肺力咳合剂联合沙美特罗替卡松治疗儿童支气管哮喘的临床研究

目的探究肺力咳合剂联合沙美特罗替卡松粉吸入剂治疗儿童支气管哮喘的临床疗效。方法选取2016年12月—2018年12月天津市儿童医院收治的142例支气管哮喘患儿为研究对象,将所有患儿随机分为对照组和治疗组,每组各71例。对照组患儿吸入沙美特罗替卡松粉吸入剂,1吸/次,1次/d;治疗组在对照组治疗的基础上口服肺力咳合剂,10 mL/次,3次/d。两组患儿持续治疗3个月。观察两组的临床疗效,比较两组的临床症状缓解时间、肺功能指标、血气指标、血清炎性因子水平。结果治疗后,对照组和治疗组的总有效率分别为84.51%、95.77%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组患儿喘憋、咳嗽、肺部啰音消失时间显著短于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患儿第一秒用力呼气容积(FEV1)、用力肺活量(FVC)和FEV1/FVC均显著升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组患儿肺功能指标明显高于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患儿全血氧分压(pO_2)水平明显升高,二氧化碳分压(pCO_2)水平明显下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组患儿血气指标水平显著优于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患儿肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平均显著降低,干扰素-γ(IFN-γ)水平显著升高,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组患儿血清炎性因子水平明显优于对照组,两组比较差异有统计学意义(P0.05)。结论肺力咳合剂联合沙美特罗替卡松粉吸入剂治疗儿童支气管哮喘具有较好的临床疗效,可缩短临床症状缓解时间,改善肺部功能,降低血清炎性因子水平,具有一定的临床推广应用价值。     

不同剂量沙美特罗替卡松粉吸入剂对COPD患者肺功能及炎性因子的影响

目的 探讨不同剂量沙美特罗替卡松粉吸入剂对慢性阻塞性肺疾病(COPD)患者肺功能及炎性因子的影响.方法 选取2019年5月—2020年5月收治的120例COPD为研究对象,按照沙美特罗替卡松粉吸入剂给药剂量不同分为观察组与对照组,每组60例.两组均予基础治疗,同时对照组和观察组分别给予沙美特罗替卡松粉吸入剂50μg/2...     

异丙托溴铵和沙美特罗/替卡松粉联合吸入治疗慢性阻塞性肺疾病稳定期疗效观察

目的探讨异丙托溴铵和沙美特罗/替卡松粉联合吸入治疗慢性阻塞性肺疾病的临床效果。方法选择我院2009年5月至2011年5月慢性阻塞性肺疾病患者82例,随机分为两组,观察组和对照组各41例。观察组给予异丙托溴铵和沙美特罗/替卡松粉联合吸入治疗;对照组给予异丙托溴铵吸入治疗。两组均连续治疗6个月。结果观察组治疗后呼吸问卷评分与对照组比较,差异有统计学意义(P<0.05);观察组治疗后的一秒用力呼气容积/用力肺活量和一秒用力呼气容积显著优于对照组,差异有统计学意义(P<0.05)。结论异丙托溴铵和沙美特罗/替卡松粉联合吸入治疗能有效地改善慢性阻塞性肺疾病稳定期患者的肺功能,缓解临床症状,值得在临床广泛推广。     

沙美特罗联合氟替卡松治疗支气管哮喘临床观察

目的观察沙美特罗联合氟替卡松治疗支气管哮喘的临床效果。方法90例支气管哮喘患者随机分为治疗组和对照组各45例。对照组予以抗感染、吸氧、止咳化痰等综合治疗,治疗组在对照组基础上联合应用丙酸氟替卡松和沙美特罗吸入治疗,分别在治疗前和治疗3个月后进行1s用力呼气容积（FEV1）、用力肺活量（FVC）和呼气峰流量（PEF）测定。并对哮喘症状进行评分。结果2组治疗后FEV1、FVC、PEF均升高,差异均有统计学意义（P〈0.05）,且治疗组改善情况优于对照组,差异均有统计学意义（P〈0.05）;2组治疗后哮喘症状评分均降低,差异均有统计学意义（P〈0.05）,且治疗组改善情况优于对照组,差异有统计学意义（P〈0.05）。结论联合吸入沙美特罗和氟替卡松治疗支气管哮喘能够达到哮喘控制,具有良好的疗效。     

The pharmacology of salmeterol

The pharmacology of salmeterol hydroxynaphthoate (SALM) has been investigated in respiratory tissues in vitro and in animal models in vivo. In guinea pig trachea and human bronchial smooth muscle, SALM was more potent than isoprenaline (ISO), salbutamol (SALB), and clenbuterol (CLEN). The duration of action was >7 h, whereas that for ISO, SALB, and CLEN was 2, 11, and 45 min, respectively. The sustained activity of SALM was reversed by sotalol, but was reestablished when theβ-blocker was removed. SALM was >3000-fold weaker than ISO in cardiac tissues, indicating highβ ₂-adrenoceptor selectivity. In the conscious guinea pig, aerosolized SALM, SALB, and CLEN caused dose-related bronchodilatation. The activity of SALM persisted for at least 6 h, compared with <2 h for SALB and CLEN. SALM is also a potent inhibitor of mediator release from human lung, this effect being sustained for up to 20 hours. In guinea pig airways in vivo, SALM inhibited histamine-induced plasma protein extravasation for ∼8 h. Salmeterol is a potent and selectiveβ ₂-adrenoceptor agonist with a unique profile of action. It induces persistent bronchodilatation, sustained suppression of mediator release, and long-lasting inhibition of edema formation. This combination of properties may represent an important new advance in the treatment of bronchial asthma.     

Salmeterol/fluticasone through breath-actuated inhaler versus pMDI: a randomized,double-blind, 12 weeks study

Objective: Salmeterol/fluticasone combination (SFC) formulated in a breath-actuated inhaler (BAI) overcomes the co-ordination problem associated with the pressurized-metered dose inhaler (pMDIs). Our aim was to compare the efficacy and the safety of SFC given through the BAI versus the conventional pMDI in moderate-to-severe asthmatics. Methods: In this randomized, double-blind, double-dummy, prospective, active-controlled, parallel group, multicenter, 12 weeks study, 150 asthmatics were randomized to receive SFC (25/125?mcg) through either BAI or pMDI. The primary efficacy endpoint was mean change in pre-dose morning PEFR value at 12 weeks and the secondary efficacy endpoints included, mean change in FEV_1, pre-bronchodilator FVC, pre-dose morning and evening PEFR, symptom scores at 2, 4, 8, and 12 weeks. Patient preferences for device and safety were also assessed. Results: At 12 weeks, the mean change in pre-dose morning PEFR in BAI and pMDI groups was 50.72?L/min and 48.82?L/min, respectively (p?<?0.0001; both groups) and the difference between the two groups was not significant. Both the treatment groups showed a statistically significant improvement in secondary endpoints at all-time points compared with baseline. The usability questionnaire assessment results showed that the BAI device was preferred by 75% of patients as compared with 25% preferring pMDI. SFC in both BAI and pMDI devices was found to be safe and well tolerated. Conclusion: This is the first study to demonstrate that SFC given through the BAI produces comparable efficacy and safety endpoints as pMDI. Additionally, BAI was the preferred inhaler by patients compared to conventional pMDI.     

沙美特罗/丙酸氟替卡松干粉剂吸入治疗成人支气管哮喘60例疗效观察

目的:探讨沙美特罗/丙酸氟替卡松干粉剂(商品名:舒利迭,葛兰素史克公司出品)吸入治疗支气管哮喘的疗效。方法:90例患者随机分为2组,治疗组采用沙美特罗/丙酸氟替卡松干粉剂50/250"g每日2次吸入,对照组采用丙酸氟替卡松气雾剂(商品名:辅舒酮,葛兰素史克公司出品)250"g每日2次吸入,治疗第4、8周两次评价患者哮喘症状和疗效。结果:在治疗第4、8周,治疗组哮喘症状和对照组相比明显减轻。结论:舒利迭为沙美特罗/丙酸氟替卡松混合吸入剂,是控制哮喘的一个良好选择。     

噻托溴铵联合福莫特罗与沙美特罗替卡松治疗稳定期慢性阻塞性肺疾病的疗效观察

目的 探讨噻托溴铵联合福莫特罗治疗稳定期慢性阻塞性肺疾病患者的临床疗效.方法 选取我院诊治的130例中重度慢性阻塞性肺疾病患者.采用数字表法随机分为噻托溴铵联合福莫特罗组(A组)和沙美特罗替卡松组(B组),每组各65例,治疗12周后,比较2组的肺功能(第1秒用力肺活量、用力肺活量)和CAT评分.结果 治疗12周后,2组患者FEV1、FVC及CAT评分较治疗前均明显增高,治疗前后比较差异均有统计学意义(P＜0.05).治疗后,A组患者FEV1、FVC高于B组,2组比较差异有统计学意义(P＜0.05).CAT评分2组差异无统计学意义(P＞0.05).结论 治疗12周后,噻托溴铵联合福莫特罗组对中重度COPD患者的肺功能的提高明显优于沙美特罗替卡松.     

沙美特罗替卡松粉吸入剂对哮喘急性发作患者肺功能的影响

目的观察支气管哮喘急性发作患者应用沙美特罗替卡松粉(50μg/250μg)吸入剂治疗后的肺功能变化情况,探讨肺功能检测的临床应用价值。方法回顾性分析北京军区总医院呼吸内科2009年3月至2010年3月收治的106例支气管哮喘急性发作患者的临床资料。所有患者均用使用沙美特罗替卡松粉吸入剂进行治疗,12 h/次,2次/d。观察治疗后患者的肺功能变化情况,并用哮喘控制测试表(ACT)评价哮喘控制情况。结果治疗后患者的肺功能明显改善,1秒用力呼气容积,1秒用力呼气容积/用力呼气肺活量、呼气峰流量等反映肺功能的指标在治疗前后比较差异有统计学意义(P<0.05)。哮喘控制情况治疗前后比较差异有统计学意义(P<0.05)。无明显不良反应。结论沙美特罗替卡松粉吸入剂能改善支气管哮喘急性发作患者的肺功能。肺功能测定可作为评估哮喘控制程度的重要依据之一,具有一定的临床应用价值。     

沙美特罗替卡松吸入剂预防急性高原反应的效果观察

目的：观察沙美特罗替卡松粉吸入荆预防急性高原反应的效果。方法：55名青年随机分为沙美特罗组（n=31）和安慰剂组（n=24），自海拔1400m历时4天进入5200m，第2天开始，沙美特罗组每天早晚各吸入沙美特罗替卡松粉一个剂量（沙美特罗50μg，丙酸氟替卡松100μg），连续7天；安慰荆组用同样方法吸入少量生理盐水。以军用卫生标准GJB1098-91《急性高原反应的诊断和处理原则》随访观察第2天、4天、7天急性高原反应的严重程度、SaO2和脉率。结果：进入海拔5200m第7天安慰剂组急性高原反应症状较沙美特罗组严重（P〈0．05），第2天、4天安慰剂组脉率较沙美特罗组减慢（P〈0．05），SaO2两组无显著性意义（P〉0．05）。随访期间沙美特罗组发生一例高原脑水肿，安慰剂组发生一例高原肺水肿。结论：沙美特罗替卡松粉吸入剂预防急性高原反应无确切效果。