Does Low FEV1 in Addition to Fixed Ratio and/or Lower Limit of Normal of FEV1/FVC Improve Prediction of Mortality in COPD? The NHANES-III-linked-mortality Cohort

Purpose

There is presently an ongoing debate on the relative merits of suggested criteria for spirometric airway obstruction. This study tests the null hypothesis that no superiority exists with the use of fixed ratio (FR) of forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) < 0.7 versus less than lower limit predicted (LLN) criteria with or without FEV1 <80% predicted in regards to future mortality.

中西医结合治疗支气管哮喘的临床观察

为了探讨支气管哮喘的治疗方法,将本病患者87例随机分为中西医结合治疗组46例和西药对照组41例,治疗组用中西医结合方法治疗,对照组单纯用西医方法治疗;观察两组症状、体征治疗前后的变化.治疗组总有效率86.96%,对照组总有效率73.81%,两组疗效有显著性差异(P＜0.05);肺功能改善治疗组明显优于对照组.应用中西医结合方法治疗支气管哮喘的疗效明显优于单用西医治疗.     

定喘汤加减治疗老年急性发作期哮喘临床研究

目的:观察定喘汤加减辅助治疗老年急性发作期哮喘的临床疗效。方法:90例老年急性发作期哮喘患者按随机数字表法平均分为对照组和观察组。对照组45例予以常规疗法治疗,观察组45例在对照组治疗基础上予以定喘汤加减治疗。比较两组临床症状,肺功能变化,炎症介质,血清Ig E、NO及超氧化物歧化酶(superoxide dismutase,SOD)水平,临床疗效及并发症状况。结果:对照组有效率75.56%低于观察组有效率91.11%,差异具有统计学意义(P0.05)。与对照组比较,观察组治疗后喘憋、咳嗽、肺部湿啰音及哮鸣音缓解时间缩短,治疗后第1秒用力呼气量(forced expiratory volume in 1 second,FEV1)、用力肺活量(forced vital capacity,FVC)、FEV1%和FEV1/FVC显著升高,差异均有具有统计学意义(P0.05);治疗后血清白细胞介素-4(interleukin 4,IL-4)、IL-8、IL-9水平降低,IL-10水平升高,差异均有具有统计学意义(P0.05);治疗后血清Ig E及NO水平降低,SOD水平升高,差异均有具有统计学意义(P0.05)。结论:定喘汤加减辅助治疗老年急性发作期哮喘临床疗效显著,同时能改善肺功能及缓解炎症反应。     

脾虚复合肺纤维化影响大鼠肺功能的初步研究

目的观察灌胃大黄致脾虚后复合博莱霉素造模对大鼠肺功能的影响,以探讨脾虚与肺纤维化的关系。方法将SD大鼠随机分为正常组、脾虚组、模型组、复合组,采用灌胃大黄加饥饱失常30 d的方法建立脾虚模型,然后采用气管内注射博莱霉素(5 mg/kg)复合肺纤维化造模,模拟脾虚证候下罹患肺纤维化。注射博莱霉素4周后检测动物肺功能,计算脏器系数,HE和Masson染色观察肺组织大体及气道病理变化。结果模型组与正常组比较,肺脏质量、肺系数升高(P0.05),肺动态顺应性(Cydn)、用力肺活量(FVC)、质量FVC下降(P0.05),第0.4秒用力呼气容积占用力肺活量的百分比(0.4秒率,FEV0.4/FVC%)增加(P0.05),用力最大呼气流速(PEF)、最大呼气中期流速(MMF)下降(P0.05),病理显示气管内注射博莱霉素所致肺纤维化为气道中心性分布,小气道内可见上皮细胞脱落及黏液栓。单纯脾虚动物停止脾虚造模后各项肺功能指标正常。脾虚复合组与模型组比较,0.4秒率显著升高(P0.05),病理显示肺组织纤维化区域占比增加。结论灌胃大黄加饥饱失常30 d造成脾虚是复合气管内注射博莱霉素造成的肺纤维化大鼠限制性通气功能障碍加重的潜在不利因素。     

Obesity-associated severe asthma in an adult Japanese population

Background

Severe asthma is increasingly being recognized as an important public health issue. Obesity has been identified as a risk factor for poor asthma control and for worsening of asthma severity. However, most studies investigating obese patients with asthma have been performed in Western countries. Reports on the characteristics of obese Japanese individuals with severe asthma are lacking. Herein, we investigated the clinical characteristics of patients with obesity-associated severe asthma in a Japanese population and the association between obesity and poor asthma control.