【摘要】 目的 分析国内布地奈德、地塞米松吸入治疗小儿急性喉炎的疗效。 方法 系统检索中国生物医学文献数字库（CBM）、中国期刊全文数据库（CNKI）、维普、万方数据库，检索时间为各个数据库建库至2010年7月。纳入布地奈德对比地塞米松吸入治疗小儿急性喉炎的随机对照试验（randomized controlled trial，RCT），对纳入研究进行质量评价和Meta分析。 结果 共纳入11个RCT，分析结果提示两组声嘶、犬吠样咳嗽、呼吸困难、喉喘鸣症状消失时间差异均存在统计学意义，其MD及95%CI分为:-0.88 （-1.10，-0.65），-1.43 （-2.01，-0.84），-0.48 （-0.63，-0.32），-0.59 （-0.78，-0.41）。 结论 基于当前国内证据，布地奈德改善小儿急性喉炎梗阻症状疗效优于地塞米松吸入治疗。【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.
Objective To evaluate the efficacy of Budesonide / formoterol to control asthma under real-life conditions. Methods A multi-center, open label, non-interventional study was conducted. Asthma control after 12 week therapy with Budesonide/ formoterol was assessed by Asthma Control Questionnaire( ACQ) and modified Asthma Control Questionnaire ( ACQ5) . Results A total of 360 asthma patients were recruited, including 228 adult patients and 132 child patients. After 12 weeks’ therapy, all the patients’medium value of ACQ was decreased significantly from 2. 03 ( adults 2. 20, children 1. 74) at baseline to 0. 60 ( adults 0. 78, children 0. 29) ( P lt; 0. 0001 ) , and the medium value of ACQ5 was also decreased significantly from2. 4 ( adults 2. 24, children 1. 76) at baseline to 0. 47 ( adults 0. 62, children 0. 20) ( P lt;0. 0001) . Conclusion Budesonide / formoterol is effective in asthma treatment, by which most asthma patients obtain and maintain clincal control.
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 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.
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.
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.
目的:评价足量布地奈德溶液雾化治疗重度慢性阻塞性肺疾病急性加重期患者的临床应用价值。方法: 90例30%≤FEV1lt;50%的重度COPD急性加重期患者随机分为3组: 布地奈德组给予布地奈德溶液雾化吸入2mg/次,每8小时1次;甲泼尼龙组给予口服甲泼尼龙片24mg /次,1/日;对照组不使用任何糖皮质激素。疗程10d,观察3组患者治疗后肺功能,动脉血气和呼吸困难评分变化,以及糖皮质激素主要不良反应。结果: 与对照组相比,吸入布地奈德组和口服甲泼尼龙组在FEV1,PaO2,PaCO2和呼吸困难评分改善值方面,有显著差异性(Plt;005);吸入布地奈德组和口服甲泼尼龙组两组各项指标改善程度相似(Pgt;005);吸入布地奈德组和对照组的不良反应少于口服甲泼尼龙组 (Plt;005)。〖HTH〗结论:〖HTSS〗足量布地奈德溶液雾化治疗与口服糖皮质激素疗效相近,全身副作用小,安全性好,是重度COPD急性加重期糖皮质激素的有效选择。
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.