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Objective:To study the efficacy of bisoprolol fumarate tablets combined with tiotropium bromide powder aerosol inhalation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pulmonary heart disease and its effect on high-sensitivity C-reactive protein (hs-CRP) and brain natriuretic peptide (BNP).Methods:From June 2016 to October 2021, 96 patients with AECOPD complicated with pulmonary heart disease admitted to the Affiliated Hospital of Jining Medical University were randomly divided into a control group and an observation group with 48 patients in each group. The patients in both groups were treated with oxygen inhalation, expectorant, cough relieving, asthma relieving and empirical antibiotics. The control group was treated with atomized inhalation of tiotropium bromide powder, and the observation group was treated with bisoprolol fumarate tablets on the basis of the control group. The left ventricular ejection fraction (LVEF), 6-minute walking distance (6MWD), 1 s forced expiratory volume (FEV 1), forced vital capacity (FVC), serum hs-CRP, BNP and other factors were compared between the two groups after treatment, and the total effective rate and adverse drug reaction of the two groups were counted. Results:After treatment, the total effective rates of the observation group and the control group were 91.67%(44/48) and 77.08%(37/48), respectively, with a statistically significant difference ( P<0.05). After treatment, the LVEF of the observation group and the control group were (43.15±6.04)% and (38.96±5.67)% respectively, the 6MWD was (294.86±30.11)m and (261.35±25.88)m, the FEV 1 was (2.36±0.69)L and (1.75±0.52)L, the FVC was (3.58±0.51)L and (2.96±0.45)L, the hs-CRP was (4.47±1.25)mg/L and (7.86±2.01)mg/L, and the BNP was (418.25±32.25)ng/ml and (496.52±43.21)ng/ml; ESR was (16.78±2.11)mm/h and (21.02±1.69)mm/h, ET-1 was (54.26±6.45)ng/ml and (73.21±8.24)ng/ml, and Interleukin 6 was (22.63±8.45)ng/L and (31.85±12.24)ng/L, respectively, with statistical significance ( P<0.05). The total incidence of adverse drug reaction in the observation group and the control group was 8.33%(4/48) and 4.17%(2/48), respectively, with no statistically significant difference ( P>0.05). Conclusions:Bisoprolol fumarate tablets combined with tiotropium bromide powder aerosol inhalation in the treatment of AECOPD complicated with cor pulmonale can improve the heart and lung function of patients, regulate the expression level of hs-CRP, BNP and other factors, improve the efficacy, and do not increase adverse reactions.
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Objective:To investigate the effects of acupoint application therapy with Chinese medicine combined with tiotropium bromide inhalation on quality of life in patients with stable chronic obstructive pulmonary disease (COPD).Methods:A total of 109 patients with stable COPD admitted to People's Hospital of Gaomi from March 2019 to May 2020 were included in this study. They were randomly divided into a control group ( n = 54) and an observation group ( n = 55). Both groups were given tiotropium bromide powder inhalation and acupoint application therapy ( Dazhui, Shenque, Feishu, Pishu, Shenshu and Zusanli). Chinese medicine ointment was applied in the observation group, but not in the control group. All patients were treated for 6 consecutive months. Before and after treatment, pulmonary function indicators [forced expiratory volume in the first second (FEV 1), the percentage of expiratory volume in the first second (FEV 1%), forced vital capacity (FVC), FEV 1/FVC], modified Medical Research Council (mMRC) dyspnea scale score, and the Saint George's Respiratory Questionnaire (SGRQ) score were compared between the two groups before and after treatment to evaluate therapeutic efficacy and quality of life. Results:Before and after treatment, there were no significant differences in FEV 1, FEV 1% and FEV 1/FVC between the two groups (all P > 0.05). After treatment, mMRC score and SGRQ total score in the observation group were (1.91 ± 0.27) points and (38.54 ± 8.18) points, respectively, which were significantly lower than (2.43 ± 0.33) points and (43.12 ± 7.86) points in the control group ( t = 4.93, 4.47, both P < 0.05). The number of exacerbations and the number of hospitalizations were (0.42 ± 0.09) times/6 months and (0.27 ± 0.05) times/6 months in the observation group and they were (0.69 ± 0.17) times/6 months and (0.47 ± 0.13) times/6 months in the control group. There were significant differences in these indices between the two groups ( t = 3.90, 3.85, P < 0.05). Conclusion:Acupoint application therapy with Chinese medicine combined with tiotropium bromide inhalation has a good therapeutic effect on stable COPD. The combined therapy can reduce the number of acute attacks and improve patient's quality of life. This study is scientific and innovative.
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ABSTRACT Objective To analyze the legal demands of tiotropium bromide to treat chronic obstructive pulmonary disease. Methods We included secondary data from the pharmaceutical care management systems made available by the Paraná State Drug Center. Results Public interest civil action and ordinary procedures, among others, were the most common used by the patients to obtain the medicine. Two Health Centers in Paraná (Londrina and Umuarama) concentrated more than 50% of the actions. The most common specialty of physicians who prescribed (33.8%) was pulmonology. There is a small financial impact of tiotropium bromide on general costs with medicines of the Paraná State Drug Center. However, a significant individual financial impact was observed because one unit of the medicine represents 38% of the Brazilian minimum wage. Conclusion Our study highlights the need of incorporating this medicine in the class of long-acting anticholinergic bronchodilator in the Brazilian public health system.
RESUMO Objetivo Analisar as demandas judiciais do brometo de tiotrópio para tratar a doença pulmonar obstrutiva crônica. Métodos Foram considerados dados secundários dos sistemas gerenciais de assistência farmacêutica, disponibilizados pelo Centro de Medicamentos do Paraná. Resultados Ações civis públicas e ações ordinárias, de procedimento comum, entre outras, foram as mais praticadas pelos pacientes para obter o medicamento. Duas Regionais de Saúde do Paraná (Londrina e Umuarama) concentraram mais de 50% das ações. Quanto à especialidade dos médicos prescritores, 33,8% eram pneumologistas. Verificou-se discreto impacto financeiro do brometo de tiotrópio nos gastos gerais com medicamentos pelo Centro de Medicamentos do Paraná. Entretanto, também houve relevante impacto financeiro individual, pois uma unidade do medicamento consome 38% do salário mínimo. Conclusão O estudo aponta para a necessidade de incorporação deste medicamento da classe broncodilatadores anticolinérgicos de longa duração, no Sistema Único de Saúde.
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Humans , Bronchodilator Agents/economics , Drugs, Essential/supply & distribution , Pulmonary Disease, Chronic Obstructive/economics , Judicial Role , Tiotropium Bromide/economics , Health Services Needs and Demand/legislation & jurisprudence , Time Factors , Brazil , Retrospective Studies , Statistics, Nonparametric , Drugs, Essential/economics , Pulmonary Disease, Chronic Obstructive/drug therapy , Health Services Accessibility/economics , Health Services Accessibility/legislation & jurisprudence , Health Services Accessibility/trends , Health Services Needs and Demand/economics , Health Services Needs and Demand/trends , National Health ProgramsABSTRACT
OBJECTIVE：To systematically e valuate the effectiveness of inhaled corticosteroids combined with tiotropium bromide versus inhaled corticosteroids alone in the treatment of asthmatic-COPD overlap syndrome ，and to provide evidence-based reference for clinical use. METHODS ：Retrieved from PubMed ，Web of Science ，Embase，Cochrane Library ，CBM，CNKI， VIP，Wanfang database ，during the establishment of the database to Nov. 2019，randomized controlled trials （RCT）about inhaled corticosteroids combined with tiotropium bromide （trial group ）versus inhaled corticosteroids alone （control group ）in the treatment of asthmatic-COPD overlap syndrome were collected. After data extraction of included literatures met inclusion criteria ，quality evaluation with modified Jadad scale ，Meta-analysis was performed for response rate ，forced expiratory volume in the first second （FEV1），forced vital capacity （FVC），FEV1/FVC，inspiratory fraction （IC/TLC），residual to total ratio （RV/TLC），asthma symptom（ACT）score，chronic obstructive pulmonary symptom （CAT）score，the times of acute exacerbations by Rev Man 5.3.0 software. RESULTS ：A total of 25 RCTs were included ，involving 2 828 patients. The results of Meta-analysis showed that the response rate [RR ＝1.16，95％CI（1.10，1.22），P＜0.001]，FEV1[MD＝0.44，95％CI（0.35，0.54），P＜0.001]，FVC [MD ＝0.70， 95％CI（0.46，0.95），P＜0.001]，FEV1/FVC [MD= 8.79，95％CI（6.22，11.37），P＜0.001]，IC/TLC [MD ＝4.93，95％CI（3.01， 6.85），P＜0.001]，RV/TLC [MD ＝－9.22，95％CI（－9.79，－8.66），P＜0.001]，ACT score [MD ＝5.38，95％CI（4.30，6.47）， P＜0.001]，CAT score [MD ＝－3.67，95％CI（－4.89，－2.45），P＜0.001] and the times of acute exacerbations [MD ＝－1.49， 95％CI（－2.82，－0.17），P＝0.03] in trial group were significantly higher than control group ，with statistical significance. CONCLUSIONS：Compared with inhaled corticosteroids alone ，inhaled hormone combined with tiotropium bromide can improve the response rate and pulmonary function ，but increase the times of acute exacerbation of patients with asthmatic-COPD overlap syndrome.
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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.
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BACKGROUND: Efficacy and safety of tiotropium bromide, a muscarinic receptor antagonist, in treatment of asthma have been reported. However, its effect on airway remodeling in chronic asthma of the elderly has not been clearly verified. The objective of this study was to investigate the effect of tiotropium and expression of muscarinic receptors as its related mechanism in an aged mouse model of chronic asthma with airway remodeling. METHODS: BALB/c female mice age 6 weeks, 9 and 15 months were sensitized and challenged with ovalbumin (OVA) for three months. Tiotropium bromide was administered during the challenge period. Airway hyperresponsiveness (AHR) and pulmonary inflammation were measured. Parameters of airway remodeling, and expression levels of M2 and M3 receptors were examined. RESULTS: Total cell with eosinophils, increased in the OVA groups by age, was decreased significantly after treatment with tiotropium bromide, particularly in the age group of 15 months. AHR and levels of interleukin (IL)-4, IL-5, and IL-13 were decreased, after tiotropium administration. In old aged group of 9- and 15-months-treated groups, hydroxyproline contents and levels of α-smooth muscle actin were attenuated. Tiotropium enhanced the expression of M2 but decreased expression of M3 in all aged groups of OVA. CONCLUSION: Tiotropium bromide had anti-inflammatory and anti-remodeling effects in an aged mouse model of chronic asthma. Its effects seemed to be partly mediated by modulating expression M3 and M2 muscarinic receptors. Tiotropium may be a beneficial treatment option for the elderly with airway remodeling of chronic asthma.
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Aged , Animals , Female , Humans , Mice , Actins , Airway Remodeling , Asthma , Eosinophils , Hydroxyproline , Interleukin-13 , Interleukin-5 , Interleukins , Ovalbumin , Ovum , Pneumonia , Receptors, Muscarinic , Tiotropium BromideABSTRACT
Objective@#To analyze the efficacy of tiotropium bromide combined with bi level positive airway pressure ventilation(BiPAP) in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).@*Methods@#From 2014 to 2016, 60 patients with AECOPD in Tongde Hospital were selected in the research, and were randomly divided into the control group and observation group according to the digital table, with 30 cases in each group.The control group was given BiPAP treatment on the basis of conventional treatment, and the observation group was given tiotropium bromide combined with BiPAP treatment.The therapeutic effects, pulmonary function, arterial blood gas analysis, serum inflammatory factors and quality of life were compared between the two groups after 12 weeks of continuous treatment.@*Results@#After treatment, the total effective rate of the control group was 76.67%, which of the observation group was 96.67%, the difference between the two groups was statistically significant(χ2=5.192, P<0.05). Before treatment, one second forced expiratory volume(FEV1), forced expiratory volume in one second/forced vital capacity(FEV1/FVC), one second forced expiratory volume percentage(FEV1%) between the two groups showed no statistically significant differences(all P>0.05). After treatment, the FEV1, FEV1/FVC and FEV1% in the observation group were (2.73±0.63)L, (77.53±10.68)%, (73.85±11.21)%, respectively, which were higher than those in the control group [(2.02±0.57)L, (68.57±11.25)%, (64.38±12.74)%], the differences between the two groups were statistically significant(t=4.577, 3.163, 3.056, all P<0.05). Before treatment, the oxygen partial pressure(PaO2), partial pressure of carbon dioxide(PaCO2) between the two groups showed no statistically significant differences(all P>0.05). After treatment, the PaO2 of the observation group [(80.48±15.64)mmHg] was higher than that of the control group[(66.05±12.05)mmHg], the PaCO2 of the observation group [(53.11±8.38) mmHg] was lower than that of the control group [(60.33±9.95)mmHg], the differences between the two groups were statistically significant(t=4.003, 3.039, all P<0.05). Before treatment, the serum interleukin 6(IL-6), tumor necrosis factorα(TNF-α), high sensitive C reactive protein(hs-CRP) levels between the two groups showed no significant differences(all P>0.05). After treatment, the levels of serum IL-6, TNF-alpha and hs-CRP in the observation group were (85.83±27.35)ng/L, (85.35±29.15)ng/L, (2.25±0.64)mg/L, respectively, which were lower than those in the control group [(102.57±32.65)ng/L, (101.45±32.14)ng/L, (2.88±0.78)mg/L], there were significant differences between two groups(t=2.152, 2.032, 3.420, all P<0.05). Before treatment, the quality of life questionnaire(SF-36) score between the two groups had no statistically significant difference(P>0.05). After treatment, the SF-36 score of the observation group[(92.48±8.64)points]was higher than the control group[(79.22±17.04)points], there was statistically significant difference between the two groups(t=3.095, P<0.05).@*Conclusion@#Tiotropium bromide combined with BiPAP has better curative effect in the treatment of AECOPD, it can help to improve the patients' lung function and blood gas index, regulate the body's inflammatory state, so that patients get better quality of life, it is worthy of clinical application.
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Objective To observe and compare the effect of Cordyceps sinensis ( bailing ) capsules com-bined with weight-bearing breathing exercises, and weight-bearing breathing exercises combined with tiotropium bro-mide and seretide, on patients with stable but moderate-to-severe chronic obstructive pulmonary disease (COPD). Methods Sixty-three patients with moderate-to-severe COPD were randomly divided into an observation group and a control group. Both groups performed weight-bearing breathing exercises, supplemented in the observation group with the oral administration of bailing capsules. The control group instead inhaled tiotropium bromide and seretide. Six-mi-nute walking distance, the COPD assessment test ( CAT scores) and concentrations of interleukin-6 ( IL-6) , interleu-kin-8 ( IL-8) and tumor necrosis factor-α ( TNF-α) were observed after 1 ( T1) , 30 ( T2) and 58 ( T3) days of the treatments. Results At T1 there were no significant differences between the two groups in any of the measurements ( P≤0.05) . At T2, there were still no significant differences except that a significant decrease in IL-8 and TNF-αlevels was observed in the control group. At T3 the average CAT scores had decreased significantly in both groups compared to before the treatment but there was no significant difference between the two groups. In the observation group, the average 6MWT distance had increased significantly compared to before the treatment and compared to the control group, where there was no significant improvement. The average IL-6, IL-8 and TNF-αreadings of the control group were significantly lower than those of the observation group at T3 and compared to before the treatment. No sig-nificant changes in those indicators were observed in the observation group at T3. Conclusions Bailing capsules combined with weight-breathing exercises are more effective for relieving dyspnea symptoms and improving exercise capacity than weight-breathing exercises combined with tiotropium bromide and seretide. However, in controlling air-way inflammation and airway hyper-responsiveness, the triple inhalation combined with weight-bearing breathing exer-cises is more effective.
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Objective To explore the influence of tiotropium bromide powder inhalant or budesonide powder inhalant on sleep quality and lung function in patients with moderate and severe chronic obstructive pulmonary disease (COPD) in stable period. Methods Sixty-three patients with moderate and severe COPD in stable period were divided into 2 groups by random sortition method:tiotropium bromide group(31 cases,the patients inhaled tiotropium bromide powder inhalant 5 μg/time, 1 time/12 h) and budesonide group (32 cases, the patients inhaled budesonide powder inhalant 200 μg/time, 1 time/12 h). All patients were treated for 3 months. The lung function monitoring and polysomnography were detected before and after treatment. Results Seven patients withdrawn: 3 patients were in tiotropium bromide group,and 4 patients were in budesonide group.The forced expired volume in 1 second(FEV1),forced vital capacity(FVC),FEV1/FVC,peak expiratory flow(PEF)and forced expiratory flow from 25% to 75% (MMEF) after treatment in 2 group were significantly improved compared with those before treatment, and there were statistical differences (P<0.05). The FEV1, FVC and FEV1/FVC levels after treatment in tiotropium bromide group were significantly higher than those in budesonide group: (2.29 ± 0.43) L vs. (2.01 ± 0.42) L, (4.19 ± 0.26) L vs. (3.93 ± 0.23) L and (52.03 ± 10.45) % vs. (49.73 ± 10.21) %, and there were statistical differences (P<0.05). The percentages of S1 phase,S2 phase,rapid eye movement(REM)phase and activity apnea-hypopnea index (AHI)after treatment in 2 groups were significantly improved compared with those before treatment,and the indexes in tiotropium bromide group were significantly better than those in budesonide group:(29.99 ± 8.43)% vs. (26.91 ± 11.66)%, (48.99 ± 10.26)% vs. (45.45 ± 10.13)%, (14.83 ± 8.36)% vs. (13.33 ± 7.44)% and (8.70 ± 5.11) times/h vs. (11.72 ± 10.09) times/h, and there were statistical differences(P<0.05).Conclusions Tiotropium bromide has better effect in promoting the lung function and sleep quality compared with budesonide in patients with moderate and severe COPD in stable period.
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Chronic obstructive pulmonary disease (COPD) is among the most prevalent pulmonary diseases. This study aimed at assessing the efficacy and safety of anticholinergic tiotropium bromide (TB) in Chronic obstructive pulmonary disease patients. This is a systematic review of randomized clinical trials performed in the Brazilian Cochrane Center. Electronic database searched: Cochrane library, Medline, LILACS, Pubmed. There were no language, date or other restrictions. Participants: Patients with Chronic obstructive pulmonary disease. Intervention: tiotropium bromide. Comparison: Other bronchodilators or placebo. Outcomes: Mortality, Chronic obstructive pulmonary disease exacerbation, hospitalizations, adverse effects. Results: 14 studies were included in this systematic review. Mortality was lower in the tiotropium bromide group when compared with the salmeterol group [statistical significance: relative risk (RR) 0.16, confidence interval 95% (CI) 0.03 to 0.89, number needed to treat (NNT) of 100]. There was not a statistical difference in the mortality outcome in the comparison between tiotropium bromide and placebo groups (RR 0.88, CI 0.74 to 1.06). Chronic obstructive pulmonary disease exacerbation decreases significantly in the tiotropium bromide group when compared to placebo (statistical significance: RR 0.85, CI 0.77 to 0.93, NNT 25), but in comparison to the salmeterol group there was no statistical difference (RR 0.93, CI 0.80 to 1.08). The number of hospitalizations was lower in the tiotropium bromide group than in the placebo group (statistical significance:RR 0.77, CI 0.59 to 0.99, NNT 50). The results indicate that tiotropium bromide is an effective once-daily bronchodilator. Tiotropium bromide was associated with consistent health benefits, including reduced chronic obstructive pulmonary disease exacerbations, hospitalizations and even mortality when compared with salmeterol.(AU)
A doença pulmonar obstrutiva crônica está entre as doenças pulmonares mais prevalentes. O objetivo deste estudo foi verificar a eficácia e segurança do brometo de tiotrópio em pacientes com doença pulmonar obstrutiva crônica. Trata-se de revisão sistemática de ensaios clínicos randomizados realizada no Centro Cochrane do Brasil. A estratégia de busca eletrônica foi realizada nos nas bases LILACS, MEDLINE, Biblioteca Cochrane, PubMed. Não houve restrições à linguagem e nem à data. Participaram pacientes com doença pulmonar obstrutiva crônica. A intervenção foi o uso de brometo de tiotrópio comparado a outros broncodilatadores ou placebo. Os desfechos analisados foram mortalidade, exacerbações da doença pulmonar obstrutiva crônica, hospitalização e efeitos adversos. A mortalidade foi menor no grupo brometo de tiotrópio quando comparado com o grupo salmeterol (significância estatística: risco relativo de 0,16; intervalo de confiança de 95% de 0,03-0,89, número necessário para tratar de 100). Não houve diferença estatística no desfecho mortalidade na comparação entre os grupos brometo de tiotrópio e placebo (risco relativo de 0,88; intervalo de confiança de 95% de 0,74-1,06). As exacerbações da doença pulmonar obstrutiva crônica diminuíram significantemente no grupo brometo de tiotrópio quando comparado ao placebo (significância estatística: risco relativo de 0,85; intervalo de confiança de 95% de 0,77-0,93; número necessário para tratar de 25), porém, quando comparado ao salmeterol não obteve significância estatística (risco relativo de 0,93; intervalo de confiança de 95% 0,80-1,08). O número de hospitalizações foi menor no grupo brometo de tiotrópio do que no grupo placebo (significância estatística: risco relativo de 0,77; intervalo de confiança de 95% 0,59-0,99; número necessário para tratar de 50). Os resultados indicam que o brometo de tiotrópio é um broncodilatador eficaz em dose única diária. O brometo de tiotrópio traz benefícios à saúde com resultados consistentes, incluindo redução de exacerbações da doença pulmonar obstrutiva crônica, internações e até mesmo a mortalidade quando comparados com salmeterol.(AU)
Subject(s)
Bronchodilator Agents/therapeutic use , Cholinergic Antagonists/administration & dosage , Pulmonary Disease, Chronic Obstructive/drug therapy , Tiotropium Bromide/therapeutic useABSTRACT
Objective To investigate the clinical effect of budesonide/formoterol single inhaler combined with tiotropium bromide in stable chronic obstructive pulmonary disease (COPD).Methods 80 cases of patients with stable COPD in China Aviation Industrial Xi'an Hospital from May 2014 to May 2016 were divided into observation group and control group,40 cases in each group.Patients in the control group were treated with budesonide/formoterol single inhaler,and in the observation group were treated with budesonide/formoterol single inhaler combined with tiotropium bromide.Compared the pulmonary function,life quality,serum levels of matrix metalloproteinases 9 (MMP-9) and interleukin 6 (IL-6),drug adverse reaction during the treatment and exacerbations episodes within the next six months.Results After treatment,the FEV1,FEV1/FVC,FEV1％ of two groups were significantly higher than before treatment (P ＜ 0.05),and in the observation group were significantly higher than that in control group (P ＜ 0.05).SGRQ scores,serum levels of MMP-9 and IL-6 of two groups were significantly lower than before treatment (P ＜ 0.05),and these indexes in the observation group were significantly lower than that in control group (P ＜ 0.05).The differences in the adverse reaction rate of two groups has no significant,the number of acute exacerbation in observation group were significantly lower than that of control group (P ＜ 0.05).Conclusion Budesonide/formoterol single inhaler combined with tiotropium bromide has remarkable clinical effect in stable COPD,and can effectively improve the pulmonary function,life quality,reduce the number of acute exacerbation,and reduce the serum levels of MMP-9,IL-6.
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Objective To evaluate the clinical efficacy of tiotropium combined with large dose salmeterol/fluticasone in the treatment of severe bronchial asthma with chronic obstructive pulmonary disease (COPD). Methods 60 patients with severe bronchial asthma with COPD stabilization in Taizhou hospital of Zhejiang province from January 2015 to December 2016 were selected and divided into the control and the study group according to the time of visiting hospital,30 cases in each group. The control group were given large dose Salmeterol/fluticasone on the basis of conventional treatment, the study group were treated with tiotropium bromide on the basis of control group. Results FEV1、FVC、FEV1/FVC、PEF and pulmonary function index were compared before the treatment between two groups. After treatment,FEV1,FVC,FEV1/FVC、PEF and pulmonary function index in the study group were better than the control group (P<0.05). Conclusion The combination of tiotropium and large dose salmeterol/fluticasone can significantly improve the clinical efficacy in the treatment of severe bronchial asthma and chronic obstructive pulmonary disease.
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Objective To analyze the clinical effect and the related performance of different tiotropium bromide in the treatment of adult asthma patients.Methods58 patients in the Second hospital of Shandong University from August 2014 to May 2016 admitted to the adult bronchial asthma, were randomly divided into observation group and control group, each of the 29 cases of patients, two patients were taken on the basis of routine treatment of tiotropium bromide in the treatment, the observation group in each given tiotropium 5 g treatment.The control group took a day sooner or later given tiotropium 2.5 g treatment, analysis of clinical effect of two groups were compared and the related performance.ResultsThis group of patients with different delivery methods after treatment, the observation group and the control group of arterial blood gas analysis results have significant difference compared to the clinical effect compared with statistical difference (P<0.05);treatment group the effective rate of treatment group and control the efficiency compared with significant differences (P<0.05);the two groups of patients after treatment, clinical symptoms were observed in groups of patients with asthma remission time were (6.24±1.92) d, while the control group was (8.33±2.47) d, the two groups were compared with statistical difference (P<0.05).ConclusionDifferent tiotropium dosing regimen for adult patients with asthma curative effect has significant clinical effect, compared with 5 per night given tiotropium Gtherapy and its clinical effect is more obvious.
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OBJECTIVE:To observe clinical efficacy and safety of tiotropium bromide combined with budesonide formoterol in the treatment of severe bronchial asthma in adults. METHODS:A total of 110 adult patients with severe bronchial asthma were selected from our hospital during Mar. 2013-Mar. 2016 were divided into control group and observation group according to random number table,with 55 cases in each group. Control group was given Budesonide formoterol powder for inhalation,2 inhalations each time,bid;observation group was additionally given Tiotropium bromide powder for inhalation 18 μg,qd,on the basis of con-trol group. Both groups were treated for 6 months. Clinical efficacies as well as ACT scores,respiration function indexes and the times of acute attack of asthma before and after treatment,the occurrence of ADR were compared between 2 groups. RESULTS:The efficiency rate and total response rate of observation group were 54.55% and 96.36%,which were significantly higher than 32.73%,78.18% in control group,with statistical significance(P0.05). After treatment,ACT scores of 2 groups were significantly higher than before treatment;FEV1,FEV1/FVC and PEF were significantly greater than be-fore treatment,PEFR was significantly lower than before treatment;and the indexes in observation group was significantly better than control group,with statistical significance(P0.05). CONCLUSIONS:Tiotropium bromide combined with budesonide formoter-ol in the treatment of severe bronchial asthma in adults can effectively relieve the severity of disease,improve respiration function, reduce the times of acute attack of asthma,and have good therapeutic efficacy and safety.
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Objective To investigate the correlation between nuclear factor-associated factor 2 gene polymorphism and COPD and the effect of tiotropium bromide combined with budesonide/formoterol inhalation. Methods Seventy-nine patients with chronic obstructive pulmonary disease and 54 healthy subjects were enrolled to determine the NRF2-617C/A(rs6721961)polymorphism by PCR-RFLP and to analyze the relationship between different genotypes and COPD ,and then to observe the therapeutic effect of different genotypes. Results The frequency of A allele in NRF2-617C/A(rs6721961)was a risk factor for COPD(OR=2.312,95%CI:1.517 to 6.824,P<0.05). The total effective rate of AA was lower than that of CC and CA(χ2=8.65,7.24,P<0.05). After treatment,FEV1% pred,FEV1/FVC in the AA type were significantly lower in the CC type(t=6.48,5.62, P<0.05),while IL-8,TNF-αand hs-CRP were significantly higher than those in the CC type(t=6.07,9.21, 4.79,P<0.05). Conclusion NRF2-617C/A(rs6721961)gene polymorphism has a certain correlation with COPD,on which it has a significant effect to tiotropium combined with budesonide treatment and has a moderating effect on inflammatory response and pulmonary function in COPD patients.
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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.
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Objective To investigate the clinical effect of Tiotropium Bromide Powder for Inhalation combined with mental intervention in the treatment of chronic obstructive pulmonary disease in stable period. Methods 80 patients with stable chronic obstructive pulmonary disease treated in our hospital from January 2015 to January 2017were divided into two groups according to the different treatment methods.The control group was treated with conventional methods, the observation group was treated with routine + Tiotropium Bromide Powder for Inhalation + psychological intervention therapy.The clinical curative effect and the improvement of clinical symptoms were recorded and analyzed. Results The clinicalcurative effect of the observation group was better than that of the control group, the improvement of clinical symptoms was better than that of the control group,the difference was statistically significant (P<0.05). Conclusion The effect of chronic obstructive pulmonary disease patients choose conventional treatment+Tiotropium Bromide Powder for Inhalation + psychological intervention mode is significant, can improve clinical symptoms, improve the therapeutic effect and prognosis in the near future and far, worthy of clinical widely used In the treatment of patients with chronic obstructive pulmonary disease in stable phase.
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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.
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Objective To study in patients with stable chronic obstructive pulmonary disease treatment, the use of Tiotropium Bromide Powder for Inhalation treatment combined with psychological intervention effect.Methods In 40 cases of patients with stable chronic obstructive pulmonary disease treatment using tiotropium bromide powder for inhalation, and classified as the control group, the other 40 patients in the control group based on the use of psychological intervention combined with treatment the treatment, and classified as the observation group, two groups of patients were in our hospital from January 2016 to January 2017.Results There was no significant difference in anxiety and depression of patients in the two groups before intervention, after the intervention group patients in the observation group improved significantly better;two groups of patients before intervention PaCO2, there was no significant difference in PaO2 index, after group intervention of patients in the observation group improved significantly better;compared two groups of patients with the treatment efficiency, the obvious observation group were higher, there were significant differences (P<0.05).Conclusion Tiotropium Bromide Powder for Inhalation combined psychological intervention treatment of patients with stable chronic pulmonary disease blocking was observed, which can improve the patient's condition, and improve the treatment effect, the patient's mental state adjustment also has a positive effect, it is worthy of reference.
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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.