Clinical efficacy of different doses of budesonide/formoterol in the treatment of an acute exacerbation of chronic obstructive pulmonary disease in patients / 中国基层医药

ABSTRACT

Objective:To investigate the clinical efficacy of different doses of budesonide/formoterol in the treatment of an acute exacerbation of chronic obstructive pulmonary disease in patients.Methods:A total of 200 inpatients with an acute exacerbation of chronic obstructive pulmonary disease graded C/D by global initiative for chronic obstructive lung disease (GOLD) staging system who received treatment in Jiuquan City People's Hospital, China from January to December in 2019 were included in this study. They were randomly divided into a control group and a treatment group ( n = 100/group). Based on anti-infection and expectorant treatment, the treatment group was given inhalation therapy (higher dose budesonide/formoterol, 320 μg/9 μg), while the control group was identically given inhalation therapy (lower dose budesonide/formoterol, 160 μg/4.5 μg), with a total course of 9 days in each group. Before treatment and at 5 and 9 days of treatment, procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), fractional exhaled nitric oxide (FeNO), percentage of eosinophils (EO%), partial pressure of oxygen (PaO 2), lactic acid, interleulin-6 (IL-6), forced expiratory volume in 1 second (FEV 1), the ratio of FEV 1/ forced vital capacity (FVC) were monitored in each group. COPD assessment test (CAT) score, modified Medical Research Council (mMRC) dyspnea score, 6-minute walking test (6MWT), and symptom improvement were determined in each group. Results:Before treatment, there were no significant differences in PCT and PaO 2 between the control and treatment groups (both P > 0.05). There were significant differences in PCT, PaO 2, FeNO, hs-CRP, E0 (%), IL-6, FEV 1, FEV 1/FVC, 6MWT, mMRC, cough, expectoration, shortness of breath and CAT score measured at 5 days of treatment between the treatment and control groups ( t = 2.416, 3.289, 3.982, 4.871, 3.332, 4.098, 5.253, 6.214, 3.843, 7.268, 5.387, 7.392, 5.398, 6.349, all P < 0.05). There were significant differences in PCT, PaO 2, FeNO, hs-CRP, E0 (%), IL-6, FEV 1/FVC, FEV 1, 6MWT, mMRC, cough, expectoration, shortness of breath and CAT score measured at 9 days of treatment between the treatment and control groups ( t = 2.508, 4.032, 2.948, 3.527, 3.118, 5.251, 5.325, 6.338, 2.907, 6.289, 3.246, 2.084, 2.151, 2.527, all P < 0.05). At 5 days of treatment, lactic acid level in the observation group was significantly lower than that in the control group ( t = 4.341, P < 0.05). At 9 days of treatment, there was no significant difference in lactic acid level between the control and observation groups ( t = 1.173, P > 0.05). There was no significant difference in the incidence of adverse reactions between the control and treatment groups [4%(4/100) vs. 5%(5/100), P > 0.05]. Conclusion:Inhalation of high doses of budesonide/formoterol can greatly improve pulmonary function, 6MWT performance, decrease mMRC and CAT scores, alleviate cough, expectoration, shortness of breath, and decrease serum levels of FeNO, hs-CRP, E0(%), IL-6 and other inflammatory factors. Inhalation of higher doses of budesonide/formoterol exhibits better efficacy in the treatment of an acute exacerbation of chronic obstructive pulmonary disease in patients than inhalation of lower doses of budesonide/formoterol.