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Introducción: En Colombia son escasos los datos sobre el uso de los inhaladores en pacientes con EPOC. Objetivo: Describir la técnica de uso de inhaladores de dosis medida y polvo seco en pacientes de un hospital colombiano. Materiales y métodos: Estudio descriptivo en pacientes mayores de 40 años con EPOC atendidos en un hospital en La Virginia, Risaralda, Colombia, entre el 1 de septiembre de 2019 al 31 de enero de 2020. La unidad de análisis fueron los pacientes. Se incluyeron variables sociodemográficas, clínicas y lista de chequeo para uso de inhaladores. Se aplicaron frecuencias y proporciones para variables discretas, estadísticas de tendencia central y dispersión para variables continuas. Resultados: Se incluyeron 104 pacientes con edad media de 73,6 ± 10,1 años; 57 eran mujeres (54,8 %). Además, 48 pacientes estaban clasificados como GOLD-D (46,2 %). Igualmente, 89 pacientes manifestaron haber recibido educación sobre el uso de broncodilatadores (85,6 %). Los más frecuentes fueron los inhaladores de dosis medida (DM) en 95 casos (91,3 %), seguido de los de polvo seco unidosis (7,7 %). Así mismo, 37 pacientes que usaron DM sin inhalocámara (35,6 %) no cumplieron los pasos de la lista de chequeo. En el sistema multidosis, el más realizado fue cerrar de manera adecuada el inhalador y el menos ejecutado, expulsar el aire lentamente evitando hacerlo cerca del inhalador (n = 6; 5,7 %). Discusión: Se lograron describir las características de la técnica de uso de los inhaladores en pacientes con EPOC. A pesar de que ningún paciente logró utilizar el inhalador de forma "perfecta", la mayoría han recibido educación por parte de los profesionales de la salud. Conclusión: Un alto porcentaje de pacientes usa inadecuadamente los dispositivos para suministrar los broncodilatadores. Esto puede impactar negativamente en el control de la enfermedad.
Introduction: In Colombia, there is limited data on the use of inhalers in patients with COPD. Objective: The objective was to describe the technique of using metered-dose inhalers and dry powder in patients in a Colombian hospital. Methods: Observational, descriptive study of patients over 40 years of age with COPD, treated in a hospital in La Virginia, Risaralda, Colombia, between September 1st, 2019 and January 31st, 2020. The unit of analysis were patients in consultation. Sociodemographic and clinical variables, and a checklist for use of inhalers were included. Frequencies and proportions were applied for discrete variables, statistics of central tendency and dispersion for continuous variables. Results: A total of 104 patients with an average age of 73.6 ± 10.1 years were included; 57 were women (54.8%). In addition, 48 patients were classified as GOLD-D (46.2%). Similarly, 89 patients reported having received education on the use of bronchodilators (85.6%). The most common were metered-dose (MD) inhalers in 95 cases (91.3%), followed by single-dose dry powder inhalers in eight patients (7.7%). Likewise, 37 patients who used DM without inhalochamber (35.6%) did not comply with the steps of the checklist. In the multidose system, the most performed was to properly close the inhaler and the least performed was to expel the air slowly, avoiding doing so near the inhaler (n=6; 5.7%). Discussion: The characteristics of the technique of using inhalers in patients with COPD were described. Although no patient was able to use the inhaler "perfectly", most have received education from health professionals. Conclusion: A high percentage of patients misuse the devices to deliver bronchodilators. This can negatively impact the control of the disease.
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Objective:To investigate the effects of aerosol therapy with budesonide suspension combined with compound ipratropium bromide on partial pressure of carbon dioxide (PaCO 2) and tumor necrosis factor α (TNF-α) in children with bronchiolitis. Methods:A total of 124 children with bronchiolitis admitted to Gujiao Central Hospital from January 2019 to December 2021 were included in this study. These children were randomly divided into two groups using the coin-tossing method. The control group ( n = 62) was treated with routine symptomatic treatment, and the study group ( n = 62) was treated with aerosol therapy of budesonide suspension combined with compound ipratropium bromide based on routine symptomatic treatment. The time at which clinical symptoms disappear, clinical efficacy, inflammatory reaction, and blood gas index were determined in each group. Results:After treatment, the time at which asthma, cough, pulmonary rales, and fever in the study group were (2.28 ± 0.71) days, (3.30 ± 0.82) days, (5.25 ± 1.03) days, and (19.01 ± 2.65) hours, respectively, which were significantly shorter than (2.71 ± 0.89) days, (3.81 ± 0.98) days, (5.72 ± 1.37) days, and (20.76 ± 3.12) hours in the control group ( t = 2.97, 3.14, 2.15, 3.36, all P < 0.05). Total response rate and PaO 2 in the study group were 91.94% and (83.94 ± 4.02) mmHg, respectively, which were significantly higher than 77.42% and (81.25 ± 5.53) mmHg in the control group ( χ2 = 5.03, t = 3.09, both P < 0.05). Interleukin-18, interleukin-33, TNF-α, and PaCO 2 in the study group were (141.03 ± 34.69) ng/L, (143.87 ± 38.43) ng/L, (75.49 ± 18.43) ng/L, and (41.85 ± 3.31) mmHg, respectively, which were significantly lower than (158.64 ± 47.92) ng/L, (162.75 ± 50.32) ng/L, (83.22 ± 21.75) ng/L, and (43.58 ± 4.46) mmHg in the control group ( t = -2.34, -2.34, -3.23, -2.45, all P < 0.05). Conclusion:Aerosol therapy with budesonide suspension combined with compound ipratropium bromide based on routine symptomatic treatment is more effective on bronchiolitis than routine symptomatic treatment alone. The combined therapy can effectively decrease PaCO 2 and TNF-α levels.
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@#Objective To evaluate the effect of perioperative nebulization of ipratropium bromide on preoperative pulmonary function and incidence of postoperative pulmonary complications as well as safety in chronic obstructive pulmonary disease (COPD) patients who underwent lung resection in thoracic surgery. Methods During November 18, 2013 to August 12, 2015, 192 COPD patients with a necessity of selective surgical procedures of lobectomy or right bilobectomy or segmentectomy under general anaesthesia in 10 centers were 1 : 1 randomized to an ipratropium bromide group (96 patients) and a placebo group (96 patients), to compare the effect on preoperative pulmonary function and incidence of postoperative pulmonary complications. The average age of treated patients was 62.90±6.50 years, with 168 male patients and 22 female patients. Results The demographic and baseline characteristics were well-balanced between the two groups. The adjusted mean increase of forced expiratory volume in one second (FEV1) in the ipratropium bromide group was significantly higher than that in the placebo group (169.90±29.07 mL vs. 15.00±29.35 mL, P<0.05). The perioperative use of ipratropium bromide significantly decreased incidence of postoperative pneumonia (2.6% vs. 14.1%, P<0.05). There was no ipratropium bromide related adverse event (AE) observed in this trial. Conclusion This trial indicates that perioperative nebulization of ipratropium bromide significantly improves preoperative lung function and reduces postoperative pneumonia in COPD patients undergoing lung resection in thoracic surgery, and has good safety profile.
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The analytical method was developed and validated for the quantification of salbutamol sulfate (SS) and ipratropiumbromide (IPB) in accordance with the International Council for Harmonization guidelines in its pure form. Thechromatographic partition was completed utilizing a blend of acetonitrile:phosphate buffer (30:70 v/v) with the pHscale adjusted to 3.0 using o-phosphoric acid at a flow rate of 1 ml/minute in Luna C-18(2)(150 × 4.6 mm i.d., 5 μm)column. The wavelength for detection was fixed at 212 nm. The SS and IPB showed a standard linearity curve in therange of 2–12 µg/ml, with retention time at 2.4 and 3.8 minutes, respectively. The developed method was reported tobe specific, linear (r2 ≥ 0.999), precise at intraday and interday levels (% relative standard deviation < 2.0%), accurate(% recovery: 96.02%–103.62%), and robust. The limit of detection and limit of quantification for SS was found to be0.42 and 1.26 µg/ml, while that of IPB was 0.44 and 1.34 µg/ml, respectively. Additionally, the developed method waseffectively applied in quantifying SS and IPB from its pure, commercial, and in-house prepared transdermal system tounderstanding the in-vitro drug release pattern from patches.
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Background: The objective of the study was to compare the efficacy between levosalbutamol and ipratropium combination over levosalbutamol nebulisation in reversing airflow obstruction and improve oxygenation, evaluated using the pulmonary asthma score, SaO2, and PEFR in mild and moderate asthma.Methods: A prospective, randomized, study was performed in RMMCH pediatric emergency department. Children between 6 and 12 years of age who presented with mild to moderate asthma exacerberations were enrolled in the study. They were randomly allocated into two different groups: one nebulised with levosalbutamol alone and another with addition of ipratropium bromide to levosalbutamol. Baseline Peak expiratory flow rate and Final absolute values or change from baseline 60-120 minutes after the inhalation are measured. Patients were evaluated using the pulmonary score.Results: After treatment there is improvement in the mean pulmonary asthma scores and PEFR percentage in A+B group than A group, but it is not statistically significant (p value >0.05). There is statistically significant improvement in pulmonary asthma score and PEFR in each of the groups after nebulisation and pulmonary asthma score has a sensitivity of 66.7% and 65.6% in diagnosing severity of asthma in relation to PEFR.
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Introduction:Asthma is a chronic inflammatory condition of the lung airways resulting in episodic airflow obstruction. This chronic inflammation heightens the airway hyper responsiveness (AHR). Asthma is defined by the history of respiratory symptoms like wheeze, shortness of breath, chest tightness and cough that vary over time and in intensity together with variable expiratory airflow limitation.1 Aims & Objectives: To compare the effectiveness of a combination of inhaled anticholinergics (ipratropium bromide) and beta 2 agonists (salbutamol) compared with beta 2 agonists (salbutamol) alone for the treatment of children with acute exacerbation of asthma. Methods: This is a randomized comparative study conducted in the Department of pediatrics ASRAM Medical College during the period May 2018 to June2019. Total 66 children between the age group of 1-15 years with eligible diagnostic criteria were included in the study. Results: The percentage increase in predicted PEFR is better in Group II with a mean of 24.74 compared to Group I with a mean of 13.35. The p value is highly significant 0.001. The mean PAS at the start of the study is 10.5 in Group I and 10.7 in Group II. The mean PAS at the end of the study is 7.19 in Group I and 5.77 in Group II. The p value is 0.001 and is highly significant. The outcome is better in Group II when compared to Group I with a better decrease in PAS and better increase in percentage predicted PEFR. Conclusion: In the present study it has been proven the repeated doses of Ipratropium bromide combined to Salbutamol is beneficial and it reduces the broncomotor cholinergic tone.
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Background: Intractable obstructive apneas requiring multiple intubations are rare innewborns. Case characteristics: We report a pair of twins born at 29 weeks gestationwho had severe obstructive apneas due to Paradoxical Vocal Cord Motion (PVCM).Outcome: The symptoms resolved promptly with ipratropium nebulization. Follow-up at12 months of age revealed normal development. Message: PVCM should be consideredin the differential diagnosis of intractable obstructive apneas in very low birth weightpreterm infants
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Objective To analyze the clinical efficacy of ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma. Methods 100 patients with acute attack of asthma treated from March 2015 to October 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group received terbutaline sulfate inhalation, and the experimental group received ipratropium bromide combined with terbutaline sulfate inhalation treatment. The patients in the experimental group and the control group were treated for 7 days continuously. The therapeutic effects of the two groups were compared and analyzed. Results After the corresponding treatment, the effective rate of treatment in the experimental group (94.0%) was significantly higher than that in the control group (72.0%),the difference was statistically significant(P<0.05). The improvement time of dyspnea, rale and cough in control group was significantly longer than that in the experimental group, the difference was statistically significant(P<0.05). Conclusion Ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma has better clinical efficacy and shorter clinical symptoms.
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Objective To analyze the clinical efficacy of ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma. Methods 100 patients with acute attack of asthma treated from March 2015 to October 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group received terbutaline sulfate inhalation, and the experimental group received ipratropium bromide combined with terbutaline sulfate inhalation treatment. The patients in the experimental group and the control group were treated for 7 days continuously. The therapeutic effects of the two groups were compared and analyzed. Results After the corresponding treatment, the effective rate of treatment in the experimental group (94.0%) was significantly higher than that in the control group (72.0%),the difference was statistically significant(P<0.05). The improvement time of dyspnea, rale and cough in control group was significantly longer than that in the experimental group, the difference was statistically significant(P<0.05). Conclusion Ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma has better clinical efficacy and shorter clinical symptoms.
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OBJECTIVE:To investigate the effects of aerosol inhalation of budesonide combined with Compound ipratropium bromide on therapeutic efficacy and safety of patients with pneumoconiosis during perioperative period of massive whole-lung la-vage (WLL). METHODS:One hundred and fifty male patients with pneumoconiosis receiving WLL under general anesthesia se-lected from our hospital during Dec. 2014-May 2016 were divided into treatment group and control group in accordance with ran-dom number table,with 75 cases in each group. Both groups received WLL under general anesthesia as well as pure-oxygen manu-al positive pressure ventilation alternating with negative pressure drainage keeping interval and respiratory rate of ventilator synchro-nization. Treatment group was given Budesonide suspension 2 mL,bid+ Compound ipratropium bromide solution 2.5 mL,tid,by aerosol inhalation from 3 d before surgery to 3 d after surgery. The levels of arterial blood gas indexes(pH,PaO2,PaCO2,BE)at different lavage stages,lung function indexes (FVC,MVV,FEV1/FVC),blood gas indexes and clinical symptom score 3 d be-fore surgery and 7 d after surgery were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:After two-lung ventilation for 20 min following unilateral/bilateral lung lavage,PaO2 of 2 groups were all increased significantly compared to be-fore surgery,with statistical significance (P0.05). three days after surgery,FVC,MVV,FEV1/FVC and PaO2 of 2 groups were all increased significantly,PaCO2 and clinical symptom score were all decreased significantly. FVC,FEV1/FVC,PaO2 and clinical symptom score of treatment group were significantly bet-ter than those of control group,with statistical significance(P<0.05). The incidence of airway spasm,hypoxemia and airway pres-sure increasing in treatment group were significantly lower than in control group,with statistical significance(P<0.05). CONCLU-SIONS:During perioperative period of WLL,the aerosol inhalation of budesonide combined with Compound ipratropium bromide for patients with pneumoconiosis can improve clinical efficacy of WLL and reduce the occurrence of ADR during surgery.
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Owing to the increasing morbidity and pulmonary infection,management of pulmonary function has become an important problem for COPD patients who undergo surgery.Surgical patient with respiratory disease such as COPD has declined lung function before operation,then increased the risk of post-operative pulmonary complications.Ipratropium bromide can significantly improve pulmonary function.Therefore,we hypothesis the treatment with nebulized ipratropium bromide will benefit the perioperative patients with COPD.A randomized,double-blind,placebo-controlled,parallel-group,multi-center trial (Ipratropium bromide in Peri-Operative COPD study,IPO-COPD study)has been conducted to evaluate the efficacy and safety of nebulized ipratropium bromide in Chinese perioperative patients with COPD under general anaesthesia.A total of 192 COPD patients who satisfied the eligibility criteria were randomly assigned(1∶1) to one of the two treatment groups(ipratropium bromide 500 μg or normal saline 4 ml) for 11 days.Measurements will include the change of the forced expiratory volume in 1 second(FEV1),the forced vital capacity(FVC),blood gas analyses and main post-operative pulmonary complications.
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Objective To study and explore the application effect of compound ipratropium bromide combined with budesonide in acute severe asthma.Methods 100 emergency patients with severe asthma were selected as study subjects,the patients were divided into two groups by following the principles of randomized single blind,each group had 50 cases.The control group received aminophylline treatment,the observation group was treated with budesonide combined with ipratropium bromide inhalation therapy.The clinical curative effect,relieve symptoms,condition of arterial blood gas and pulmonary function were compared between the two groups.Results The total effective rate of the observation group was 96％,which of the control group was 80％,the difference was statistically significant (x2 =6.061,P ＜ 0.05).The remission time of cough [(5.60 ± 1.35) d],expectoration [(3.54 ± 1.25) d],shortness of breath[(1.93 ± 0.87) d],wheezing [(6.09 ± 1.26) d] and other symptoms in the observation group were significantly shorter than those in the control group [(7.39 ± 1.72) d,(5.17 ± 1.54) d,(3.26 ± 1.08) d,(8.43 ±1.95) d](t =5.789,5.811,6.781,7.127,all P ＜ 0.05).After treatment,the arterial blood gas and lung function in the observation group were significantly improved (all P ＜ 0.05),which were better than those in the control group after treatment (all P ＜ 0.05).Conclusion The clinical curative effect of budesonide combined with ipratropium bromide in the treatment of patients with severe asthma is significant,it can improve the symptoms,pulmonary ventilation function and arterial blood gas.
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Objective To investigate the therapeutic effect of ipratropium bromide on bronchial spasm of patients with asthma and chronic obstructive pulmonary disease (COPD).Methods 174 patients with asthma and COPD were selected and divided into two groups, 87 cases in the control group treated with budesonide and formoterol fumarate powder for inhalation , 87 cases in the experimental group received ipratropium bromide on the basis of the control group, pulmonary ventilation function, airway resistance and cytokine levels in induced sputum, the clinical effect and incidence of adverse reactions were compared after the treatment.Results The effective rate in the control group(81.61%)was lower than the experimental group (93.11%), with significant difference (P<0.05); compared with the control group, levels of peak expiratory flow (PEF), maximum midexpiratory flow (MMEF), forced expiratory volume in one second to forced vital capacity ratio (FEV1%), forced vital capacity (FVC) were higher in the experimental group after treatment, levels of airway resistance (Raw), Raw% were lower, level of specific airway conductance (Gsp) was higher after treatment, induced sputum levels of vascular endothelial growth factor (VEGF), intercellular adhesion molecular-1 (ICAM-1), interleukin-13 (IL-13), IL-17 were lower after treatment, with significant difference (P<0.05);there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The clinical effect of ipratropium bromide in the treatment of asthma and COPD was exactly , ipratropium bromide can significantly improve the pulmonary ventilation function in patients, relieve bronchial spasm, reduce airway resistance, inhibit airway inflammation, and the safety is higher.
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OBJECTIVE:To investigate the safety and effects of different doses of budesonide combined with ipratropium bro-mide on rational symptom,lung function and arterial blood gas indexes of patients with acute exacerbation of chronic obstructive pulmonary diseases (AECOPD). METHODS:186 AECOPD inpatients were selected and randomly divided into low-dose,medi-um-dose and high-dose groups,with 61 cases in each group. All groups received routine treatment as ipratropium bromide 500 μg+0.9%Sodium chloride injection(NS)2 ml,oral inhalation with oxygen drive atomization nebulizer,oxygen flow rate of 4-5 L/min, 15-20 min/time,tid. Low-dose,medium-dose and high-dose group were additionally given Budesonide suspension 0.5,1.0,2.0 mg+NS 2 ml respectively,oral inhalation with oxygen drive atomization nebulizer,oxygen flow rate of 4-5 L/min 20 min/time,bid. Pa-tients in 3 groups were treated for 7 days. Pulmonary function,MRC score,arterial blood gas indexes and ADR were compared among 3 groups before treatment,3 and 7 days after treatment. RESULTS:FEV1% of 3 groups were significantly improved after treatment;3 and 7 days after treatment,FEV1% of high-dose group was higher than that of medium-dose and higher than that of low-dose group,with statistical significance(P0.05). After treatment,there was statistical significance in PaCO2 and PaO2 among 3 groups (P<0.05),and the improvement of high-dose group was better than those of medium-dose and better than that of low-dose group,with statistical significance(P<0.05). No severe ADR was found in 3 groups. CONCLU-SIONS:Aerosol inhalation of 2.0 mg budesonide combined with ipratropium bromide can effectively improve pulmonary function, rational symptoms and arterial blood gas indexes with good safety.
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Objective To explore the clinical efficacy on hyperbaric oxygenation combined with 0.025% ipratropium bromide inhalation in treatment of patients with stable chronic obstructive pulmonary disease( COPD) .Methods 86 elderly patients with stable COPD were divided into control group (n=42)and observation group(n=44)according to therapeutic methods.The patients in both groups were firstly given the conventional treatment such as oxygen inhalation, anti-infection, eliminating phlegm and reliving asthma, nutritional support, spasmolysis as well as a balance of water, electrolyte and PH.And the patients of the observation group were given hyperbaric oxygenation combined with 0.025% ipratropium bromide inhalation on basis of the conventional treatment.The clinical effects of the two groups were compared.Results In the control group, there were no statistical differences in parameters of pulmonary function before and after the treatment.However, after treatment, the relative index level of pulmonary function in the observation group was significantly higher than that of pre-treatment and that of the control group after treatment(P<0.05).After treatment, PaO2, SaO2 and pH of the two groups were significantly higher than those of pre-treatment(P<0.05).The level of PaCO2 in the two groups was significantly lower than that of pre-treatment(P<0.05).Also, the difference in PaO2, PaCO2 and SaO2 level was statistically significant before and after treatment between thw two groups(P<0.05).The scores of each dimension in PSQI scale of both groups were significantly lower than those of pre-treatment(P<0.05).And the scores of each dimension in PSQI scale of observation group was significantly lower than those of the control group after treatment(P<0.05).Whole blood cholinesterase activity of both groups was obviously greater than before treatment between theo two groups(P<0.05).Serum creatinine level of both groups were obviously lower than those of pre-treatment(P<0.05),and the differences in two groups in both blood cholinesterase activity and serum creatinine level were statistically significant ( P<0.05 ) .Conclusion The combination of high pressure oxygen and 0.025%ipratropium bromide for patients with stable COPD has a very significant clinical efficacy.It can effectively improve cholinesterase activity and lower serum creatinine level.
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Objective To investigate the application value of combination of ambroxol and fluidmicronized ipratropium bromide in full dose and frequency in treating senile refractory pneumonia.Methods From January 2010 to November 2013,84 cases of elderly patients with refractory pneumonia were divided into 3 groups.On the basis of anti-inflammatory and symptomatic treatment,the control group (n=28) received routine sputum suction and normal saline irrigation;the routine dose group (n=28) received the intravenous ambroxol 15 mg twice daily and the inhalation of 2.5 ml of nebulized ipratropium bromide once daily plus treatment in control group while full dose group (n=28) received intravenous ambroxol hydrochloride 30 mg three times a day and the inhalation of 2.5 ml of nebulized ipratropium bromide four times a day.The severity of pulmonary infection was described by clinical pulmonary infection score (CPIS) and C reactive protein (CRP),and therapeutic efficiency was evaluated by clinical symptom remission time,average hospitalization days and effective rate.Results At the 5 day and 10 days after treatment,the CPIS in full dose group was (4.82 ± 1.21) scores and (4.39± 1.03),respectively,C-reactive protein (CRP) was (58.11 ± 11.12) mg/L and (57.57±12.69) mg/L respectively,and these CPIS and CRP values at the 5 day and 10 days were significantly lower than those in the control group (6.10 ± 1.10) scores and (5.36 ± 0.95) scores,(74.50± 12.79)mg/L and (68.46± 13.77) mg/L (all P＜0.05).The above Values were lower as compared with those [(5.43±0.84) and (5.21 ±0.83),(65.11 ±834) mg/L and (59.11± 13.77) mg/L (P＜ 0.05)] in routine dose group.The CPIS and CRP concentration in full dose group and routine dose group were lower at the 10 days than at the 5 days (P＜0.05).Besides,clinical symptom remission time (4.43 ± 1.75) days,average hospitalization duration(26.32 ± 4.92) days in full dose group,clinical symptom remission time (5.68 ± 2.29) day,average hospitalization (32.21 ± 5.63) days in conventional dose group were significantly lower than in the control group (7.79±2.74) and (36.71 ± 11.78) days (P ＜ 0.05).Clinical manifestation,time of remission,and average hospitalization days of the full dose group were also reduced as compared with the conventional dose group (P＜0.05).The efficiency rates in the three groups of control,conventional dose and full dose were 42.9％ (12/28),71.4％ (20/28),92.9％ (26/28),among which the efficiency of full dose group was significantly higher than those of the control group and the conventional dose group,(x2 =16.047,6.788,P＜0.01).The conventional dose group showed a higher efficiency than the control group (x2 =4.667,P ＜ 0.01).Conclusions Combination of ambroxol and fluid-micronized ipratropium bromidet in full dose and frequency for treating senile refractory pneumonia is a useful managemen in the elderly patients.
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Objective To investigate the effect of ipratropium bromide combined with budesonide /formoterol fumarate inhalation powder on serum FeNO and lung function of bronchial asthma patients.Methods 102 cases with clear bronchial asthma during Jan 2013 and Mar.2015 from the affiliated Qianfo Hill Hospital of Shandong University were randomly divided into three groups, control group A (34 cases) were treated with ipratropium bromide, control group B (34 cases) were treated with budesonide/formoterol fumarate powder, experiment group (34 cases) were given ipratropium bromide combined with budesonide/formoterol fumarate powder, all groups were treated for 6 months.Pulmonary function, serum FeNO and IgE levels, clinical efficacy were compared after treatment.Results The effective rate of control group A, B (70.59%, 67.65%) were significantly lower than experiment group (91.18%), the difference were significant (P<0.05).FEV1, FVC, FEV1%pre of experiment group were significantly higher than control group A and B after the treatment.Serum IgE and FeNO concentration were significantly lower than control group A, B, the difference were significant ( P<0.05 ) .Conclusion Ipratropium bromide combined with budesonide/formoterol fumarate powder for inhalation in bronchial asthma patients can effectively reduce FeNO concentration, improve lung function.
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Abstracts: Background: This study compared the efficacy of levosalbutamol alone and ipratropium bromide alone with levosalbutamol and ipratropium bromide combined, through inhalational route in stable patients of chronic obstructive pulmonary disease (COPD). The study was carried out in 102 patients of COPD. Levosalbutamol inhalation was administered to 33 patients and ipratropium bromide inhalation was given to 31 patients.38 patients were treated with combination of levosalbutamol and ipratropium bromide inhalation. Pulmonary functions were noted before and after 15, 30, 60,120,180 and 240 minutes of inhalation of these drugs. Bronchodilation was significantly more in patients treated with combination therapy as compared to patients treated with single drug separately. The effect was more sustained in combination therapy as it started declining after 120 minutes with levosalbutamol, after 180 minutes in ipratropium bromide and after 240 minutes with combination therapy. So it was concluded that combination therapy with levosalbutamol and ipratropium bromide is better in management of COPD patients than using either of agents alone.
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Objective To observe the effect and the influence on PCT,CRP in the treatment of patients with acute exacerbation pulmonary disease by Budesonide and ipratropium bromide.Methods 80 patients with acute exacerbation pulmonary disease were randomly divided into 40 cases of the control group and 40 cases of the observa-tion group,the two groups were given routine treatment,the control group then had been given ipratropium bromide for 7d,and the observation group had been given Budesonide and ipratropium bromide for 7d,the blood gas indicators (PaO2 ,PCO2 ),pulmonary function (FEV1 ,PEF,FEV1 /FVC),dyspnoea and exercise tolerance score,serum PCT levels,serum CRP levels and clinical efficacy were compared,Adverse reactions were recorded.Results (1 )the PaO2 ,FEV1 ,PEF,FEV1 /FVC of the observation group and the control group after treatment were (70.7 ±2.3)mmHg and (62.5 ±3.0)mmHg,(2.15 ±0.63)L and (1.76 ±0.56)L,(3.49 ±0.82)L/s and (3.06 ±0.75)L/s, (68.52 ±6.53)% and (60.14 ±6.03)%,These indicators were significantly higher than those before treatment,all P <0.05,the PCO2 ,PCT,CRP were (51.4 ±1.7)mmHg and (56.6 ±2.3)mmHg,(1.75 ±1.20)μg/L and (2.58 ± 1.17)μg/L,(10.25 ±6.77)mg/L and (19.07 ±5.75)mg/L,These indicators were significantly lower than those before treatment,all P <0.05,the PaO2 ,FEV1 ,PEF,FEV1 /FVC of the observation group were significantly higher than those of the control group,the PCO2 ,PCT,CRP were significantly lower than those of the control group,all P <0.05;(2)The dyspnoea and exercise tolerance score of the observation group and the control group after treatment was significantly lower than those before treatment,the dyspnoea and exercise tolerance score of the observation group was significantly lower than those of the control group;(3)The clinical total effective rate of the observation group was 90%,which was higher than 65% of the control group(χ2 =7.312,P <0.05).Conclusion The method containing Budesonide and ipratropium bromide Inhalation has exact effect,and can effectively improve respiratory function, which is an effective treatment of choice for acute exacerbation of COPD.
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Objective To explore the effect of ipratropium bromide on serum interleukin-13 (IL-13), transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor (VEGF) in children with asthma.Methods Eighty-six children with asthma in pediatrics department of Hanggang Hospital from January 2014 to June 2014 were selected and divided into two groups according to different therapy, 43 cases in each group.Control group received aminophylline of intravenous drip infusion and salbutamol and ketotifen orally.Experimental group received ipratropium bromide of aerosol inhalation on the basis of control group, twice daily and treated for two courses, 7 days of one course.The clinical efficacy , serum IL-13, TGF-β1, VEGF and lung function post-treatment were compared between two groups.Results The total curative effect of experimental group was 90.69%, which was significantly higher than 72.09% of control group(χ2 =4.91,P<0.05).The serum levels of IL-13, TGF-β1 and VEGF after 3, 7 and 14 days’ treatment in two groups were lower than those pre-treatment(P<0.05).The above indicators of experimental group were lower than those of control group at the same time point(P<0.05).The FEV1 and FEV1/FVC% after 7, 14 days’ treatment in control group and the above indicators after 3, 7, 14 days’ treatment in experimental group were significantly higher than those pre-treatment (P<0.05).The above indicators of experimental group were higher than those of control group at the same time point (P<0.05).Conclusion Ipratropium bromide could affect serum IL-13, TGF-β1 and VEGF levels in children with asthma, improve lung function and clinical curative effect.