莫特罗粉加沙丁胺醇混悬液;②B组（n=45）,使用贮雾罐和面罩,吸入布地奈德福莫特罗粉加沙丁胺醇气雾剂;③对照组（n=25）,不接受表面激素的吸入治疗.观察期为1a,在第4,12,24,48周随访,记录观察期的临床症状评分及哮喘急性发作时药物使用的情况.结果：与对照组相比,A组和B组明显降低了日间症状评分、夜间症状评分,有更多的无症状天数;显著减少了口服激素和吸入速效β2受体激动剂的需求,减少了哮喘的急性发作.而A组在观察期的第4,12周的治疗效果比B组更明显（P〈0.05）,两组在观察期的第24,48周的治疗指标的差异则无统计学意义.结论：雾化吸入布地奈德福莫特罗粉加沙丁胺醇治疗可以更好地减轻哮喘症状,更早地达到长期稳定,是婴幼儿哮喘的首选吸入方式.     

Streptococcal endocarditis (nonenterococcal, non-group A): single vs combination therapy.

A 14-year experience with streptococcal endocarditis was reviewed. The effect of single vs combination antibiotic therapy on the relapse rate was found to be comparable. Of 68 patients treated, four patients died during therapy. Two of 46 patients receiving single-agent and none of 18 patients receiving combination therapy experienced a relapse. Duration of symptoms before diagnosis was the main risk factor predisposing to relapse, which occurred in two of 13 patients with symptoms for longer than three months and in none of 51 patients with symptoms for three months or less before diagnosis. Combination therapy offered no advantage over a single agent in the latter group. Optimal therapy for patients with symptoms for longer than three months could not be determined in this study. However, no relapses were observed in this high-risk group when a single agent was given for longer than 21 days.     

Bronchodilator effects of salbutamol powder administered via Rotahaler and of terbutaline aerosol administered via Misthaler. A comparison study in children with asthma

A study to compare the bronchodilator effect of salbutamol powder (Ventolin, 200 micrograms) administered via a Rotahaler (SR), with that of terbutaline sulphate (Bricanyl, 500 micrograms) administered via a Misthaler (TM) was carried out in 25 children with stable moderate to severe asthma. The bronchodilator effects of salbutamol powder and terbutaline sulphate were measured by means of spirometry and clinical assessment in a double-blind, randomized fashion. The children were monitored for three hours after administration of the medication on three consecutive days. The administration of salbutamol via a Rotahaler and of terbutaline sulphate via a Misthaler resulted in significant bronchodilatation as measured by peak expiratory flow rate and spirometry. There was a significant trend for SR to give greater bronchodilatation than TM at several time intervals. Over 70% (18 of 25) of the children in this study preferred the Ventolin Rotahaler to the Bricanyl Misthaler. Both SR and TM give effective bronchodilatation and, consequently, these devices should be particularly useful in younger children who have difficulty with managing standard, metered aerosols.