Efficacy of nebulized fluticasone propionate compared with oral prednisolone in children with an acute exacerbation of asthma

The aim of the present study was to investigate the efficacy and safety of nebulized fluticasone propionate (FP Nebules) compared with oral soluble prednisolone in children with an acute exacerbation of asthma. The study used an international, multi-centre, randomized, double-blind, parallel group design. Three hundred and twenty-one patients, aged 4-16 years old, who presented with an acute exacerbation of asthma, were randomly allocated to either nebulized FP (1 mg b.d.) or oral prednisolone (2 mg kg(-1) day(-1) for 4 days then 1 mg kg(-1) day(-1) for 3 days) for 7 days. Patients in the FP group showed a significantly greater increase in diary card morning peak expiratory flow (PEF) over 7 days compared with patients in the prednisolone group (difference = 9.51 min(-1), CI = 2.1, 16.8, P = 0.034). Similar increases for both treatments were shown for evening PEF. Clinic PEF improved with both treatments, but was significantly greater in patients taking FP after 7 days (difference = 11.41 min(-1), CI = 2.8, 20.0, P = 0.029). Both treatments reduced symptom scores to a similar extent. The two treatments were well tolerated, and there was no difference in the incidence of adverse events. The present study demonstrated that nebulized FP is at least as effective as oral prednisolone in the treatment of children presenting with an acute exacerbation of asthma.     

沙美特罗替卡松治疗支气管哮喘的临床效果研究

目的探讨分析沙美特罗替卡松粉吸入剂治疗支气管哮喘的临床疗效。方法回顾性分析2009年4月～2012年5月本院收治的100例支气管哮喘患者临床资料,将100例患者随机分为两组,观察组50例患者使用沙美特罗替卡松粉吸入剂治疗,对照组50例患者采用布地奈德粉吸入治疗。比较两组患者治疗前后肺功能指标及临床症状变化。结果两组患者治疗后,临床症状、肺功能各项指标均有明显改善;治疗后观察组临床症状及肺功能改善情况明显优于对照组。结论沙美特罗替卡松粉吸入剂治疗支气管哮喘安全有效。     

沙美特罗／替卡松粉吸入剂对慢性阻塞性肺疾病患者糖代谢的影响

目的探讨沙美特罗／替卡松粉吸入剂对慢性阻塞性肺疾病患者糖代谢的影响。方法将稳定期慢性阻塞性肺疾病患者120例根据数字表法平分为两组,即治疗组与对照组各60例,对照组患者采用常规疗法．治疗组在对照组治疗基础上给予沙美特罗／替卡松吸人剂吸入治疗。结果经过观察,治疗后治疗组的FEV1、FEV1／FVC与PEF值明显高于对照组（P〈0．05）,表明其肺功能状况有了明显恢复。同时两组治疗前后的空腹血糖、餐后2h血糖比较差异均无统计学意义（P〉0．05）。结论沙美特罗／替卡松粉吸人剂的应用能在改善慢性阻塞性肺疾病患者肺功能状况的基础上,不影响糖代谢,值得临床推广应用。     

Detection of fluticasone propionate in horse plasma and urine following inhaled administration

Fluticasone propionate (FP) is an anti‐inflammatory agent with topical and inhaled applications commonly used in the treatment of asthma in steroid‐dependent individuals. The drug is used in racehorses to treat Inflammatory Airway Disease; this work was performed in order to advise on its use and detect potential misuse close to racing. Methods were developed for the extraction and analysis of FP from horse plasma and a carboxylic acid metabolite (FP‐17βCOOH) from horse urine. The methods utilize ultra high performance liquid chromatography coupled to tandem mass spectrometry (UPLC‐MS/MS) in order to detect the extremely low concentrations of analyte present in both matrices. The developed methods were used to analyse plasma and urine samples collected following inhaled administration of FP to six thoroughbred horses. FP was detected in plasma for a minimum of 72 h post‐administration and FP‐17βCOOH was detected in urine for approximately 18 h post‐administration. The results show that it is possible to detect FP in the horse following inhaled administration. Copyright © 2012 John Wiley & Sons, Ltd.     

清热涤痰定喘汤联合穴位贴敷治疗支气管哮喘随机平行对照研究

[目的]观察清热涤痰定喘汤联合穴位贴敷治疗支气管哮喘疗效。[方法]使用随机平行对照方法,将78例住院及门诊患者按随机数字表法分为两组。对照组39例氨茶碱,4~6mg/kg,3次/d;沙美特罗替卡松粉吸入剂,50/250ug,1吸/次,2次/d。治疗组39例清热涤痰定喘汤(荆芥、麻黄、黄芩各12g,炙百部、炙冬花、炙金沸草、射干各6g,石膏、法夏各10g,葶苈子、苏子、神曲、山楂、橘红各15g,芦根30g);1剂/d,水煎至300mL,3次/d。痰涎壅盛、苔白腻加复方蛇胆陈皮末;腑气不通加胖大海10g,瓜壳15g;口渴加天花粉15g;舌苔黄腻加滑石15g,木通12g,郁金10g,黄连3g。穴位敷帖:在患者大椎、气海、肺俞等穴位贴敷冬病夏治消喘贴膏,白芥子、细辛各21g,甘遂、元胡各12g,皂角20g,研细末生姜汁调膏敷贴;0.5~2h/次,如皮肤异常,将贴敷时间缩短。每年夏季入伏日期,1次/10d,共贴3次。连续治疗30d为1疗程。观测临床症状、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈25例,显效12例,无效2例,总有效率94.87%。对照组痊愈12例,显效16例,无效11例,总有效率71.79%。治疗组疗效优于对照组(P0.05)。[结论]清热涤痰定喘汤联合穴位贴敷治疗支气管哮喘效果显著,值得推广。     

固本平喘汤联合沙美特罗替卡松粉吸入治疗瘀血阻络型支气管哮喘慢性持续期随机平行对照研究

[目的]观察固本平喘汤联合沙美特罗替卡松粉吸入治疗支气管哮喘慢性持续期疗效。[方法]使用随机平行对照方法,将108例住院患者按抽签法随机分为两组。对照组54例沙美特罗替卡松粉吸入剂,1吸/次,2次/d。治疗组54例固本平喘汤(黄芪30g,补骨脂、党参各15g,甘草3g,五味子6g,麻黄、苦杏仁各10g,射干12g,桔梗、地龙各15g,全蝎、细辛各6g,紫菀、款冬花、法半夏、白芥子、桃仁打碎各12g),1剂/d,水煎200mL,早晚口服;沙美特罗替卡松粉吸入剂同对照组。连续治疗42d为1疗程。观测临床症状、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效25例,有效28例,无效1例,总有效率98.75%。对照组显效20例,有效27例,无效7例,总有效率87.05%。治疗组疗效优于对照组(P0.05)。[结论]固本平喘汤联合沙美特罗替卡松粉吸入剂治疗支气管哮喘慢性持续期效果显著,值得推广。     

舒利迭治疗对慢性阻塞性肺疾病患者肺功能及血清炎症因子的影响

目的探讨应用沙美特罗/氟替卡松粉吸入剂(舒利迭)在慢性阻塞性肺疾病(COPD)稳定期治疗中对肺功能和全身炎症标记物的影响。方法选取2011年11月至2012年11月在潍坊市人民医院治疗的COPD稳定期患者60例作为研究对象。将所有患者随机分为实验组和对照组,每组各30例。对照组患者给予为期8周的常规止咳、平喘、吸氧等对症支持治疗;实验组在与对照组患者相同治疗的基础上加用沙美特罗/氟替卡松粉吸入剂(舒利迭)治疗,为期8周,单次剂量为50/500μg,每日两次。观察患者治疗前及治疗8周后血清可溶性细胞间黏附分子-1和白细胞介素IL-6、IL-8、IL-17等指标,同时观察两组患者肺功能的变化。结果实验组稳定期COPD患者血清可溶性细胞间黏附分子-1浓度在治疗前后变化差异有统计学意义(P<0.05)。实验组患者治疗后血清IL-6、IL-8、IL-17的水平较治疗前明显降低,差异有统计学意义(P<0.05)。实验组患者肺功能指标FVC、FEV1、FEV1/FVC%在治疗前后有明显统计学差异(P<0.05)。结论通过吸入沙美特罗/氟替卡松粉吸入剂可以明显改善慢性阻塞性肺疾病患者肺功能,降低患者血清中可溶性细胞间黏附分子-1及IL-6、IL-8、IL-17的水平,减轻气道炎性细胞浸润。     

沙美特罗替卡松粉吸入剂治疗儿童哮喘疗效观察

目的探讨沙美特罗替卡松粉吸入剂(商品名舒利迭Seretide,葛兰素史克公司生产)治疗儿童哮喘的疗效及副作用.方法62例儿童哮喘按就诊顺序随机分成两组,治疗组患儿按病情严重程度分别予舒利迭50/100、100/200、150/300μg·d-1吸入,对照组按病情严重分别予丙酸氟替卡松吸入剂(商品名辅舒酮,葛兰素史克公司生产)125、250、375μg-1吸入,分别于治疗后4、8、12周评价其日、夜间哮喘症状计分及PEFR值变化.结果治疗后4、8、12周,治疗组与对照组相比,患儿日夜间哮喘症状计分明显减少(P＜0.01);治疗组PEFR值占预计值的百分比与对照组相比明显改善(P＜0.05),差异非常显著.且两组患儿在治疗期间均未发现明显副作用.结论联合应用糖皮质激素和长效β2-肾上腺素受体激动剂具有协同抗炎和平喘作用,且联合使用时可以减少糖皮质激素的用量,减少较大剂量的糖皮质激素的不良反应.舒利迭就是含有沙美特罗和丙酸氟替卡松的混合干粉吸入剂,用舒利迭治疗不同程度的儿童哮喘疗效明显优于辅舒酮.