A comparative study on efficacy and safety of glycopyrronium bromide + salmeterol/fluticasone and tiotropium bromide + salmeterol/fluticasone in hronic obstructive pulmonary disease

Objective: To compare the effect of tiotropium bromide and glycopyrronium bromide in the treatment of chronic obstructive pulmonary disease. Methods: This was an open labeled Randomized controlled trial study. Patients diagnosed with COPD according to the Global Initiative for chronic Obstructive Lung Disease (GOLD) strategy were included in the study. The patients were divided in two groups and each group had 100 patients. Group A- COPD patients on Tiotropium bromide + Salmeterol/Fluticasone; Group B – COPD patient on Glycopyrronium bromide + Salmeterol/Fluticasone. Tiotropium bromide: 18 mcg OD, Glycopyrronium bromide: 50 mcg OD along with Salmeterol 50 mcg/Fluticasone 100mcg was given. Results: The mean age of patients of Group A and Group B was 56.28±7.78 and 57.64±8.06 years respectively. Baseline variables were comparable between the groups. There was significant (p<0.05) difference in PFT parameters between the groups at 12 and 24 weeks except for FEV1/FVC. The mean change was higher in Group B compared to Group A from 0 week to 24 weeks. There was clinical improvement among all the patients in both the groups. Conclusion: Once-daily GLY demonstrated similar effects to TIO when combined with SAL/FP in patients with moderate and severe COPD.

Treatment adherence and level of control in moderate persistent asthma in children and adolescents treated with fluticasone and salmeterol / Adesão ao tratamento e nível de controle da asma persistente moderada em crianças e adolescentes tratados com fluticasona e salmeterol

Abstract Objective: There is a scarcity of studies that assessed the association between adherence to combination therapy and asthma control in pediatric patients. The authors investigated the association between adherence to fluticasone propionate/salmeterol xinafoate combination-metered aerosol and the level of asthma control in children. Methods: This was a prospective observational study of 84 patients aged 5-16 years with moderate persistent asthma, who remained uncontrolled despite the use of 1000 µg/day of inhaled nonextrafine-hydrofluoric alkane-beclomethasone dipropionate in the three months prior to study enrollment. Participants were prescribed two daily doses of FP (125 µg)/salmeterol xinafoate (25 µg) combination by metered aerosol/spacer for six months. Adherence rates were assessed using the device's dose counter after the 2nd, 4th, and 6th months of follow up. Asthma control was assessed using a simplified Global Initiative for Asthma 2014 Report classification. Results: Mean adherence rates after the second, fourth, and sixth months were 87.8%, 74.9%, and 62.1% respectively, for controlled asthma, and 71.7%, 56.0%, and 47.6% respectively, for uncontrolled asthma (all p-values ≤ 0.03). The proportion of children achieving asthma control increased to 42.9%, 67.9% and 89.3% after the 2nd, 4th and 6th months of follow-up, respectively (p ≤ 0.001). Conclusion: Adherence rates between 87.8% in the 2nd month and 62.1% in the 6th month were strong determinants of asthma control.

Resumo Objetivo: São escassos os estudos que avaliaram a relação entre a taxa de adesão à combinação de proprionato de fluticasona/xinafoato de salmeterol e o nível de controle da asma na infância. O presente estudo teve como objetivo avaliar essa relação. Métodos: Estudo prospectivo observacional com 84 participantes, de 5 a 16 anos, todos eles com asma persistente moderada que permaneceram não controlados apesar do uso de 1.000 µg/dia de dipropionato de beclometasona em partículas não extrafinas nos três meses que antecederam a admissão no estudo. Os participantes receberam prescrição de 125 µg de propionato de fluticasona e 25 µg xinafoato de salmeterol através de inalador pressurizado, duas vezes ao dia, e foram avaliados após o 2°, 4° e 6° meses de tratamento. A taxa de adesão foi obtida por meio do contador analógico de doses incorporado ao inalador. A classificação do nível de controle da asma foi baseada numa simplificação das recomendações da Global Initiative for Asthma. Resultados: As taxas de adesão aos 2, 4 e 6 meses para a asma controlada foram 87,8%, 74,9% e 62,1% e para a asma não controlada de 71,7%, 56,0% e 47,6% (p ≤ 0,03), respectivamente. A proporção de pacientes com asma controlada elevou- se para 42,9%, 67,9% e 89,3% nas três avaliações subsequentes (p ≤ 0,001). Conclusões: Taxas de adesão entre 87,8% no 2° mês e de 62,1% no 6° mês foram determinantes para o nível de controle da asma.

Comparison of the efficacy of montelukast or ketotifen combined with salmeterol/fluticasone in the treatment of cough variant asthma / 中国基层医药

Objective@#To compare the efficacy of montelukast or ketotifen combined with salmeterol/fluticasone powder inhalation in the treatment of cough variant asthma.@*Methods@#From July 2016 to July 2017, 74 patients with cough-variant asthma admitted to the 903rd Hospital of People's Liberation Army Joint Service Support Unit were selected.According to the random number table method, the patients were randomly divided into the control group and observation group, with 37 patients in each group.All patients were treated with inhalation of salmeterol/fluticasone, with montelukast chewable tablets in the observation group, and ketotifen tablets in the control group.The adverse reactions in the two groups after treatment were recorded, and the treatment effect and typical asthma conversion rate in the two groups were compared.@*Results@#The total effective rate of the observation group was 94.59%, which was significantly higher than 78.38% of the control group (χ2=8.283, P<0.05). The incidence rate of adverse reactions was 10.81% in the observation group and 16.22% in the control group, there was no statistically significant difference between the two groups (χ2=2.082, P>0.05). In the observation group, 2 patients had nausea, and 2 patients had laryngopharyngeal discomfort.In the control group, 1 patient had laryngopharyngeal discomfort, 2 patients had dizziness, and 3 patients had somnolence.All the above symptoms were mild and could be relieved after symptomatic treatment.After 1 year of follow-up, the recurrence rate of the observation group was 27.03%, which was significantly lower than 43.24% of the control group (χ2=8.072, P<0.05). After 1 year of follow-up, the typical asthma conversion rate of the observation group was 21.62%, which was significantly lower than 37.84% of the control group (χ2=7.322, P<0.05).@*Conclusion@#Montelukast in the treatment of cough variant asthma can greatly reduce the recurrence rate and the conversion rate of typical asthma.It is not only safe but also effective.It is worthy of popularizing in clinic.

Therapeutic effect of salmeterol-fluticasone aerosol on mild to moderate chronic obstructive pulmonary disease / 中国基层医药

Objective@#To analyze the clinical efficacy of salmeterol-fluticasone aerosol in the treatment of mild to moderate chronic obstructive pulmonary disease (COPD).@*Methods@#From February 2017 to February 2018, 68 patients with mild to moderate COPD treated in the General Hospital of Shanxi Tongmei Group were selected in the study.The patients were divided into control group (34 cases) and observation group (34 cases) by random number table method.The control group was treated with salbutamol aerosol inhalation, while the observation group was treated with salmeterol and fluticasone aerosol inhalation.Both two groups were treated for 12 weeks.The clinical efficacy, improvement of pulmonary function, 6-minute walking distance, oxygen saturation and heart rate were compared between the two groups.@*Results@#The total effective rate of the observation group was 97.06% (33/34), which was significantly higher than that of the control group [73.53%(25/34)] (χ2=7.503, P<0.05). Before treatment, FEV1%, FEV1/FVC (percentage of forced expiratory volume in 1 second forced vital capacity), FEV1 (1 second hard breathing volume), blood oxygen saturation, heart rate and 6 min walking distance had no statistically significant differences between the two groups (all P>0.05). After treatment, the FEV1, FEV1/FVC, FEV1% in the observation group were (65.48±4.06)%, (74.66±8.12)%, (1.99±0.55) L, respectively, which were significantly higher than those in the control group [(63.55±6.14)%, (70.85±7.56)%, (1.71±0.52)L] (t=2.321, 2.002, 2.157, all P<0.05). The oxygen saturation, heart rate and 6-minute walking distance in the observation group were (92.27±1.83)%, (80.55±4.08)times/min and (263.35±28.73)m, respectively, which in the control group were (88.52±2.06)%, (91.43±5.16)times/min and (231.95±22.69)m, respectively, and there were statistically significant differences between the two groups (t=7.936, 9.644, 5.001, all P<0.05).@*Conclusion@#Salmeterol and fluticasone aerosol inhalation has good clinical efficacy in the treatment of mild to moderate COPD, and can significantly improve the lung function of patients.

Comparison of the efficacy of montelukast or ketotifen combined with salmeterol/fluticasone in the treatment of cough variant asthma / 中国基层医药

Objective To compare the efficacy of montelukast or ketotifen combined with salmeterol/fluticasone powder inhalation in the treatment of cough variant asthma.Methods From July 2016 to July 2017,74 patients with cough-variant asthma admitted to the 903rd Hospital of People's Liberation Army Joint Service Support Unit were selected.According to the random number table method,the patients were randomly divided into the control group and observation group,with 37 patients in each group.All patients were treated with inhalation of salmeterol/fluticasone,with montelukast chewable tablets in the observation group,and ketotifen tablets in the control group.The adverse reactions in the two groups after treatment were recorded,and the treatment effect and typical asthma conversion rate in the two groups were compared.Results The total effective rate of the observation group was 94.59％,which was significantly higher than 78.38％ of the control group (x2 =8.283,P ＜ 0.05).The incidence rate of adverse reactions was 10.81％ in the observation group and 16.22％ in the control group,there was no statistically significant difference between the two groups (x2 =2.082,P ＞ 0.05).In the observation group,2 patients had nausea,and 2 patients had laryngopharyngeal discomfort.In the control group,1 patient had laryngopharyngeal discomfort,2 patients had dizziness,and 3 patients had somnolence.All the above symptoms were mild and could be relieved after symptomatic treatment.After 1 year of follow-up,the recurrence rate of the observation group was 27.03％,which was significantly lower than 43.24％ of the control group (x2 =8.072,P ＜ 0.05).After 1 year of follow-up,the typical asthma conversion rate of the observation group was 21.62％,which was significantly lower than 37.84％ of the control group (x2 =7.322,P ＜ 0.05).Conclusion Montelukast in the treatment of cough variant asthma can greatly reduce the recurrence rate and the conversion rate of typical asthma.It is not only safe but also effective.It is worthy of popularizing in clinic.

Eficacia de la budesonida/formoterol comparado con la fluticasona/salmeterol en la mejoría de la capacidad pulmonar de personas mayores con Enfermedad Pulmonar Obstructiva Crónica: revisión sistemática de literatura / Effectiveness of budesonide/formoterol compared to fluticasone / salmeterol in improving the lung capacity of older people with Chronic Obstructive Pulmonary Disease: systematic literature review / Eficiência da budesonida/formoterol comparado com fluticasona/salmeterol na melhora da capacidade pulmonar de idosos com Doença Pulmonar Obstrutiva Crônica: revisão sistemática da literatura

Introducción. La Enfermedad Pulmonar Obstructiva Crónica (EPOC) es una patología no transmisible, caracterizada por una limitación de flujo de aire en las vías respiratorias debido a una respuesta inmunológica anormal frente a partículas. Objetivo. Conocer la eficacia que tiene la budesonida/formoterol comparado con la fluticasona/salmeterol en la mejoría de la capacidad pulmonar en personas mayores de 40 años con Enfermedad Pulmonar Obstructiva Crónica. Materiales y métodos. Se realizó una revisión sistemática de documentos producidos entre el año 2000 y 2018 en distintas bases de datos, donde se incluyeron ensayos clínicos. Se identificaron cuatro artículos para el análisis final. Resultados. Durante la evaluación comparativa de budesonida con formoterol, los artículos muestran un total de 709 personas evaluadas, con un promedio de edad de 53,5 años. El 65,4 % eran varones, el 21 % manifestaba no haber consumido tabaco, todos con diagnóstico de Enfermedad Pulmonar Obstructiva Crónica moderada-severa, según la escala GOLD (Global Initiative For Chronic Obstrutive Lung Disease). Los estudios determinaron que al administrar budesonida/formoterol de 400/12 mcg y 320/9 mcg, los pacientes tuvieron una leve mejoría en el Volumen Espiratorio Forzado del primer segundo (VEF1). Solo dos pacientes presentaron efectos adversos. No obstante, para los resultados mencionados anteriormente no se encontró diferencias significativas. Conclusiones. El uso de budesonida/formoterol es eficaz al mejorar la capacidad ventilatoria pulmonar, disminuye el número de exacerbaciones anuales y genera un adecuado control de los síntomas, sin embargo, es igual de efectivo a la fluticasona/salmeterol.

Introduction. Chronic Obstructive Pulmonary Disease (COPD) is a not transmissible disease, characterized by a limitation of airflow in the respiratory tract, due to an abnormal immune response to particles. Objective. This article aims to show that the application of budesonide / formoterol improves lung capacity in people over 40 years with Chronic Obstructive Pulmonary Disease. Materials and methods. A systematic review was conducted in the period between 2000 and 2018 in different databases where clinical trials were included. Four articles were identified for the final analysis. Results. During the comparative evaluation of budesonide with formoterol, a total of 709 people were evaluated, with an average age of 53.5 years, 65.4% were male, 21% reported not having used tobacco, all with a diagnosis of moderate-severe Chronic Obstructive Pulmonary Disease according to the GOLD scale (Global Initiative For Chronic Obstrutive Lung Disease). The studies determined that when budesonide / formoterol of 400/12 mcg and 320/9 mcg was administered, the patients had a slight improvement in the Forced Expiratory Volume of the first second (FEV1). Only two patients presented adverse effects. However, for the results mentioned above no significant differences were found. Conclusions. The use of budesonide / formoterol is effective in improving pulmonary ventilatory capacity, decreases the number of annual exacerbations and generates adequate control of symptoms, however, it is equally effective in fluticasone / salmeterol.

Introdução. A Doença Pulmonar Obstrutiva Crônica (DPOC) é uma patologia não transmissível, caraterizada por uma limitação do fluxo de ar nas vias aéreas devido a uma resposta imune anormal contra partículas. Objetivo. Conhecer a eficiência que apresenta a budesonida/formoterol comparado com fluticasona/salmeterol na melhora da capacidade pulmonar em pessoas com mais de 40 anos com Doença Pulmonar Obstrutiva Crônica. Materiais e métodos. Foi realizada uma revisão sistemática dos documentos produzidos entre 2000 e 2018 em diferentes bancos de dados, onde foram incluídos ensaios clínicos. Quatro artigos foram identificados para a análise final. Resultados. Durante a avaliação comparativa de budesonida com formoterol, os artículos mostram um total de 709 pessoas avaliadas, com uma idade média de 53,5 anos. O 65,4 % eram do sexo masculino, o 21 % disseram que não usavam tabaco, todos diagnosticados com Doença Pulmonar Obstrutiva Crônica moderada a grave, de acordo com a escala GOLD (Global Initiative For Chronic Obstrutive Lung Disease). Os estudos determinaram que administrar budesonida/formoterol de 400/12 mcg e 320/9 mcg, os pacientes apresentaram uma leve melhora no Volume Expiratório Forçado no primeiro segundo (VEF1). Apenas dois pacientes tiveram efeitos adversos. No entanto, não foram encontradas diferenças significativas para os resultados mencionados acima. Conclusões. O uso de budesonida/formoterol é eficaz na melhora da capacidade ventilatória pulmonar, diminui o numero de exacerbações anuais e gera controle adequado dos sintomas, no entanto, é igualmente eficaz para a fluticasona/salmeterol.

Cost-effectiveness of indacaterol/glycopyrronium in comparison with salmeterol/fluticasone combination for patients with moderate-to-severe chronic obstructive pulmonary disease: a LANTERN population analysis from Singapore

<p><b>INTRODUCTION</b>In light of the growing evidence base for better clinical results with the use of the dual bronchodilator indacaterol/glycopyrronium (IND/GLY) over inhaled corticosteroid-containing salmeterol/fluticasone combination (SFC), this study aimed to evaluate the cost-effectiveness of IND/GLY over SFC in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) who are at low risk of exacerbations, in the Singapore healthcare setting.</p><p><b>METHODS</b>A previously published patient-level simulation model was adapted for use in Singapore by applying local unit costs. The model was populated with clinical data from the LANTERN and ECLIPSE studies. Both costs and health outcomes were predicted for the lifetime horizon from a payer's perspective and were discounted at 3% per annum. Costs were expressed in 2015 USD exchange rates. Uncertainty was assessed through probabilistic sensitivity analysis.</p><p><b>RESULTS</b>Compared to SFC, use of IND/GLY increased mean life expectancy by 0.316 years and mean quality-adjusted life years (QALYs) by 0.246 years, and decreased mean total treatment costs (drug costs and management of associated events) by USD 1,474 over the entire lifetime horizon. IND/GLY was considered to be 100% cost-effective at a threshold of 1 × gross domestic product per capita. The cost-effectiveness acceptability curve showed that IND/GLY was 100% cost-effective at a willingness-to-pay threshold of USD 0 (additional cost) when compared to SFC.</p><p><b>CONCLUSION</b>IND/GLY was estimated to be highly cost-effective compared to SFC in patients with moderate-to-severe COPD who are not at high risk of exacerbations in the Singapore healthcare setting.</p>

Efficacy and Safety of Salmeterol/fluticasone Combined with Montelukast versus Salmeterol/fluticasone in the Treatment of Cough Variant Asthma: A Meta-analysis / 中国药房

OBJECTIVE: To evaluate the efficacy and safety of salmeterol/fluticasone combined with montelukast versus salmeterol/fluticasone in the treatment of cough variant asthma, and to provide reference for evidence-based reference in clinic.METHODS: Retrieved from Cochrane library, PubMed, Chinese Journal Full-text Database, VIP and Wanfang database, randomized controlled trials (RCTs) about therapeutic efficacy (total response rate, marked improvement rate, cough disappearance time, 6-12 months recurrence rate) and safety (the incidence of ADR) of salmeterol/fluticasone combined with montelukast (trial group) vs. salmeterol/fluticasone (control group) in the treatment of cough variant asthma were included. Meta-analysis was performed by using Rev Man 5. 3 software after data extraction and quality evaluation with Cochrane system evaluation manual 5. 1. 0. RESULTS: Totally 10 RCTs were included, involving 976 patients. Results of Meta-analysis showed the total response rate [RR=1. 22, 95％CI(1. 16, 1. 29), P<0. 001] and marked improvement rate [RR= 1. 38,95％CI(1. 22,1. 56),P<0. 001] of trial group were significantly higher than those of control group; the cough disappearance time was significantly shorter than control group [MD= - 3. 07, 95％ CI (- 3. 54, -2. 59),P<0. 001],and 6-12 months recurrence rate was significantly lower than control group [RR=0. 24, 95％CI(0. 11, 0. 54), P<0. 001], with statistical significance. There was no statistical significance in the incidence of ADR between 2 groups [RR=1. 58, 95％ CI (0. 99, 2. 51), P=0. 05]. CONCLUSIONS: The salmeterol/fluticasone combined with montelukast is better than of salmeterol/fluticasone in the treatment of cough variant asthma, but great importance should be attached to the occurrence of adverse events when using drug combination.

Effects of Yupingfeng Granules on Immune Function and Related Indexes of Children with Allergic Rhinitis Complicated with Bronchial Asthma / 中国药房

OBJECTIVE: To investigate the effects of Yupingfeng granules on immune function and related indexes of children with allergic rhinitis (AR) complicated with bronchial asthma (BA). METHODS: Clinical information of 101 children with AR complicated with BA during Feb. 2014-Sept. 2017 were analyzed retrospectively, and they were divided into control group (47 cases) and observation group (54 cases) according to treatment plan. Control group was given Salmeterol xinafoate and fluticasone propionate powder for inhalation through mouth, one inhalation, twice a day+Mometasone furoate nasal spray 50 μg each nostril. Observation group was additionally given Yupingfeng granules 5 g orally, 3 times a day, for consecutive 2 weeks, drug withdrawal at 2 weeks interval, recycled 3 times. Both groups received treatment for consecutive 3 months. Clinical symptom and sign scores, the levels of T-lymphocyte subgroup (CD4+, CD8+, CD4+/CD8+), IL-4, IFN-γ and IgE before and after treatment, the occurrence of ADR were observed in 2 groups. RESULTS: Before treatment, there was no statistical significance in clinical symptom and sign scores, levels of T-lymphocyte subgroup, serum levels of IL-4, IFN-γ or IgE between 2 groups (P＞0. 05). After treatment, clinical symptom and sign scores, CD4+, CD4+/CD8+, serum levels of IL-4 and IgE in 2 groups were all significantly lower than before treatment; observation group was significantly lower than control group. CD8+ and serum levels of IFN-y in 2 groups after treatment were significantly higher than before treatment; observation group was significantly higher than control group, with statistical significance (P＜0. 05). There was no statistical significance in the incidence of ADR between 2 groups (P＞0. 05). CONCLUSIONS: Yupingfeng granules can effectively improve immune function of children with AR complicated with BA, and relieve clinical symptom without increasing the occurrence of ADR.

Effects of salmeterol fluticasone inhalation on pulmonary function and inflammatory cytokines in patients with acute exacerbation of chronic obstructive pulmonary disease / 中国基层医药

Objective To investigate the effect of salmeterol fluticasone inhalation on pulmonary function and inflammatory cytokines in patients with acute exacerbation of chronic obstructive pulmonary disease ( COPD ) . Methods 110 patients with acute exacerbation of asthma combined with COPD were selected and divided into observation group (55 cases) and control group (55 cases) by the random number table .The control group was given conventional treatment ,while the observation group was given salmeterol fluticasone inhalation therapy on the basis of routine treatment .The pulmonary function ,inflammatory cytokines and curative effects were compared between the two groups.Results After treatment,the FVC,FEV1,FEV1/FVC of the observation group were (2.64 ±0.45) L, (1.98 ±0.46)L and (80.42 ±6.43)％,which were significantly better than those of the control group (t=2.89, 2.59,6.27,all P<0.05),the improvement of lung function was more obvious than that of the control group (P<0.05).After treatment,the levels of TNF-α,IL-8,IL-10 and IL-17 in sputum of the observation group were (30.03 ±6.78)μg/L,(59.96 ±7.73)μg/L,(29.89 ±4.11)μg/L and (92.37 ±9.79)μg/L,respectively,which were significantly lower than those of the control group (t=7.54,6.16,7.04,12.31,all P<0.05).After treatment, the levels of TNF -α, IL -8, IL-10 and IL -17 in peripheral blood of the observation group were ( 14.08 ± 5.36)μg/L,(26.32 ±4.03)μg/L,(30.32 ±5.04)μg/L and (173.82 ±18.19)μg/L,respectively,which were significantly lower than those of the control group (t =4.26,7.95,11.25.5.31,all P<0.05).The decrease of inflammatory cytokines in sputum and peripheral blood of the observation group was more significant than that of the control group (P<0.05).The effective rate of the observation group was 94.55％,which was significantly higher than 81.82％of the control group (P<0.05).Conclusion Salmeterol fluticasone inhalation can improve patients'pulmonary function,decrease the level of inflammatory cytokines in sputum and peripheral blood ,which is worthy of clinical application and spread .

Effects of salmeterol xinafoate and fluticasone propionate powder in combination with montelukast on pulmonary function and serum inflammatory cytokines in children with cough variant asthma / 中国基层医药

Objective To investigate the therapeutic effects of salmeterol xinafoate and fluticasone propio-nate powder(seretide) in combination with montelukast on children with cough variant asthma (CVA),and its effect on pulmonary function and serum inflammatory cytokines .Methods 200 patients with CVA were enrolled ,and they were randomly divided into two groups according to the random number table ,100 cases in each group .The control group was treated with seretide ,while the observation group was treated with seretide and montelukast sodium ,both two groups were treated for 3 months.The clinical efficacy,pulmonary function and serum inflammatory cytokines were compared between the two groups .Results The total effective rate of the observation group ( 88.3％) was significantly higher than that of the control group (70.3％;χ2 =9.146,P<0.05).The duration of remission and disappearance of cough symptoms in the observation group were (5.45 ±1.32) d,(8.63 ±1.96) d,respectively, which were significantly shorter than those in the control group [(7.33 ±2.46) d,(12.61 ±1.84) d;t =6.505, 14.229,all P<0.05].There were no statistically significant differences in FEV 1,FEV1/FVC,PEF,IgE,TNF-αand IL-17 between the two groups before treatment (all P>0.05).After treatment,the levels of FEV1,FEV1/FVC, PEF were all significantly higher than those before treatment [(2.11 ±0.34) L,(73.71 ±11.44)％,(86.34 ± 7.85)％,t=18.149,7.664,19.196,all P<0.05;(1.82 ±0.35)L,(69.36 ±10.79)％,(81.66 ±8.03)％,t=9.312,5.418,13.627,all P <0.05],and IgE,TNF -α,IL -17 levels were significantly decreased [(141.3 ± 38.2)ng/L,(624.7 ±213.2) ng/L,(6.1 ±2.1) ng/L,t =15.200,13.708,15.881,all P <0.05;(191.5 ±41.9) ng/L,(835.5 ±326.3)ng/L,(9.4 ±2.7) ng/L,t=6.784,6.206,8.550,all P<0.05].The differences between the two groups were statistically significant(t=5.717,2.659,4.008,8.521,4.842,9.296,all P<0.05). Conclusion Salmeterol xinafoate and fluticasone propionate powder in combination with montelukast sodium has excellent clinical effect in the treatment of children with CVA ,which can improve the pulmonary function and reduce inflammatory cytokines .

Tiotropium bromide combined with salmeterol/fluticasone on the treatment of 122 cases with asthma COPD overlap syndrome / 中国生化药物杂志

Objective To evaluate the clinical efficacy of tiotropium combined with salmeterol/fluticasone on the treatment of the patients with asthma COPD overlap syndrome. Methods 122 patients with asthma COPD overlap syndrome were divided into 2 groups by randomized envelope, the experimental group and the control group. The experimental group were given tiotropium bromide combined with salmeterol/fluticasone. The control group were received compound ipratropium bromide combined with salmeterol/fluticasone. The clinical effect was observed. Results Before treatment, there was no significant difference in lung function between the two groups. After treatment, the improvement of pulmonary function indexes in the experimental group was significantly higher than that in the control group (P<0.05). And the number of acute attack and attack time in the experimental group were also better than those in the control group (P<0.05). Conclusion Tiotropium combined with Shah Mette Lo/fluticasone is effective on the treatment of asthma COPD overlap syndrome, and has some clinical advantages in improving lung function and reducing the frequency of attack.

Effect of Fufei Gushen Decoction on BODE Index of Patients with Chronic Obstructive Pulmonary Disease at Stable Stage / 广州中医药大学学报

Objective To observe the effect of Fufei Gushen Decoction on the BODE index, an index for body mass index(BMI), airflow obstruction, dyspnea, and exercise capacity, in severe and extremely severe chronic obstructive pulmonary disease (COPD) patients with lung-kidney deficiency interweaved with phlegm and blood stasis at stable stage. Methods Eighty qualified COPD patients were randomly divided into treatment group and control group, 40 cases in each group. Both groups were given inhalation of Seretide (Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation) , and the treatment group was given oral use of Fufei Gushen Decoction additionally. The treatment for the two groups lasted for 3 months. Before and after treatment, BMI, the percentage of forced expiratory volume in one second of the predicted value (FEV1%) , dyspnea index of modified British Medical Research Council (MMRC), and exercise performance index of 6-min walking test (6MWT) in the two groups were observed. Results (1) After treatment, FEV1%, MMRC dyspnea index, 6MWT scores and BODE index overall scores of severe and extremely severe patients in the treatment group were much improved(P 0.05). MMRC dyspnea index, 6MWT scores and BODE index overall scores of severe and extremely severe patients inthe control group were much improved (P 0.05).(2) Except for BMI, the parameters of FEV1%, MMRC dyspnea index, 6MWT scores and BODE index overall scores of the treatment group were much improved as compared with those of the control group after treatment(P < 0.05). Conclusion Fufei Gushen Decoction combined with inhalation of Seretide exerts certain effects on decreasing the BODE index scores, relieving symptoms, and improving pulmonary function, exercise performance and the quality of life of COPD patients with lung-kidney deficiency interweaved with phlegm and blood stasis at stable stage.

Effects of salmeterol and fluticasone propionate combined montelukast in the treatment of patients with bronchial asthma / 药物评价研究

Objective To compare the effects of salmeterol and fluticasone propionate combined montelukastin the treatment of patients with bronchial asthma.Methods Ninety-eight bronchial asthma patients from April 2014 to March 2016 in the Fourth People's Hospital Sichuan Province were selected anddivided into observation group and control group with 49 patients in each group according to the above principles by prospective study.The control group was given salmeterol treatment,and the observation group was added given montelukast treatment based on the control group.The treatment days were 15 d recorded the prognosis of the two groups.Results The total effective rates of the observation group and the control group were 95.9％ and 81.6％ respectively,the total effective rate of the observation group was significantly higher than that of the control group (P ＜ 0.05).The FEV1 and FVC values after treatment in the observation group and control group were significantly higher than before treatment (P ＜ 0.05),while the FEV1 and FVC values in the observation group after treatment were significantly higher than those in the control group (P ＜ 0.05).The scores of ACT scale after treatment of two groups were obviously higher than before treatment,and the score of observation group was statistically higher than control group after treatment (P ＜ 0.05).During treatment,there was no statistical significance on adverse reaction between two groups.Conclusion Salmeterol and fluticasone propionate combined montelukast in the treatment of patients with bronchial asthma can promote the improvement of lung function,so as to improve the quality of life and clinical treatment.

Clinical Observation of Tiotropium Bromide Combined with Salmeterol Fluticasone Aerosol in the Treat-ment of Elderly Severe COPD / 中国药房

OBJECTIVE:To observe the clinical efficacy and safety of tiotropium bromide combined with Salmeterol flutica-sone aerosol in the treatment of severe COPD in elderly patients. METHODS:A total of 90 elderly patients with severe COPD se-lected from May 2013 to May 2015 in our hospital as research objects were divided into control group and observation group ac-cording to random number table,with 45 cases in each group. Control group was given Salmeterol xinafonate and fluticasone propi-onate aerosol 1 press/time,bid;observation group was additionally given Tiotropium bromide powder for inhalation 18 μg,qd,on the basis of control group. Both groups were treated for 8 weeks. The short-term clinical efficacy,dyspnea score,pulmonary venti-lation function indexes [FVC,EFV1,EFV1%],blood gas analysis indexes [p(O2),p(CO2)] and QLI score before and after treat-ment were observed in 2 groups. The re-hospitalization time and the occurrence of ADR were compared between 2 groups. RE-SULTS:The total response rate of short-term treatment in observation group was 97.78%,which was significantly higher than 80.00% of control group,with statistical significance (P0.05). After treatment,dyspnea scores and p(CO2) of 2 groups were decreased significantly,while pulmonary ventilation function indexes,p??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????(O2)and QLI scores were increased significantly;the observation group was significantly better than the control group,with statis-tical significance(P<0.05). The re-hospitalization time of observation group was significantly less than that of control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P<0.05). CON-CLUSIONS:Tiotropium bromide assisted with Salmeterol fluticasone aerosol show significant therapeutic efficacy for elderly se-vere COPD,and effectively relieve dyspnea symptom,improve pulmonary ventilation function and quality of daily life,reduce the re-hospitalization risk and do not increase the incidence of ADR.

Analysis on the effect of salmeterol Lo fluticasone combined with montelukast on the treatment of the elderly patients with severe bronchial asthma / 中国生化药物杂志

Objective To analyze the effect of salmeterol Lo fluticasone combined with montelukast on the treatment of the elderly patients with severe bronchial asthma. Methods According to the order of admission, 90 elderly patients with moderate or severe bronchial asthma treated in our hospital from October 2015 to October 2016 were divided into two groups: the study group (n=45) and the control group (n=45). The control group were given salmeterol and fluticasone. The study group were received montelukast on the basis of the control group. The therapeutic effects and pulmonary function in the two groups were compared. Results The total effective rate in the study group was significantly higher than that in the control group, the lung function was significantly better than that in the control group, the differences was statistically significant (P<0.05). Conclusion The clinical efficacy is significant which salmeterol fluticasone combined with montelukast was used on the treatment of elderly patients with moderate and severe bronchial asthma , pulmonary function is improved significantly, which is worthy of reference and promotion.

Effect of Jiuweiqianghuo pill combined with salmeterol fluticasone propionate on chronic obstructive pulmonary disease / 中国生化药物杂志

Objective To observe the effect of of Jiuweiqianghuo pill combined with salmeterol fluticasone propionate on chronic obstructive pulmonary disease.Methods136 patientswith chronic obstructive pulmonary disease from January 2016 to December 2016 were grouped two groups by admission sequence.Two groups were treated with routine treatment and observation group was treated another with Jiuweiqianghuo pill to analyse its effect.ResultsThe total effective rate of observation group was 94.12%,higher than control group 79.41%(P<0.05).FEV1/ expected value and FEV1/FVC of observation group were(66.32±4.27),(71.15±4.41)%,higher than that of control group(58.37±4.19,65.16±4.30)%(P<0.05).6MWT and CAT score of observation group were(319.1±19.5m,19.15±2.97points),better than that of control group(287.4±18.0)m,(23.01±3.08)points(P<0.05).IL-8,TNF-α and hs-CRP level of observation group were(13.40±4.05)ng/L, (18.64±4.21)ng/L, (10.91±2.59)mg/L,lower than that of control group(18.92±4.27)ng/L, (25.13±4.48)ng/L, (14.67±2.75)mg/L(P<0.05).Adverse reactions rate of observation group was 2.94%,slightly lower than control group with 5.88%.ConclusionJiuweiqianghuo pill can decreased serum inflammation and improve lung function to improve the therapeutic effect of chronic obstructive pulmonary disease and it does not increase adverse reactions.

Feasibility Study on Treating Bronchial Asthma with Spleen Intervention Syndrom / 中国生化药物杂志

Objective To investigate the efficacy and safety of tiotropium bromide aerosol combined with salmeterol in the treatment of ACOS. Methods 76 patients with ACOS were enrolled in this study from October 2014 to November 2016. They were divided into experimental group and control group according to the random number table method. The test group was given tiotropium bromide combined with salmeterol Casson aerosol treatment, the control group was given salmeterol tacrolone aerosol treatment, compared the two groups of patients with clinical efficacy and adverse reactions. Results The total effective rate was 92.11% in the experimental group and 73.68% in the control group, the difference was statistically significant (Z = 4.547, P<0.05). The ACT score of the test group was higher than that of the control group, the CAT score was lower than that of the control group, the difference was statistically significant (P<0.05); The incidence of adverse reactions in the test group was 10.53%, the incidence of adverse reactions in the control group was 13.16%,the difference was not statistically significant (χ2 = 0.126). Conclusion Tiotropium powder combined with salmeterol tegon aerosol in the treatment of bronchial asthma-chronic obstructive pulmonary syndrome is reliable and worthy of clinical practice.

Clinical Observation of Salmeterol Fluticasone Combined with Tiotropium Bromide in the Treatment of COPD via Different Inhalation Devices / 中国药房

OBJECTIVE:To observe clinical efficacy and safety of salmeterol fluticasone combined with tiotropium bromide in the treatment of COPD via different inhalation devices.METHODS:Eighty COPD patients were selected from our hospital during Jan.2014 to Jan.2015,and then divided into trial group and control group according to random number table,with 40 cases in each group.Both groups were given Salmeterol fluticasone inhalant 500 μg,bid+Tiotropium bromide inhalant 18 μg,qd.Control group was given medicine via inhalation device coming with medicine,while trial group was given medicine via gas compression type ultrasonic spray inhalator.Both groups were treated for 1 year.Blood concentration of medicine 0.5 h after medication,mMRC score and COPD acsessment test (CAT) score 3,6,9 months after treatment,the times of acute exacerbation during treatment,FEV1％ before and af ter treatment were all observed in 2 groups.The occurrence of ADR was recorded.RESULTS:Four cases withdrew from trial group and 1 case from control group.After medication,there was no statistical significance in blood concentration of fluticasone,salmeterol and tiotropium bromide between 2 groups (P＞0.05).0.5 h after medication,mMRC score of trial group was slightly lower than that of control group,without statistical significance (P＞0.05);CAT score of it was significantly lower than that of control group,with statistical significance (P＜0.05).The times of acute exacerbation in trial group during treatment was significantly less than control group,with statistical significance (P＜0.05).The decrease of FEV1％ in trial group was slightly lower than control group,without statistical significance (P＞0.05).The incidence of ADR in trial group was significantly lower than control group,with statistical significance (P＜0.05).CONCLUSIONS:For COPD patients,salmeterol fluticasone combined with tiotropium bromide via gas compression type ultrasonic spray inhalator is better than inhalation device coming with medicine in clinical efficacy and safety.

Tiotropium and salmeterol xinafoate and fluticasone propionate powder for inhalation combined with non-invasive ventilation in respiratory failure / 中国生化药物杂志

Objective To explore the clinical efficacy of tiotropium and salmeterol xinafoate and fluticasone propionate powder for inhalation combined with noninvasive ventilator in the treatment of respiratory failure, and to provide reference for clinical treatment.Methods 72 patients with respiratory failure were randomly divided into treatment group (n=36) and control group (n=36).The patients were randomly divided into treatment group and control group.Patients in the control group were treated with conventional noninvasive ventilators and treatment group were treated with tiotropium and salmeterol xinafoate and fluticasone propionate powder for inhalation on the basis of control group.Then compare the exercise tolerance, arterial carbon dioxide partial pressure, heart rate, pH, respiratory rate, blood oxygen pressure between two groups.Results After the treatment, condition of the patients in the two groups have different degrees of improvement.The final results showed that the average hospital stay was significantly reduced, respiratory frequency was(28 ±5) times/min in treatment group, heart rate was(98 ±16) times per minute, PaO2 also increased to(72 ±3) mmHg, PaCO2 was(57 ±17) mmHg, pH value increased to (7.42 ±0.03), compared with the control group, with statistically significant difference (P<0.05).Conclusion In patients with clinical implementation of tiotropium and seretide combined with non-invasive ventilator treatment of respiratory failure, can significantly improve the patient's condition, so that patients with respiratory function was significantly improved, so that the indicators of patients tend to normal.Its can effectively reduce PaCO2 , increased PaO2 and speed up its cure rate.