Objective To evaluate the efficacy of specific immunotherapy in combination with budesonide formoterol dry powder inhaler ( BUD/FM) in the treatment of moderate to severe bronchial asthma. Methods The data of 93 patients with moderate to severe asthma from September 2006 to September 2008 were analyzed. 46 cases who received BUD/FM therapy were recorded as a BUD/FM treatment group, and 47 cases who received BUD/FMand dustmite specific immunotherapy were recorded asa combination treatment group. After 6, 12, 18, and 24 months, asthma symptom scores, pulmonary function,effective rate, and scores of Asthma Quality of Life Questionnaire ( AQLQ) were compared in the two treatment groups. Results Compared with the BUD/FMtreatment group, the effective rate was significantlyhigher ( 83. 0% vs. 65. 2% , P lt;0. 05) , the lung function improvements in FEV1% pred and expiratory peak flow were more significant in the latter period of treatment, and AQLQ scores improved more significantly after 24 months’treatment in the combination treatment group. Conclusion For patients with moderate tosevere asthma, specific immunotherapy in combination with BUD/FMcan improve asthma symptoms and lung function with good compliance and long lasting efficacy.
Objective To investigate the efficacy and safety of nebulized budesonide for acute exacerbation of chronic obstructive pulmonary disease, and to formulate an evidence-based treatment protocol for a patient with acute exacerbation of chronic obstructive pulmonary disease. Methods We searched The Cochrane Library (Issue 4, 2009), MEDLINE (1990 to February 2010), ACP Journal Club (1991 to February 2010) and Chinese Journal Full-text Database (1979 to February 2010), and critically appraised the available evidence. Results Four randomized controlled trials were included, and all were of relatively high quality. Evidence showed that nebulized budesonide could alleviate symptoms, improve pulmonary function without any serious side effects. Given the current evidence, we used nebulized budesonide which helped the control of symptoms with no adverse effects. Conclusion Nebulised budesonide may be an effective and safe alternative to systemic corticosteroids in the treatment of acute exacerbation of chronic obstructive pulmonary disease.
ObjectiveTo systematically evaluate the efficacy and safety of budesonide/formoterol combined with tiotropium versus budesonide/formoterol alone for Chinese patients with COPD. MethodsWe electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 3, 2015), CNKI, VIP and WanFang Data to collect randomized controlled trials (RCTs) about budesonide/formoterol combined with tiotropium vs. budesonide/formoterol alone for Chinese COPD patients from inception to March 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was conducted by RevMan 5.3 software. ResultsA total of 15 studies involving 1123 Chinese patients were included. The results of meta-analysis showed that, compared with the budesonide/formoterol alone group, the budesonide/formoterol plus tiotropium group could significantly improve the levels of FEV1 (MD=0.19, 95%CI 0.12 to 0.25, P<0.00001), FVC (MD=0.35, 95%CI 0.14 to 0.57, P=0.001), FEV1% (MD=5.96, 95%CI 4.48 to 7.43, P<0.00001), FEV1% pred (MD=6.82, 95%CI 2.21 to 11.43, P=0.004), FEV1/FVC (MD=7.72, 95%CI 5.69 to 9.75, P<0.00001), mMRC (MD=-0.43, 95%CI -0.52 to -0.33, P<0.00001), CAT (MD=-1.45, 95%CI -2.26 to -0.64, P=0.0005), SGRQ (MD=-7.05, 95%CI -9.16 to -4.94, P<0.00001) and 6MWT (MD=32.52, 95%CI 16.68 to 48.37, P<0.00001). While there was no significant difference in adverse reaction rates between the two groups (OR=1.77, 95%CI 0.79 to 3.98, P=0.16). ConclusionCurrent evidence shows that budesonide/formoterol plus tiotropium can improve lung function and clinical symptom in Chinese patients with COPD. Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.
Objective To explore the effect of budesonide nebulization in the treatment of mechanically ventilated patients with chronic obstructive pulmonary disease(COPD).Methods A total of 25 intubated and ventilated COPD patients complicated with respiratory failure was randomly divided into two groups.The control group consisted of 12 patients received salbutamol nebulization on the routine treatment.The budesonide group consisted of 13 patients received budesonide plus salbutamol nebulization on the routine treatment.Variables such as tumor necrosis factor-α(TNF-α) and interleukin-8(IL-8) in the bronchoalveolar lavage fluid(BALF) ， incidence of ventilation-associated lung injury(VALI) ， days of mechanical ventilation ，， days of hospitalization and survival rate were measured and compared.Results The survival rate and incidence of VALI were not different significantly between the two groups.However ， the levels of TNF-α and IL-8 in BALF of the control patients were significantly lower than those in the budesonide group[ （ 1.2±0.2 ） mg/L vs （ 1.5±0.4 ） mg/L ，（ 85.7±26.5 ）（ 125.6±30.4 ）， both Plt;0.05).And the days of mechanical ventilation and hospitalization were statistically shorter in the budesonide group compared with the control group[ (7.2±2.5 ） d vs （ 10.5±6.2 ） d ， (10.5±4.7 ） d vs (15.8±6.6 ） d ， both Plt;0.05].Conclusion Our data suggest that nebulization of budesonide can suppressed the pulmonary inflammation and decreased days of the mechanical ventilation and hospitalization in mechanically ventilated COPD patients.
ObjectiveTo explore the effect of respiratory support in Community Respiratory Support Center on patients with chronic obstructive pulmonary disease (COPD) in stable phase. MethodsSixty-four GOLD gradeⅢpatients with stable COPD over age of 55 years were randomly divided into two groups.A respiratory support group received respiratory support in Community Respiratory Support Center, including health education, long-term oxygen therapy (LTOT), long-term ambroxol for atomization, long-term budesonide and formoterol for inhalation.A control group were prescribed budesonide and formoterol for inhalation when recruited, informed LTOT and long-term ambroxol for atomization at home, and follow-up visits to clinic every month. ResultsAfter 24 months of treatment in the respiratory support group, SpO2, PaO2, FEV1%pred, 6MWD, BMI, and ALB increased, mMRC, CAT, Hb, PaCO2 decreased (P < 0.05).While in the control group, FEV1%pred decreased, mMRC and CAT increased (P < 0.05), other indexes did not change significantly (P > 0.05).The times of acute exacerbation and hospitalization of the respiratory support group was less than that in the control group(P < 0.05). ConclusionsEstablishing Community Respiratory Support Center will benefit patients with stable COPD correct hypoxemia, slow the deterioration of lung function, improve the nutritional status of patients, and can also increase patients compliance to treatment.
目的:評價足量布地奈德溶液霧化治療重度慢性阻塞性肺疾病急性加重期患者的臨床應用價值。方法: 90例30%≤FEV1lt;50%的重度COPD急性加重期患者隨機分為3組: 布地奈德組給予布地奈德溶液霧化吸入2mg/次,每8小時1次;甲潑尼龍組給予口服甲潑尼龍片24mg /次,1/日;對照組不使用任何糖皮質激素。療程10d,觀察3組患者治療后肺功能,動脈血氣和呼吸困難評分變化,以及糖皮質激素主要不良反應。結果: 與對照組相比,吸入布地奈德組和口服甲潑尼龍組在FEV1,PaO2,PaCO2和呼吸困難評分改善值方面,有顯著差異性(Plt;005);吸入布地奈德組和口服甲潑尼龍組兩組各項指標改善程度相似(Pgt;005);吸入布地奈德組和對照組的不良反應少于口服甲潑尼龍組 (Plt;005)。〖HTH〗結論:〖HTSS〗足量布地奈德溶液霧化治療與口服糖皮質激素療效相近,全身副作用小,安全性好,是重度COPD急性加重期糖皮質激素的有效選擇。
Objective To systematically evaluate the efficacy and safety of tiotropium plus budesonide/formoterol compared with tiotropium in Chinese patients with chronic obstructive pulmonary disease (COPD). Methods PubMed (from 1980 to March, 2015), Wiley Online Library (from 1990 to March, 2015), Elsevier (from 1990 to March, 2015), CNKI(from 1990 to March, 2015), VIP(from 1990 to March, 2015) and WanFang Data(from 1990 to March, 2015) were searched for randomized controlled trials (RCTs) of tiotropium plus budesonide/formoterol compared with tiotropium in treating Chinese patients with COPD from the establishment of the database to March 2015. The quality of included studies was assessed according to Cochrane Methods 5.1 for Systematic Review, and Meta-analysis was conducted by RevMan 5.3 software. Results Atotal of 9 studies involving 503 patients were included. Compared with the tiotropium therapy group, tiotropium plus budesonide/formoterol in treating Chinese patients with COPD can more significantly improve FEV1 (MD=0.10, 95%CI 0.05 to 0.15, P<0.000 01), FEV1%pred (MD=4.27, 95%CI 2.44 to 6.09, P<0.000 01), FEV1/FVC (MD=3.48, 95%CI 3.21 to 3.74, P<0.000 01), mMRC (MD=-0.27, 95%CI -0.38 to -0.17, P<0.000 01), CAT (MD=-0.91, 95%CI -1.74 to -0.08, P=0.03), 6MWT (MD=27.64, 95%CI 11.76 to 37.53, P<0.000 01) and the frequency of repeated exacerbations (OR=0.25, 95%CI 0.08 to 0.76, P=0.01) while no significant difference was found between two groups in SGRQ (MD=-5.11, 95%CI -11.57 to 1.36, P=0.12). There was no significant differences in adverse reaction rates (OR=1.33, 95%CI 0.65 to 2.73, P=0.44) between the tiotropium plus budesonide/formoterol group and the control group. Conclusions Tiotropium plus budesonide/formoterol is effective in treating Chinese patients with COPD. It can effectively improve treatment efficiency and does not increase the incidence of adverse drug reactions. However, due to the limitation of both quantity and quality of included studies, this conclusion should be further confirmed by more high quality and large sample studies.
【摘要】 目的 分析國內布地奈德、地塞米松吸入治療小兒急性喉炎的療效。 方法 系統檢索中國生物醫學文獻數字庫（CBM）、中國期刊全文數據庫（CNKI）、維普、萬方數據庫，檢索時間為各個數據庫建庫至2010年7月。納入布地奈德對比地塞米松吸入治療小兒急性喉炎的隨機對照試驗（randomized controlled trial，RCT），對納入研究進行質量評價和Meta分析。 結果 共納入11個RCT，分析結果提示兩組聲嘶、犬吠樣咳嗽、呼吸困難、喉喘鳴癥狀消失時間差異均存在統計學意義，其MD及95%CI分為:-0.88 （-1.10，-0.65），-1.43 （-2.01，-0.84），-0.48 （-0.63，-0.32），-0.59 （-0.78，-0.41）。 結論 基于當前國內證據，布地奈德改善小兒急性喉炎梗阻癥狀療效優于地塞米松吸入治療。【Abstract】 Objective To evaluate the effectiveness of budesonide versus dexamethasone for the treatment of acute laryngitis in children of china. Methods Literatures in CBM, CNKI, VIP, WanFang databases were searched from the time of establishment of these databases till July 2010. Randomized controlled trials (RCT) of budesonide versus dexamethasone for the treatment of acute laryngitis in children were gathered, and quality was evaluated and meta-analysis was carried out. Results Eleven RCTs were identified, and meta-analysis indicated that there were significant differences between the two groups in the disappearing time of hoarseness, barking cough, dyspnea and laryngeal stridor. The MD values and their 95% CI were respectively -0.88 (-1.10, -0.65), -1.43 (-2.01, -0.84), -0.48 (-0.63, -0.32), and -0.59 (-0.78, -0.41). Conclusion Based on current evidence in China, budesonide is better than dexamethasone for the improvement of acute laryngitis in children.
Objective To investigate the expression of stromal cell derived factor-1 ( SDF-1) and the effects of budesonide suspension for inhalation ( Pulmicort Respules) in mice with asthma. Methods Thirty Kunming female mice were randomly divided into three groups, ie. a control group, an asthma group, and a pulmicort treatment group. The asthma group and the pulmicort treatment group were sensitized with ovalbumin ( OVA) by a combination of intraperitoneal injection and repeated OVA intranasal challenges to establish mouse asthma model. The pulmicort treatment group received 100μL pulmicort by intranasal administration before OVA challenge. The immunohistochemistry was used to estimate the expression of SDF-1 in lung tissues. HE staining and Wright-Giemsa staining method were used to assess inflammatory infiltration in the airway and bronchoalveolar lavage fluid ( BALF) respectively. Results The expression of SDF-1 in the asthma group increased significantly compared with the control group ( 0.48 ±0.03 vs. 0.21 ± 0.02, Plt;0.05) , and significantly decreased after the intervention with pulmicort ( 0.29 ±0.01 vs. 0.48 ± 0.03, Plt; 0.05 ) . Compared with control group, the infiltration of inflammatory cells in airway was significantly enhanced in the asthma group, and attenuated in the pulmicort treatment group. The total number of inflammatory cells and eosinophil, lymphocyte, neutrophil counts in BALF increased significantly in the asthma group compared with the control group, and decreased significantly after pulmicort intervention. Conclusion SDF-1 may play an important role in the recruitment of inflammatory cells in asthmatic airway and pulmicort may relieve airway inflammation by decreasing the expression of SDF-1.
ObjectiveTo observe the effect of Budesonide formoterol inhalant on teenager patients with allergic rhinitis accompanied with asthma. MethodsForty-five teenager patients with allergic rhinitis accompanied with asthma treated between January 2012 and December 2013 were randomly divided into general treatment group, budesonide group and budesonide formoterol group, with 15 patients in each. Another 15 subjects undergoing physical examination were designated as the control group. Besides routine treatment, the budesonide group was also treated with budesonide inhalation at 100-200 μg twice a day, and the budesonide formoterol group was also treated with budesonide formoterol inhalation at 160 μg and 4.5 μg twice a day. The course of treatment lasted for four weeks. The patients were followed up for four weeks after the use of medicine halted. After treatment, exhaled nitric oxide (NO) examination were performed. ResultsThe amount of NO in the exhaled gas in all the three treatment groups were significantly different from the control group (P<0.05), and it was also significantly different between the Budesonide group and the budesonide formoterol group (P<0.05). ConclusionBudesonide formoterol inhalant has a good effect on teenager patients with allergic rhinitis accompanied with asthma in terms of improving exhaled NO.