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.
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.
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 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 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.
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 explore the influence of general anesthesia with laryngeal mask and preoperative inhalation of budesonide aerosol on the incidence of respiratory adverse events during pediatric anesthesia recovery.
MethodsA total of 100 child patients scheduled to undergoing inguinal hernia repair between December 2012 and February 2014 were randomly divided into two groups (group A and B) with 50 in each. All the patients underwent general anesthesia with laryngeal mask, while patients in group B inhaled budesonide aerosol before anesthesia. Then, we observed the incidence of adverse events in both groups, including laryngospasm, respiratory tract infection, and pulmonary complications.
ResultsCompared with group A, patients in group B had a lower incidence of adverse events (P<0.05).
ConclusionPreoperative application of budesonide aerosol inhalation can significantly reduce adverse events in the process of anesthesia recovery in children.
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.
