Résumé
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.
Résumé
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.
Résumé
This study explored the relationship between the fractional exhaled nitric oxide (FeNO) level and the efficacy of inhaled corticosteroid (ICS) in asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) patients with different disease severity. A total of 127 ACOS patients with ACOS (case group) and 131 healthy people (control group) were enrolled in this study. Based on the severity of COPD, the ACOS patients were divided into: mild ACOS; moderate ACOS; severe ACOS; and extremely severe ACOS groups. We compared FeNO levels, pulmonary function parameters including percentage of forced expiratory volume in 1 second (FEV1) to predicted value (FEV1%pred), ratio of FEV1 to forced vital capacity (FEV1/FVC), inspiratory capacity to total lung capacity (IC/TLC) and residual volume to total lung capacity (RV/TLC), arterial blood gas parameters, including PH, arterial partial pressure of oxygen (PaO₂) and arterial partial pressure of carbon dioxide (PaCO₂), total serum immunoglobulin E (IgE), induced sputum eosinophil (EOS), plasma surfactant protein A (SP-A), plasma soluble receptor for advanced glycation end products (sRAGE), sputum myeloperoxidase (MPO), sputum neutrophil gelatinase-associated lipocalin (NGAL) and Asthma Control Test (ACT) scores, and COPD Assessment Test (CAT) scores. Compared with pre-treatment parameters, the FeNO levels, RV/TLC, PaCO₂, total serum IgE, induced sputum EOS, plasma SP-A, sputum MPO, sputum NGAL, and CAT scores were significantly decreased after 6 months of ICS treatment, while FEV1%pred, FEV1/FVC, IC/TLC, PH, PaO₂, plasma sRAGE, and ACT scores were significantly increased in ACOS patients with different disease severity after 6 months of ICS treatment. This finding suggests that the FeNO level may accurately predict the efficacy of ICS in the treatment of ACOS patients.