丙酸氟替卡松每日不同吸入次数治疗哮喘儿童疗效对比

目的比较丙酸氟替卡松在哮喘控制良好的轻到中度哮喘儿童中qd与bid吸入治疗的疗效.方法选择77例哮喘控制良好的患儿,随机分为两组,分别给予100μg丙酸氟替卡松qd和bid吸入8周后,评价晨间PEF等指标,通过方差分析比较两组差异.结果两组1～8、1～6、7～8周晨间PEF均在95%的可信区间,证明bid与qd吸入丙酸氟替卡松的疗效在本组实验设计中无差异.无论是qd还是bid吸入,对轻到中度哮喘患儿症状的控制均让人满意.结论对于控制良好的轻到中度哮喘患儿,丙酸氟替卡松100 μg晚上一次性吸入与50 μg早晚各吸入一次的效果均确切,且没有差别.     

丙酸氟替卡松治疗过敏性鼻炎对哮喘的影响

目的：现察丙酸氟替卡松治疗过敏性鼻炎对哮喘控制的影响。方法：74名6—12岁儿童随机分为治疗组和对照组,治疗组38例给予丙酸氟替卡松治疗。对照组36例给予抗组胺药及0．5％呋麻液。随访一年。比较两组患儿哮喘急性发作次数、急诊次数及使用快速缓解药物次数的差异。结果：与对照组相比,治疗组哮喘急性发作次数、急诊次数、使用快速缓解药物次数均明显较对照组为少。结论：丙酸氟替卡松治疗过敏性鼻炎有助于哮喘的控制。     

丙酸氟替卡松治疗儿童哮喘临床分析

目的：明确丙酸氟替卡松对儿童哮喘的临床治疗效果。方法：选取2009年6月～2010年3月入本院治疗的36例患儿为研究对象,随机将其分为观察组和对照组,每组18例,其中对照组患儿口服酮替芬片（1mg,2次/d）治疗哮喘,观察组患儿在对照组基础上加服丙酸氟替卡松吸入（125μg,2~4次/d）,治疗3个月,记录患儿的肺功能指标并定期随访做记录。结果：观察组患儿的临床症状得到了有效缓解,治疗前后最大呼气峰流速值（PEF）和临床症状评分对比,差异有统计学意义（P〈0.05）,对照组患儿PEF值无变化（P〉0.05）。结论：长期吸入丙酸氟替卡松有助于缓解患儿哮喘的临床症状,改善患儿肺功能,可以在临床中进一步应用。     

沙美特罗/氟替卡松干粉剂治疗咳嗽变异型哮喘疗效观察

目的 探讨沙美特罗/氟替卡松干粉剂吸入治疗咳嗽变异型哮喘(CVA)的临床效果及安全性.方法 45例CVA患儿随机分为治疗组23例和对照组22例,治疗组给予沙美特罗/氟替卡松干粉剂吸入,早晚各1次;对照组单纯给予丙酸氟替卡松干粉剂吸入,早晚各1次;两组疗程均为3个月.观察两组治疗前、后临床症状缓解情况、哮喘控制时间、肺功能改善情况和不良反应.结果 治疗后两组咳嗽哮喘症状均有明显改善,治疗后1周治疗组改善情况好于对照组(x2=10.24,P＜0.05);治疗后2周、4周时两组差异均无统计学意义(均P＞0.05);治疗组哮喘完全控制时间明显短于对照组(t=8.36,P＜0.05).治疗后1周、2周、4周,治疗组PEF％均明显高于对照组(t=6.22、7.68、7.95,均P＜0.05);治疗后12周,治疗组PEF％与对照组差异无统计学意义(P＞0.05).两组无严重不良反应发生.结论 沙美特罗/丙酸氟替卡松干粉吸入治疗CVA安全、有效、使用方便,值得推广.     

沙美特罗替卡松在哮喘治疗中的控制作用

目的研究沙美特罗替卡松粉吸入剂治疗支气管哮喘的临床安全性及疗效。方法选择2009年2～10月笔者所在医院110例支气管哮喘患者,随机分成治疗组和对照组,每组各55例。治疗组患者选择沙美特罗替卡松粉吸入剂治疗;对照组患者只选择丙酸氟替卡松进行治疗,观察两组患者药物反应和症状改善情况,比较两组患者咳嗽、喘息及呼吸困难消失时间。结果治疗组患者咳嗽、喘息及呼吸困难消失时间都比对照组患者短,差异有统计学意义(P<0.05);治疗组用药后各项肺功能改变率与对照组比较,差异有统计学意义(P<0.05)。结论应用沙美特罗替卡松粉吸入剂治疗哮喘,不但治疗效果好而且使用安全,值得临床上推广应用。     

Superiority of fluticasone propionate/formoterol fumarate versus fluticasone propionate alone in patients with moderate-to-severe asthma: a randomised controlled trial

Abstract

Objective:

To demonstrate the efficacy and safety of fluticasone propionate/formoterol fumarate (flutiform) in a pressurised metered-dose inhaler (pMDI) compared to two formulations of the fluticasone propionate component (Skyepharma fluticasone [SKP FP] or Flovent, GlaxoSmithKline [GSK FP]) in adults and adolescents with moderate-to-severe asthma.     

Adrenocortical activity with repeated administration of one-daily inhaled fluticasone propionate and budesonide in asthmatic adults

Objective: The aim of this study was to evaluate the steady-state effects of once-daily inhaled fluticasone propionate (FP) and budesonide (BUD) on adrenocortical activity in asthmatic patients. Methods: Ten asthmatic patients with a mean age of 31.2 years, a mean forced expiratory volume in 1 s (FEV₁) of 91% predicted and a forced mid-expiratory flow (FEF_25–75) of 62.3% predicted were studied in a single-blind randomised crossover design comparing placebo (PL), FP (375 μg per day and 750 μg per day) and BUD (400 μg per day and 800 μg per day) all given once daily for 4 days at each dose via a pressurised metered dose inhaler (pMDI) at 0800 hours. After 4 days of treatment, plasma cortisol was measured at 0800 hours (24 h after the last dose) and a 10-h overnight urine collection was taken, 14 h after the last dose (2200–0800 hours) for analysis of cortisol and creatinine excretion. Results: Plasma cortisol levels (nmol · l⁻¹, as geometric mean) at 0800 hours demonstrated a significant difference between the highest doses of FP and BUD (424.1 vs 510.3 nmol · l⁻¹, respectively) but not between the low doses (506.8 vs 514.9 nmol · l⁻¹; PL 532.2 nmol · l⁻¹). For the highest dose FP (750 μg) this equated to 20% suppression of 0800 hours plasma cortisol. Likewise, for overnight urinary cortisol output (nmol · 10 h⁻¹, as geometric mean), there was a significant difference at the high doses of FP and BUD (25.5 vs 38.2 nmol · 10 h⁻¹), but not at the low doses 31.3 vs 34.8 nmol · 10 h⁻¹; PL 32.0 nmol · 10 h⁻¹. For the overnight urinary cortisol/creatinine ratio (nmol · mmol⁻¹, as geometric mean) there was a similar trend; 4.5 vs 6.1 nmol · mmol⁻¹ for high dose and 5.6 vs 6.3 nmol · mmol⁻¹ for low dose; PL 5.9 nmol · mmol⁻¹. Conclusion: Repeated doses of FP 750 μg once daily caused greater adrenal suppression than BUD 800 μg once daily, when comparing effects on plasma cortisol levels at 0800 hours, 24 h after the last dose, as well as effects on overnight urinary cortisol output. Neither FP 375 μg once daily nor BUD 400 μg once daily produced detectable adrenal suppression. Received: 29 April 1997 / Accepted in revised form: 5 July 1997     

沙美特罗氟替卡松粉吸入剂在儿童哮喘治疗中的临床疗效观察

目的观察沙美特罗氟替卡松粉吸入剂（舒利迭）在治疗儿童哮喘中的临床疗效。方法将130例患有哮喘的儿童随机分为研究组和对照组,每组65例,所有患儿均停用原来治疗哮喘的药物,研究组给予沙美特罗氟替卡松粉吸入剂,对照组给予氟替卡松（辅舒酮）进行治疗。结果患儿在接受药物治疗后的肺功能有明显的改善,且研究组改善更为明显。研究组患者的有效率明显高于对照组。两组差异均具有统计学意义（P〈0.05）。结论沙美特罗氟替卡松粉吸入剂能够很好地治疗儿童哮喘,对缓解症状和改善肺功能均能起到良好效果。     

沙美特罗替卡松粉吸入剂配合氨茶碱治疗哮喘的效果探讨

目的 探讨采用沙美特罗替卡松粉吸入剂配合氨茶碱治疗哮喘的临床效果.方法 随机选取本院2013年2月至2015年4月期间收治的哮喘患者94例,按照患者意愿将其分为观察组和对照组,其中对照组患者仅采用沙美特罗替卡松粉吸入剂进行治疗,观察组患者则在对照组的治疗基础上结合氨茶碱进行治疗,对两组患者临床症状的改善情况进行观察对比.结果 观察组患者的临床治疗总有效率、临床症状改善情况均明显高于对照组,差异具有统计学意义(P＜0.05).结论 氨茶碱联合沙美特罗替卡松粉吸入剂是一种有效的哮喘治疗方案,能够显著改善患者的临床症状,建议在临床上进一步推广.     

Safety and efficacy of long-term treatment with fluticasone propionate and salmeterol via DISKUS versus fluticasone propionate alone

This 52 week study (ADA109057; ClinicalTrials.gov identifier: NCT00452348) was designed to assess the safety and efficacy of fluticasone propionate (FP)/salmeterol 250/50 mcg via DISKUS (FSC) vs FP 250 mcg in subjects with persistent asthma symptomatic on FP 100 mcg. The objective was to demonstrate superiority in lung function (FEV₁) of FSC 250/50 mcg vs FP 250 mcg. Secondary objectives included AM PEF, percentage of symptom-free days, and rate of asthma attacks. Three hundred and ten subjects received FSC 250/50 mcg and 318 subjects received FP 250 mcg, both administered twice daily following a 14–21 days of open-label FP 100 mcg. Treatment with FSC 250/50 mcg resulted in an improvement in lung function vs FP 250 mcg (p?=?0.09). Additionally, treatment with FSC 250/50 mcg improved AM PEF and increased the percentage of symptom-free days. The asthma attack rate was similar between treatments, as was the safety profile. FSC 250/50 mcg demonstrated improvements in lung function and asthma control vs FP 250 mcg, although statistically significant differences were not consistent. The differences may be representative of this population with less severe disease at entry. In patients with mild-to-moderate persistent asthma FSC offers improved parameters of asthma control compared with ICS alone.     

沙美特罗/丙酸氟替卡松治疗儿童中重度哮喘的疗效观察

目的观察吸入沙美特罗/丙酸氟替卡松干粉剂治疗儿童中重度哮喘的疗效及安全性。方法对153例中重度哮喘儿童采用沙美特罗/丙酸氟替卡松干粉剂吸入治疗,观察治疗前、治疗后第2、4、12周患儿日、夜哮喘症状严重程度并计分,记录每天需吸入短效β2受体激动剂的剂量和次数、哮鸣音改善情况;比较治疗前、治疗12周后PEF值或FEV1值。结果经吸入沙美特罗/丙酸氟替卡松治疗,第2、4、12周后患儿日、夜哮喘症状分值、吸入短效β2受体激动剂(特布他林)的剂量和次数明显减少,差异有显著意义(P<0.05);哮鸣音逐渐减少,直至消失;第12周时PEF/预计值或FEV1/预计值的百分比明显提高,差异有极显著意义(P<0.01)。不良反应发生率为6.0%,反应轻微。结论沙美特罗/丙酸氟替卡松干粉剂治疗儿童中重度哮喘有疗效显著、安全的特点。     

沙美特罗／丙酸氟替卡松治疗支气管哮喘的临床观察

目的观察沙美特罗／丙酸氟替卡松治疗支气管哮喘的临床疗效和安全性。方法将76例支气管哮喘患者随机分为治疗组和对照组,各38例。治疗组予沙美特罗／丙酸氟替卡松粉吸入剂（商品名：舒利迭）治疗,对照组予丙酸倍氯米松吸入剂（商品名：必可酮）治疗。结果治疗组的显效率为60．5％和总有效率94．7％分别高于对照组的34．2％和71．1％,差异均有统计学意义（P〈0．05）。2组治疗后第1秒用力呼气容积（FEV1）和呼气峰流量（PEF）均有显著改善,治疗组优于对照组,差异均有统计学意义（P〈0．01）。结论沙美特罗／丙酸氟替卡松粉吸入剂治疗支气管哮喘疗效肯定,且使用方便。     

Cost-effectiveness of salmeterol xinafoate/fluticasone propionate combination inhaler in chronic asthma

ABSTRACT

Objective: To determine where in the treatment steps recommended by the British Thoracic Society and Scottish Intercollegiate Guidelines Network (BTS/SIGN) Asthma Guideline it is cost-effective to use salmeterol xinafoate/fluticasone propionate combination inhaler (SFC) (Seretide^*) compared with other inhaled corti­costeroid (ICS) containing regimens (with and without a long acting beta?2 agonist (LABA)) for chronic asthma in adults and children.

Research design and methods: Meta-analyses of percentage symptom-free days (%SFD) were used within a cost-effectiveness model. Time spent in two asthma control health states, ‘symptom-free’ and ‘with-symptoms’ was used as the measure of differential treatment effectiveness. SFC was compared with varying doses of fluticasone propionate (FP) and beclometasone dipropionate (BDP) with or without a separate salmeterol inhaler, and with the budeson­ide/formoterol combination inhaler (BUD/FORM) (Symbicort^?). Drug costs, non-drug costs and quality adjusted life years (QALY) were incorporated into the analyses. Results are presented as cost per QALY ratios and uncertainty explored using probabilistic sensitivity analysis.

Results: Compared with an increased dose of FP in adults, SFC either ‘dominates’ (i.e. cheaper and more effective) FP or the cost per QALY is £6852. The cost per QALYs estimated in sensitivity analyses using BDP costs range from £5679 to £15?997. For children the cost per QALY for SFC 50 Evohaler* compared with an increased dose of FP is £15?739. SFC is similarly clinically effective in improving %SFDs compared with FP plus salmeterol delivered in separate inhalers (mean differences for each dose comparison of –3.9 (low) (with a 95% confidence interval (CI): –12.96; 5.16); 4.10 (medium) (95% CI: –3.01; 11.21); –0.4 (high) (95% CI: –8.88; 8.08)) and BUD/FORM (mean difference of 0.40 (95% CI –3.69; 4.49)) in adults, and a cheaper SFC option is available at all doses (annual cost savings range from £18–£427 per patient). SFC was similarly effective compared with FP plus salmeterol in separate inhalers in children under 12 and also resulted in annual cost savings of between £47 and £77. A number of other comparisons were also made and the results are available as electronic supplementary data.

Conclusions: This is the first analysis to estimate the cost-effectiveness of SFC in chronic asthma compared with multiple comparators and based on a systematic identification of relevant trials and data on %SFDs. The findings suggest that for adults and children uncontrolled on BDP 400?μg/day or equivalent it is a cost-effective option to switch to SFC (at an equivalent ICS dose) compared with increasing the dose of ICS. For adults and children aged 12 years and over who have passed this point and are uncontrolled on BDP 800?μg/day or equivalent, switching to SFC remains a cost-effective approach. Where an adult or child requires an ICS and a LABA to be co-prescribed, SFC is a cost-effective option compared with FP or BDP plus salmeterol delivered in separate inhalers. In adults who require combination therapy, SFC is a cost-effective option compared with BUD/FORM.     

沙美特罗替卡松吸入治疗儿童哮喘的疗效观察及护理

目的:观察沙美特罗替卡松吸入治疗儿童哮喘的疗效和护理方法。方法:按病情轻、中、重度持续不同,分别给予不同剂量沙美特罗替卡松吸入,同时按需使用短效β2受体激动剂吸入,对<7岁的患儿可加用储雾罐。并由专科护士讲解使用方法。结果:治疗2周后,日间、夜间症状、肺部哮鸣音评分显著下降,治疗至6个月时无症状的病例已达99.15%,治疗2周后用万托林的量明显减少。6月时有记录的357例随访中显效355例(99.4%),有效1例(0.3%),无效1例(0.3%),总有效率99.7%。结论:沙美特罗替卡松治疗哮喘,只要用量恰当,吸入的方法正确,可以减少哮喘发作的次数和减轻哮喘发作的程度。     

丙酸氟替卡松联合斯奇康治疗儿童哮喘对肺功能的影响

目的:观察哮喘患儿吸入丙酸氟替卡松(辅舒酮)和注射斯奇康治疗后对肺功能的影响程度。方法:应用MasterScope儿童肺功能仪对儿童哮喘进行用药前后肺功能指标测定。结果:在受检20例患儿中,治疗前后其肺功能指标除FVC、FEV1外,PEF、FEF25、FEF50、FEF75均有显著性差异(P<0.05)。结论:丙酸氟替卡松和斯奇康联合用于儿童哮喘的治疗及预防,对缓解症状和改善肺功能均能收到良好效果。