吸入氟替卡松联用孟鲁司特对婴幼儿哮喘的防治作用

目的 观察吸入氟替卡松的基础上联合应用孟鲁司特在婴幼儿哮喘防治中的作用.方法 采用随机分组方法,将63例中-重度婴幼儿哮喘患者分3组吸入氟替卡松联用孟鲁司特组为A组(n=24)、单吸入氟替卡松为B组(n=22)、把不依从治疗者的作对照组C组(n=17)进行6个月的治疗,观察各组患儿在6个月的研究期中发生急性发作时的哮喘症状评分、每次发作持续的天数、发作次数和全身使用糖皮质激素的总量.结果 规律吸入氟替卡松并联合每天口服孟鲁司特组的患儿哮喘的症状评分、每次发作持续的天数、发作次数和全身使用糖皮质激素的总量明显低于单吸入氟替卡松组和对照组,(P＜0.01);单吸入氟替卡松组的患儿哮喘症状评分、每次发作持续的天数、发作次数和全身使用糖皮质激素的总量也明显低于对照组.(P＜0.01).结论 在吸入氟替卡松的基础上联合应用孟鲁司特可显著提高婴幼儿哮喘的疗效.同时减少全身糖皮质激素使用量.     

孟鲁司特钠联合氟替卡松治疗支气管哮喘患者有效率及其对肺功能影响分析

目的:分析孟鲁司特钠联合氟替卡松治疗支气管哮喘患者的临床疗效及其对肺功能影响。方法:将2015年5月~2018年5月间我院治疗的190例支气管哮喘患者随机分为治疗组和对照组。治疗组应用孟鲁司特钠联合氟替卡松治疗,对照组单独应用氟替卡松治疗,分析两组的疗效。结果:治疗组的总有效率、肺功能及生活质量均优于对照组,差异均具统计学意义(P<0.05)。结论:孟鲁司特钠联合氟替卡松治疗支气管哮喘患者的临床疗效显著。     

丙酸氟替卡松联合孟鲁司特对儿童轻度支气管哮喘气道功能的影响

目的观察丙酸氟替卡松吸入联合孟鲁司特对儿童轻度支气管哮喘患者气道功能的影响。方法 181例轻度支气管哮喘患儿随机分为观察组91例和对照组90例。两组均在常规治疗基础上予丙酸氟替卡松吸入,对照组加用氨茶碱,观察组加用孟鲁司特钠片。观察两组临床控制率及气道功能的变化。结果观察组临床控制率高于对照组,治疗后大气道功能指标3项中的2项,小气道功能中的3项指标均高于对照组,差异有统计学意义。结论丙酸氟替卡松吸入联合孟鲁司特治疗儿童轻度支气管哮喘可提高临床控制率,大、小气道功能改善情况,尤其是小气道收缩逆转改善更加明显,可降低气道高反应性。     

评价口服孟鲁司特联合吸入沙美特罗替卡松治疗支气管哮喘的疗效及安全性

目的探究口服孟鲁司特联合吸入沙美特罗替卡松治疗支气管哮喘的疗效及安全性。方法收集我院2016年4月至2017年5月支气管哮喘患者68例患者治疗资料进行回顾分析,根据用药不同将68例患者分成观察组和对照组,其中对照组34例患者单用孟鲁司特口服治疗,观察组患者采用孟鲁司特联合吸入沙美特罗替卡松,对比评估两组患者的用药安全性。结果观察组94.12%疗效显著高于对照组67.65%,具有统计学意义(P<0.05),治疗后观察组显著优于对照组患者(P<0.05),具有统计学意义。结论口服孟鲁司特联合吸入沙美特罗替卡松治疗支气管哮喘的疗效明确,能够有效改善患者肺功能,提高用药安全性,值得在临床治疗支气管哮喘中推广应用。     

孟鲁司特钠联合丙酸氟替卡松治疗小儿咳嗽变异性哮喘的临床效果及安全性

目的 观察孟鲁司特钠联合丙酸氟替卡松治疗小儿咳嗽变异性哮喘的临床效果及安全性.方法选取2018年1月-2019年6月柳州市中医医院收治的小儿咳嗽变异性哮喘患儿104例,遵照随机双盲法分为观察组和对照组,各52例.对照组给予单一孟鲁司特钠咀嚼片治疗,观察组在对照组基础上加用丙酸氟替卡松吸入气雾剂治疗.比较2组患儿治疗效果...     

孟鲁司特联合丙酸氟替卡松治疗支气管哮喘的疗效

目的观察并分析孟鲁司特联合丙酸氟替卡松治疗支气管哮喘的疗效。方法以我院2017年3月至2018年3月期间收治的78例支气管哮喘患者为分析对象,分为两组,对照组(n=39)给予丙酸氟替卡松进行治疗,观察组(n=39)给予孟鲁司特联合丙酸氟替卡松进行治疗,对这两种方法的临床治疗效果进行对比。结果观察组治疗总有效率高达92.31%,显著高于对照组的74.36%,<0.05;且观察组患者出现不良反应发生率7.70%,比对照组的15.38%低,两组差异显著,P <0.05。结论在治疗支气管哮喘中采用孟鲁司特联合丙酸氟替卡松的疗效突出,值得推广实施。     

孟鲁司特钠联合沙美特罗/氟替卡松治疗慢性持续期哮喘疗效分析

目的研究孟鲁司特钠联合沙美特罗/氟替卡松治疗慢性持续期哮喘的临床疗效。方法对80例慢性持续期哮喘门诊患者进行随机分组对照研究。治疗组40例,对照组40例。治疗组予孟鲁司特钠(10mg每晚口服1次)联合沙美特罗/氟替卡松(舒利迭粉吸入剂50μg/250μg)早晚各一吸。对照组仅予沙美特罗/氟替卡松。治疗6个月,观察两组治疗前后临床症状及肺功能(FEV1%、FEV1/FVC%、PEF%)情况,观察药物不良反应。结果治疗组与对照组比较,临床症状完全控制率及肺功能有明显改善,差别有统计学意义(P<0.01)。结论孟鲁司特联合沙美特罗/氟替卡松,治疗支气管哮喘疗效明显,值得推广。     

孟鲁司特钠联合氟替卡松治疗儿童哮喘疗效的Meta分析

]目的：评价孟鲁司特钠联合氟替卡松治疗儿童哮喘的疗效和安全性。方法：检索the Cochrance Library, PubMed、EMBase、CBM、Science Direct, 中国知网、万方及维普数据库,纳入孟鲁司特钠联合氟替卡松治疗儿童哮喘的随机对照试验,观察组采用孟鲁司特钠氟替卡松吸入治疗,对照组单用氟替卡松吸入治疗,提取符合纳入标准的临床研究文献信息,采用RevMan5.3软件对纳入文献进行质量评价和Meta分析。结果：共纳入13篇中文文献,包括1 440例受试者。Meta分析结果显示,观察组总有效率及肺功能指标第一秒用力呼气容积（FEV1）、用力肺活量（FVC）高于对照组（P<0.01）;观察组复发率低于对照组（P<0.01）。结论：孟鲁司特钠联合氟替卡松吸入治疗儿童哮喘临床治疗效果显著。     

孟鲁司特钠联合沙美特罗/氟替卡松对咳嗽变异型哮喘的治疗效果探讨

目的探讨孟鲁司特钠联合沙美特罗/氟替卡松对咳嗽变异型哮喘的治疗效果。方法选取我院2016年3月至2017年3月收治的60例咳嗽变异型哮喘患者,按照患者入院顺序分为观察组30例和对照组30例,其中对照组使用沙美特罗/氟替卡松治疗,观察组在对照组的基础上联合使用孟鲁司特治疗,观察两组的临床疗效和不良反应情况。结果观察组总有效率显著高于对照组、观察组治疗后肺功能改善情况显著优于对照组(P <0.05)、两组均为出现严重的不良反应情况(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,可以有效的改善患者的肺功能,降低不良反应发生率,临床效果更好,值得临床进一步推广。     

口服孟鲁司特联合吸入沙美特罗替卡松治疗支气管哮喘的疗效及安全性

目的探析口服孟鲁司特联合吸入沙美特罗替卡松治疗支气管哮喘的疗效及安全性。方法对我院2015年1月至2016年6月收治的80例支气管哮喘患者予以研究,根据数字表法分为对照组与观察组,各40例。对照组给予孟鲁司特治疗,观察组给予孟鲁司特联合沙美特罗替卡松治疗,对比两组患者的治疗效果。结果观察组患者临床总有效率是92.5%,明显高于对照组患者的75.0%,组间比较差异存在统计学意义(P<0.05),且两组患者均未出现不良反应。结论对支气管哮喘患者施行孟鲁司特联合沙美特罗替卡松治疗,能够有效提高临床疗效,具有安全、可靠的特点,可作为临床首先治疗方法予以推广应用。     

Inhaled salmeterol/fluticasone propionate: a review of its use in asthma

Salmeterol/fluticasone propionate, administered twice daily via a multidose dry powder inhaler (Seretide/Advair Diskus), Seretide Accuhaler or metered-dose hydrofluoroalkane (chlorofluorocarbon-free) inhaler (Seretide Evohaler), is a combination of the long-acting beta(2)-adrenoceptor agonist (beta(2)-agonist) [LABA] salmeterol and the corticosteroid fluticasone propionate.Maintenance therapy with combined salmeterol/fluticasone propionate is at least as effective in improving lung function and symptoms and is as well tolerated in patients with asthma as concurrent salmeterol plus fluticasone propionate. In patients previously receiving as-required short-acting beta(2)-agonists (SABAs) or inhaled corticosteroids, salmeterol/fluticasone propionate was significantly more effective in providing asthma control than fluticasone propionate and in improving lung function and asthma symptoms than inhaled corticosteroids (at equivalent or higher dosages), salmeterol or montelukast (as monotherapy or in combination with fluticasone propionate). Salmeterol/fluticasone propionate was more effective in improving asthma symptoms than adjusted-dose budesonide/formoterol in patients with uncontrolled asthma despite treatment with inhaled corticosteroids with or without a LABA in a well designed 1-year study. In pharmacoeconomic analyses, salmeterol/fluticasone propionate compared favourably with inhaled corticosteroids and mono- or combination therapy with oral montelukast. Salmeterol/fluticasone propionate is, therefore, an effective, well tolerated and cost-effective option for the maintenance treatment of patients with asthma.     

Inhaled salmeterol/fluticasone propionate combination: a pharmacoeconomic review of its use in the management of asthma

Asthma guidelines recommend an inhaled corticosteroid plus a long-acting inhaled beta(2)-agonist (beta(2)-adrenoceptor agonist) as the preferred maintenance therapy for moderate and severe persistent asthma. Advair/Seretide Diskus also registered as Accuhaler is fixed-dose salmeterol (a long-acting inhaled beta(2)-agonist) and fluticasone propionate (a corticosteroid) administered via a single powder inhalation device. The clinical effectiveness of salmeterol/fluticasone propionate in patients with persistent asthma symptoms has been established in comparative clinical trials. Pharmacoeconomic analyses, based on data from these clinical trials, have been conducted from a healthcare payer perspective in various countries. In patients with asthma not controlled with inhaled corticosteroids, salmeterol/fluticasone propionate was associated with more favourable (lower) cost-effectiveness ratios than fluticasone propionate monotherapy, oral montelukast plus inhaled fluticasone propionate, inhaled budesonide, and inhaled formoterol plus budesonide. As the initial maintenance therapy in patients with persistent asthma symptoms while receiving short-acting beta(2)-agonists alone, salmeterol/fluticasone propionate was cost effective relative to montelukast monotherapy. Although the total cost of asthma management tended to be slightly higher with salmeterol/fluticasone propionate than with fluticasone propionate or montelukast monotherapy, salmeterol/fluticasone propionate consistently had a more favourable cost-effectiveness ratio in terms of per successfully treated week or symptom-free day and/or was associated with small incremental costs to achieve significant additional clinical benefits. In clinical practice, salmeterol plus fluticasone propionate was associated with lower asthma-related costs than treatment with other maintenance therapies.In patients with asthma symptoms despite treatment with inhaled corticosteroids, salmeterol/fluticasone propionate produced clinically meaningful improvements in overall Asthma Quality of Life Questionnaire (AQLQ) scores relative to salmeterol or placebo monotherapy, in emotional function domain scores relative to fluticasone propionate or budesonide, and in asthma symptoms domain scores relative to budesonide. In patients with persistent asthma symptoms while receiving short-acting beta(2)-agonists alone, salmeterol/fluticasone propionate produced clinically meaningful improvements in overall AQLQ scores compared with fluticasone propionate or montelukast. CONCLUSIONS: Pharmacoeconomic analyses indicate that salmeterol/fluticasone propionate administered via a single inhaler represents a cost-effective treatment option (relative to fluticasone propionate at the same nominal dosage, budesonide, formoterol plus budesonide and montelukast plus fluticasone propionate) in patients with asthma not controlled with inhaled corticosteroid therapy. In patients with asthma not controlled with short-acting beta(2)-agonists alone, salmeterol/fluticasone propionate is a cost effective treatment relative to monotherapy with montelukast. Importantly, salmeterol/fluticasone propionate is also associated with improvements in health-related quality of life.     

沙美特罗丙酸氟替卡松联合孟鲁司特钠治疗咳嗽变异型哮喘的疗效观察

目的 观察沙美特罗丙酸氟替卡松联合孟鲁司特钠治疗成人咳嗽变异型哮喘的疗效.方法 采用完全随机对照试验方法将93例咳嗽变异型哮喘患者分为3组各31例,观察组吸入沙美特罗/丙酸氟替卡松(50 μg/250 μg)1吸,早晚各1次,孟鲁司特钠10 mg/次,顿服,共8周.沙美特罗/丙酸氟替卡松组吸入沙美特罗/丙酸氟替卡松(50 μg/250μg)1吸,早晚各1次,共8周.孟鲁司特钠组服用孟鲁司特钠10 mg/次,顿服,共8周.比较3组患者症状改善和肺功能变化情况.结果 治疗后症状积分均较治疗前低,差异有统计学意义(P＜0.05),3组组间差异有统计学意义(P＜0.05).8周治疗后观察组、沙美特罗/丙酸氟替卡松组和孟鲁司特钠组第1秒用力呼气容积(FEV1)、FEV1占预计值的百分比(FEV1％)、呼气峰流速(PEF)与治疗前比较差异均有统计学意义(均P＜0.05);治疗后观察组FEV1、FEV1％、PEF高于沙美特罗/丙酸氟替卡松组及孟鲁司特钠组,差异均有统计学意义[ FEV1:(1.65±0.52)L比(1.52±0.63)L,(1.46±0.53)L;FEV1％:(64.41±10.31)％比(62.81±11.03)％,(59.02±11.19)％; PEF:(5.24±1.15) L/min比(6.10±1.28) L/min,(6.62±1.00) L/min,均P＜0.05].结论 沙美特罗/丙酸氟替卡松与孟鲁司特钠联合应用治疗咳嗽变异型哮喘疗效优于单用沙美特罗/丙酸氟替卡松或孟鲁司特钠.     

丙酸氟替卡松与孟鲁司特对儿童感染后咳嗽疗效的对比观察

目的观察感染后咳嗽儿童在分别接受丙酸氟替卡松与孟鲁司特治疗后的症状改变,比较两药在治疗儿童感染后咳嗽中的疗效。方法以本院2010年5月～2011年12月诊断感染后咳嗽的3岁以上患儿为研究对象,分为3组:仅予常规治疗的对照组、常规+丙酸氟替卡松治疗组、常规+孟鲁司特钠治疗组,研究结束后共收集病例66例,其中,对照组19例、丙酸氟替卡松治疗组24例、孟鲁司特钠治疗组23例,疗程2周。监测患儿治疗后咳嗽症状积分变化,比较患儿咳嗽开始缓解的天数、达到显效的天数和达到痊愈的天数,比较各组患儿最终痊愈例数、显效例数、缓解例数、无效例数以及治疗有效率。结果入组前3组患儿咳嗽症状积分差异无统计学意义(P>0.05),治疗前、后各组患儿咳嗽症状积分均明显下降,治疗组下降幅度尤为显著(对照组P<0.05,治疗组P<0.01),两治疗组在缩短咳嗽持续时间及治疗有效率等方面明显优于对照组(P<0.01),而丙酸氟替卡松组治疗后达痊愈例数比孟鲁司特组显著增多(P<0.05),其他观察指标与孟鲁司特组比较,差异无统计学意义(P>0.05)。结论丙酸氟替卡松与孟鲁司特在儿童感染后咳嗽治疗中均具有较好的疗效,两者比较,丙酸氟替卡松的总治疗有效率更高,咳嗽症状改善更快。     

孟鲁司特治疗咳嗽变异性哮喘的临床效果观察

目的 探讨孟鲁司特口服治疗咳嗽变异性哮喘的临床效果.方法 将234例咳嗽变异性哮喘患儿随机分为治疗组（126例）和对照组（108例）,治疗组给予口服孟鲁司特治疗,对照组给予口服盐酸丙卡特罗和吸入丙酸氟替卡松治疗,疗程为3个月,比较两组的临床疗效.结果 对照组显效84例,有效17例,无效7例,总有效率为93.5％;治疗组显效102例,有效20例,无效4例,总有效率为96.8％;两组总有效率比较差异无统计学意义（χ2=0.2896,P＞0.05）.结论 孟鲁司特治疗咳嗽变异性哮喘效果显著,应用更加方便.     

单独和联合应用孟鲁司特、沙美特罗替卡松治疗成人感染后咳嗽的疗效比较

目的:评价单独和联合应用孟鲁司特、沙美特罗替卡松治疗成人感染后咳嗽的疗效。方法:68例感染后咳嗽的患者(日间或夜间咳嗽症状积分在3分以上者)随机分为孟鲁司特组、沙美特罗替卡松组、孟鲁司特与沙美特罗替卡松联合治疗组(简称联合用药组),连用2周。在治疗前、治疗2周后分别记录患者的咳嗽症状积分,比较3组疗效和肺功能变化。结果:治疗2周后,孟鲁司特组、沙美特罗替卡松组、联合用药组咳嗽症状评分分别为3.67±1.72、2.79±1.50、1.81±1.01,较治疗前均有降低;治疗后3组间比较,联合用药组较孟鲁司特组、沙美特罗替卡松组差异均有统计学意义(P<0.05)。孟鲁司特组、沙美特罗替卡松组、联合用药组的有效率分别为73.9%、68.2%、87.0%,联合用药组较孟鲁司特组、沙美特罗替卡松组差异均有统计学意义(P<0.05)。3组FEV1/预计值、FEV1/FVC在治疗前、后比较及组间比较,差异均无统计学意义(P>0.05)。结论:孟鲁司特、沙美特罗替卡松对成人感染后咳嗽均有明显的疗效,并且两药联合可能具有协同作用,可为成人感染后咳嗽提供一种治疗选择。     

沙美特罗氟替卡松联合孟鲁司特钠治疗慢性支气管炎临床观察

目的：对在慢性支气管炎治疗中,运用沙美特罗氟替卡松粉吸入剂与孟鲁司特钠的效果进行观察。方法：通过随机对照研究,对比观察组采用沙美特罗氟替卡松联合孟鲁司特钠治疗,对照组采用沙美特罗氟替卡松治疗的临床效果及肺功能改善情况。结果：观察组总有效率为92.59%,对照组总有效率为70.37%;观察组肺功能各项指标改善效果更加显著。结论：在慢性支气管炎治疗中,采用沙美特罗氟替卡松粉吸入剂与孟鲁司特钠进行联合治疗效果显著。     

孟鲁司特联合吸入糖皮质激素治疗小儿中度持续哮喘的疗效及机制

目的 观察孟鲁司特联合吸入糖皮质激素治疗小儿中度持续哮喘的临床疗效及探讨孟鲁司特的抗炎机制。方法 采用随机分组的方法，将60例2～5岁的中度持续哮喘患儿分为两组：孟鲁司特4mg／d口服联合吸入布地奈德200ug／d为A组（n=30）、单纯吸入布地奈德200ug／d为B组（n=30）进行3个月的治疗，于治疗开始、治疗第4周和第3个月进行临床评估，同时检测血清半胱氨酰白三烯（CysLTs）和IL-5水平。结果 治疗前，中度持续哮喘患儿血清CysLTs、IL-5水平均明显高于正常组（P〈0．01）；治疗3个月后，A组的患儿哮喘的症状评分、每次发作持续的天数、发作次数和全身使用糖皮质激素的总量均明显低于B组（P〈0．01），同时A组患儿血清CysLTs、IL-5水平较B组显著下降（P〈0．05，P〈0．01），而B组患儿治疗前后血清CysLTs水平差异无统计学意义（P〉0．05）。结论 孟鲁司特联合吸入糖皮质激素可佩著提高中度持续哮喘患儿的疗效，同时减少全身使用糖皮质激素的总量。孟鲁司特能降低中度持续哮喘患儿血清CysLTs、IL-5水平，抑制炎症介质释放，抑制效应可能是孟鲁司特抗哮喘呼吸道炎症的重要机制。     

Inhaled salmeterol/fluticasone propionate combination: a review of its use in persistent asthma

The long-acting beta2-agonist salmeterol and the corticosteroid fluticasone propionate are available as a combination inhalation device for the treatment of persistent asthma. Well designed studies in adults, adolescents and children aged > or =4 years, demonstrate that combined salmetero/fluticasone propionate 50/100, 50/250 and 50/500 microg administered via a dry powder inhaler (DPI) is clinically equivalent to concurrent delivery of the same dosages of the 2 drugs via separate DPIs. In adults and adolescents, combined salmeterol/fluticasone 50/100 and 50/250 microg twice daily produced rapid improvements in lung function that were consistently greater than those in patients receiving monotherapy twice daily salmeterol 50 microg, fluticasone propionate 100 or 250 microg or placebo in 2 well designed studies. Recipients of the combination had a significantly greater probability of completing 12 weeks of treatment than patients receiving monotherapy or placebo. The combination also produced significant improvements between baseline and end-point in all secondary outcome variables (morning and evening peak expiratory flow, daytime symptom scores, days and nights without asthma symptoms and requirements for as-needed beta-agonists) and health-related quality of life (QOL). Combination therapy was superior to monotherapy with salmeterol and placebo for all outcomes in both studies, and was superior to fluticasone propionate 100 microg for all but 1 outcome (nights without awakenings) in 1 study. Similar results were obtained in patients who had previously been using short acting beta2-agonists alone. Combined twice daily salmeterolfluticasone propionate 50/100 and 50/250 microg produced greater improvements in lung function than inhaled budesonide at higher dosages than fluticasone propionate in the combination. Combined salmeterol/fluticasone propionate 50/250 microg produced similar improvements in lung function to concurrent budesonide 800 microg plus formoterol 12 microg when given twice daily for 12 weeks. In another 12-week trial, combined salmeterol/fluticasone propionate 50/100 microg was more effective than oral montelukast 10 mg/day plus fluticasone propionate 100 microg twice daily in patients with suboptimally controlled asthma. Salmeterol/fluticasone is more cost effective than monotherapy with fluticasone propionate or budesonide. The most frequent adverse events associated with salmeterol/fluticasone propionate are headache, throat irritation, hoarseness and candidiasis. CONCLUSION: Combined salmeterol/fluticasone propionate is as effective as the 2 drugs given concurrently via separate inhalers and significantly more effective than either drug given alone at the same nominal dosage. The combination is also significantly more effective than montelukast plus fluticasone propionate or monotherapy with inhaled budesonide. Furthermore, the combination is more cost effective than inhaled corticosteroid monotherapy.