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OBJECTIVE: A retrospective analysis was performed to explore the clinical effect of the Posterior Nasal Nerve (PNN) resection combined with hormone transnasal nebulization on Difficult-to-Treat Rhinosinusitis (DTRS). METHODS: A total of 120 DTRS patients were selected and divided into a control group (nâ¯=â¯60) and a study group (nâ¯=â¯60) according to different treatments. The control group patients were treated via PNN resection, followed by normal saline transnasal nebulization; the study group patients were given PNN resection and then treated with budesonide suspension transnasal nebulization. Subsequently, the comparison was performed between the two groups in terms of (1) Clinical baseline characteristics; (2) Sino-nasal Outcome Test (SNOT)-22 scores before treatment and after 3-months, 6-months and 12-months of treatment; (3) Lund-MacKay scores before treatment and after 10, 30, 90, and 180 days of treatment; (4) Incidence of adverse reactions during treatment. RESULTS: There was no significant difference in SNOT-22 or Lund-Kennedy scores between the two groups before treatment (pâ¯>â¯0.05). After treatment, the SNOT-22 and Lund-Kennedy scores of the control and the study groups were decreased, and compared with the control group, the SNOT-22 and Lund-Kennedy scores in the study group improved more significantly (pâ¯<â¯0.05). In addition, the study group and the control group presented with 1 and 4 cases of nasal adhesion, 2 and 3 cases of epistaxis, 1 and 4 cases of sinus orifice obstruction, 1 and 3 cases of lacrimal duct injuries, respectively. The incidence of adverse reactions in the study group was significantly lower than that in the control group (8.3% vs. 23.3%) (pâ¯<â¯0.05). CONCLUSION: PNN resection combined with hormone transnasal nebulization treatment can improve the symptoms and quality of life of DTRS patients, with good clinical efficacy but few adverse reactions. Therefore, such combination treatment deserves a promotion and application clinically. LEVEL OF EVIDENCE: Level 3.
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Objectives: To investigate the clinical efficacy of budesonide suspension through bronchofiberscopic lavage in the treatment of refractory mycoplasma pneumoniae pneumonia.(RMPP). Methods: A total of 108 children with refractory mycoplasma pneumoniae pneumonia from June 2018 to October 2020 were randomly divided into two groups: the study group and the control group, with 54 cases in each group. Children in the control group were treated with anti-infective, antitussive, antipyretic routine symptomatic treatment and nebulization of budesonide suspension, while children in the study group were treated with bronchofiberscopic lavage with Budesonide suspension along with standard treatment as in control group. The clinical efficacy, changes in blood gas analysis indexes, levels of inflammatory mediators, time for improvement of clinical symptoms and the incidence of adverse reactions were compared between the two groups. Results: The efficacy of treatment in the study group was 85.19%, which was higher than 66.67% in the control group (P<0.05). The antipyretic time, antitussive time, lung rales disappearance time and length of hospital stay in the study group were shorter than those in the control group (P<0.05). Moreover, the levels of arterial oxygen partial pressure (PaO2) in the study group were higher than those in the control group, while the levels of partial pressure of carbon dioxide (PaCO2) and arterial oxygen saturation (SaO2) in the study group were lower than those in the control group (P<0.05). The levels of inflammatory mediators interleukin-6 (IL-6), interleukin-4 (IL-4), and interferon-γ (IFN-γ) in the study group were lower than those in the control group (P<0.05), and no significant difference was found in the comparison of the incidence of adverse reactions between the two groups (P>0.05). Conclusions: Budesonide suspension combined with bronchofiberscopic lavage with Budesonide suspension is a safe treatment regimen that can significantly improve the clinical outcome in children with RMPP. With such a combined treatment regimen, the clinical symptoms of children can be ameliorated, the ventilation function can be enhanced, and the level of inflammatory mediators will be reduced.
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Objective To explore the effect of budesonide suspension for inhalation in the treatment of childhood asthma and its influence on growth and development in 1-2 years. Methods The 68 children with asthma admitted to our hospital from October 2016 to January 2017 were selected. Every patient had acute attacks and received continued medication. 34 patients treated with salbutamol sulfate inhaled aerosol were used as the control group. 34 patients treated with budesonide suspension combined with salbutamol sulfate aerosol were classified as the observation group. The interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), high-sensitivity-C-reactive protein (hs-CRP), maximum respiratory flow, IS maximum expiratory volume, regulatory B cell ratio, wheezing disappearance time, shortness of breath relief time, wet rales disappearing time, cough disappearing time, and the two year follow-up indicators of growth and development were compared. Results After medication, IL-6, TNF-α, hs-CRP, regulatory B cell ratio, wheezing disappearance time, shortness of breath relief time, moist rales disappearance time, and cough disappearance time were lower in the observation group(P<0.05). The maximum respiratory flow and IS maximum expiratory volume in the observation group were higher than those in the control group (P<0.05). The GH level, height, and weight obtained from two year follow up in the observation group were lower than those in the control group (P<0.05). Conclusion Budesonide suspension combined with salbutamol sulfate aerosol inhalation therapy can alleviate the inflammatory reaction, improve the lung function and immune function of children, and accelerate the disappearance of clinical symptoms, but it will affect the growth and development of children to a certain extent.
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One-third of the children who suffer from first-time wheezing are estimated to experience recurrences; however, no standard therapeutic strategy with which to prevent these recurrences currently exists. A few studies have compared the three drugs commonly used for the treatment of persistent asthma in children to identify the most effective one for preventing recurrent wheezing. In this study, in an aim to determine the most effective of these drugs, we recruited patients <5 years of age with recurrent wheezing at our hospital, and assigned them randomly to either the oral montelukast [leukotriene receptor antagonist (LTRA)], the inhaled fluticasone propionate (FP), or the inhaled budesonide suspension (BUD) groups for 12-week treatments. We then determined the treatment efficacy (symptomatic improvement) by recording the number of wheezing episodes and emergency visits, the daily treatment cost, the mean accumulated down time and the patient compliance; we then compared the results among the groups. All treatments were found to be equally effective. The daily cost of inhaled FP was lower than that of oral LTRA and inhaled BUD (P<0.00001). The difference in the mean accumulated down time between these groups was not significant (P=0.132). The adherence (patient compliance) to LTRA was significantly higher than the adherence to inhaled corticosteroids (ICS) (P<0.017). On the whole, the findings of this study indicated that all three treatments prevented recurrent wheezing in our pediatric population. FP was found to be more convenient, to require fewer doses, and that it could be easily adjusted. Patient adherence/compliance to treatment was significantly better with LTRA than with ICS.
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Objective To investigate the effect of montelukast combined with budesonide suspension inhalation in the treatment of children with cough variant asthma (CVA),and its effect on inflammatory cytokines. Methods 96 patients with CVA were selected ,and they were randomly divided into observation group ( n=48 ) and control group ( n=48 ) according to the digital table .The control group was treated with routine western medicine only.On the basis of the control group , the observation group was treated with aerosol inhalation of budesonide suspension and montelukast sodium tablets .The children in the two groups were treated for 3 months, then the treatment effect was evaluated.Results The total effective rate in the observation group was 95.8％,which was significantly higher than 77.1％in the control group(χ2 =4.914,P<0.05).After treatment,the FVC,FEV1,FEV1/FVC and PEF in the two groups were significantly improved (t=4.98,3.09,4.33,4.11,all P<0.01).There were statistically significant differences between the two groups after treatment (t=2.03,2.15,2.33,2.91,all P<0.01). After treatment,the MDA level of the observation group was significantly lower ,SOD value was significantly higher , compared with before treatment,the differences were statistically significant(t=5.13,4.09,all P<0.01).But there were no statistically significant differences between before and after treatment in the control group (t=0.12,0.32,all P>0.05).After treatment,the levels of IL-8,IL-6 and TNF-αin the two groups were significantly lower than before treatment(t=2.09,3.13,2.97,all P<0.01).The decrease of inflammatory cytokines was more significant in the observation group(t=2.67,3.45,2.14,all P<0.01).After treatment,the levels of IgA and IgG in the observa-tion group were significantly higher than those in the control group (all P<0.05),but the IgM level in the observation group was not significantly changed (t=3.44,3.53,3.22,all P<0.05).The IgE,IgM and IgG levels in the control group were significantly lower than those before treatment (t=2.09,2.33,2.76,all P>0.05).There were no serious adverse reactions in the treatment group , and the treatment cycle was completed successfully .Conclusion Monte-lukast combined with budesonide suspension inhalation in the treatment of children with CVA can significantly improve pulmonary ventilation function , reduce cough symptoms , it is safe and effective , which is worthy of clinical reference .
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Objective To observe the clinical efficacy of budesonide suspension combined with antibiotics in the treatment of children with acute otitis media.Methods 256 children with acute otitis media in Shaoxing Central Hospital from January 2016 to December 2016 were selected,and they were randomly divided into observation group and control group by using the method of random number table,128 cases in each group.Both two groups were given antibiotic therapy (azlocillin sodium),on this basis,the observation group was given budesonide suspension,the control group was given chloramphenicol ear drops.At the end of treatment,the treatment effect of the two groups was compared.Results Compared with the control group,the improvement of hearing in the observation group was significantly improved (x2 =21.05,P ＜ 0.01),the rate of tympanic effusion was significandy lower (t =15.30,P ＜ 0.01),and the effective decrease rate of tympanic cavity pressure was significantly higher (t =10.61,P ＜ 0.01).The clinical symptom score of the observation group was significantly reduced,and the degree of improvement was much better than that of the control group (t =16.99,P ＜ 0.01).The onset time and hospitalization time of the observation group were significantly shortened,and the differences were statistically significant (t =13.37,13.89,all P ＜ 0.01).The total effective rate of the observation group was 95.3％,which of the control group was 78.9％,and there was statistically significant difference between the two groups (x2 =20.19,P ＜0.01).The incidence rate of adverse reactions in the observation group was significantly lower than that in the control group,the difference was statistically significant (x2 =8.07,P ＜ 0.05).Conclusion Budesonide suspension combined with antibiotics in the treatment of children with acute otitis media has significant effect,it is conducive to reduce the formation of tympanic effusion,improve children's hearing and treatment effect,and worthy of further clinical application.
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Objective To investigate the therapeutic effect of inhaled budesonide suspension combined with psychological intervention on children with asthma. Methods 64 children with asthma were enrolled in our hospital from October 2015 to December 2016. They were divided into experimental group and control group, 32 cases in each group. The control group was treated with inhaled budesonide suspension.The experimental group was treated with inhalation with budesonide suspension combined with psychological intervention, the treatment efficiency and symptom improvement were compared and analyzed in the two groups. Results The effective rate of the experimental group was 96.87%, which was higher than that of the control group 84.37%, the difference was statistically significant (P<0.05). The symptoms of cough, wheezing, wheezing and dyspnea in the experimental group was obviously better than that in the control group, the difference was statistically significant (P<0.05). Conclusion The effect of inhalation with budesonide suspension combined with psychological intervention in the treatment of children with asthmais pbvious.It can effectively improve the clinical symptoms, and promote recovery of children.
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OBJECTIVE: To describe the impact of nebulized budesonide inhalation suspension (BIS) on guardian-reported symptoms in Chinese pediatric patients with cough variant asthma (CVA). METHODS: This was a secondary analysis of a prospective, non-interventional study conducted at 39 Chinese sites. Patients with CVA aged ≤5 years were classified according to the severity of baseline symptoms: mild (symptom score ≤3) or severe (symptom score >3). Daytime and night-time symptom scores, disease control, use of bronchodilators, and improvements in symptoms control were compared after 1, 3, 5 and 7 weeks of treatment between groups. RESULTS: Among 914 patients, 821 (89.8%) completed the 7-week treatment. Among all patients, 368 (40.3%) were classified as mild CVA and 529 (57.9%), as severe CVA. Symptom scores in the severe group were higher than those in the mild group at weeks 1, 3, and 5 (p < 0.05), but not at week 7 (p > 0.05). Further, more patients in the mild group achieved disease control at any time point (98.6% at 3 weeks and 99.7% at 7 weeks), compared with the patients in the severe group (p < 0.001). The proportion of patients requiring bronchodilators differed between the groups until week 5 (p < 0.001). No severe or drug-related adverse events were reported. CONCLUSIONS: Individualized BIS treatment should be formulated according to the severity of baseline symptoms in CVA patients. Patients with mild CVA showed improvement after a shorter treatment time, while patients with severe CVA might require a longer time to respond to the treatment.
Subject(s)
Asthma/drug therapy , Bronchodilator Agents/administration & dosage , Budesonide/administration & dosage , Cough/drug therapy , Administration, Inhalation , Asian People , Bronchodilator Agents/therapeutic use , Budesonide/therapeutic use , Child , Female , Humans , Male , Nebulizers and Vaporizers , SuspensionsABSTRACT
OBJECTIVE:To analyze the pathological characteristics and therapy method for influenza A(H1N1/H3N2)in-fection complicated with plastic bronchitis (PB). METHODS:Clinical information of 3 children with influenza A (H1N1/H3N2) infection complicated with PB were reported to summarize the experience of aerosol inhalation of Budesonide suspen-sion combined with fiber bronchoscope lavage. Based on literatures,this rare disease were analyzed. RESULTS:Among 3 chil-dren,2 children suffered from influenza A H1N1 infection and one child influenza A H3N2 infection complicated with PB;2 of them got basic disease,i.e. bronchial asthma and primary renal syndrome. 3 children were diagnosed as severe pneumonia,re-spiratory failure and pulmonary atelectasis;2 of them suffered from mediastinal emphesema and subcutaneous emphysema. The branchlike foreign bodies,removed by fiber bronchoscope,were fibrin complicated with neutrophile granulocyte,eosinophile granulocyte and leukomonocyte infiltration by pathological examinations. It was diagnosed as PB. 3 children received symptom-atic support treatment as assisted respiration,respiratory tract management and anti-infective treatment,and aerosol inhalation of Budesonide suspension combined with fiber bronchoscope lavage. And then they were cured and discharged from the hospi-tal. CONCLUSIONS:PB is one complication of influenza A pneumonia and severe. Fiber bronchoscope must be carried out as soon as possible based on aerosol inhalation of Budesonide suspension once PB is suspected,so as to diagnose early and treat promptly.
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Objective To study the effect of Pingchuanguben Decoction on IL-17 level of bronchial alveolar lavage fluid (BALF) and airway remolding in mice with asthma.Methods Forty healthy female Kunming mice were randomly divided into 4 groups (10 rats in each group):normal control group,asthma group,Pingchuanguben Decoction group and Budesonide group.The asthmatic models were established by ovalbumin (OVA) ; the normal control group was treated with phosphate buffer solution (PBS liquid) by celiac injection,during this period Pingchuanguben Decoction was administered to the mice in Pingchuanguben Decoction group each day.In stimulation stage,the normal control group was atomization inhalated PBS liquid,and the rest of the 3 groups were given aerosolized OVA instead.Budesonide atomization was administered to mice in Budesonide group before stimulation.The levels of IL-17 in BALF were measured with enzyme-linked immunosorbent assay (ELISA),and the levels of matrix metalloproteinase-9 (MMP-9)and the tissue inhibitor of metalloproteinase-1 (TIMP-1) in lung tissues were tested with immunohistochemical analysis.Results 1.The levels of IL-17 in BALF in Pingchuanguben Decoction group and Budesonide group were significantly lower than those in asthma group (all P ＜0.05),and the IL-17 in BALF was increased compared with the normal control group (P ＜0.01).2.The levels MMP-9,T IMP-1 and MMP-9/TIMP-1 were decreased in the Pingchuanguben Decoction group and Budesonide group compared with those of asthmatic group (all P ＜ 0.01),and the MMP-9 and MMP-9/TIMP-1 were increased compared with the normal control group(all P ＜0.01).There was no significant difference between Pingchuanguben Decoction group and Budesonide group (all P ＞ 0.05).Conclusions Pingchuanguben Decoction may restrain airway inflammation and remolding,which can replace Budesonide to a certain extent.
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Objective To investigate the curative effect of noninvasive positive pressure ventilation combined with aerosol inhalation of budesonide on patients with severe asthma.Methods One hundred and twenty-one patients with severe asthma were randomly assigned to two groups.Both groups were treated with noninvasive positive pressure ventilation based on routine treatment.In addition,patients in the treatment group were given aerosol inhalation of 2 ml budesonide and 2 ml NS,two times each day,14 days for a course.Clinical symptoms improvement and arterial blood pressure changes of two groups before and after treatment were studied to compare the curative effect of the treatments in the two groups.Results There were no significant differences in pH,PaO2 and PaCO2 between the treatment and the control groups(P ＞ 0.05).After one course of treatment,the treatment group had significantly higher levels of pH(7.43 ± 0.04 vs.7.34 ± 0.02,t =3.423,P ＜ 0.05) and PaO2 ( [77.4 ± 16.7 ] mm Hg vs.[ 62.4 ± 16.5 ] mm Hg,t =3.414,P ＜ 0.05 ) and lower levels of PaCO2 ( [43.4 ±8.9] mm Hg vs.[50.9 ± 9.1 ] mm Hg,t =5.317,P ＜ 0.05 ) than the control group.There were significant differences in the total effective rate between the Budesonide group and the control group (96.7％ vs.88.3％,x2 =4.218,P ＜ 0.05 ).Conclusion Noninvasive positive pressure ventilation combined with aerosol inhalation of budesonide is a simple and effective strategy for patients with severe asthma.Thus it may be worthy to be widely used clinically.
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OBJECTIVE:To evaluate the therapeutic efficacy of oxygen-driven aerosol inhalation of Ventolin plus Atrovent and Budesonide suspension for acute episode of intermediate or severe degree of bronchial asthma. METHODS:A total of 48 patients with bronchial asthma were divided into two groups randomly:26 cases in the treatment group received normal saline (1 mL) +Ventolin (2 mL) + Atrovent (2 mL) and Budesonide suspension(4 mL) q6 h in addition to the routinetherapy by high-flow oxygen driven in addition to the routine therapy; 22 cases in the control group received Ventolin inhaler(200 ?g) q 6 h. The improvement of clinical symptoms in the two groups after treatment for 3 days,the forced expiratory volume in one second (FEV1),forced vital capacity (FVC),peak expiratory flow (PEF) at 3 h and 5 days,respectively,the blood sugar level,arterial blood gas index as well as duration of systemic use of hormone and the hospital days were compared between two groups. RESULTS:After treatment for 3 days,the effective rate in the treatment group(24/26) was significantly higher than in the control group (14/22),showing significant differences between two groups. At 3 h,there were significant differences between the treatment group and the control group in FEV1 and PEF but not in FVC; at 5 days,there were significant differences between the treatment group and the control group in FEV1,FVC and PEF. On day 5,there were significant differences between two groups in PaO2,PaCO2 and blood sugar level as well as in the duration of systemic use of hormone and the hospital days. CONCLUSION:Aerosol inhalation of Ventolin plus Atrovent and Budesonide suspension shows remarkable therapeutic efficacy for acute episode of intermediate or severe degree of bronchial asthma.
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Objective To compare the inhibition effect of budesonide suspension and dexamethasone on the rats′ pneumonic anaphylacticitis and serum IL-5,and study the effect mechanism in treatment of asthma with glucocorticoids on systemic administration and with budesonide suspension.Methods Twenty-six health wistar rats were randomly divided into normal group,asthmatic group,budesonide suspension group and dexamethasone group.Asthma models were sensitized with egg albumin.Before sensitized,budesonide suspension group were administered inhalation of budesonide suspension,and dexamethasone group were administered abdominal injection of dexamethasone.The level of IL-5 was measured with enzyme linked immunosorbent assay(ELISA) reagent box,lung was eviscera-(ted after collecting) blood,pathological slice was made.Results The rats′ pathological changes of lung and bronchus were significant between asthma group and other groups,while there were no significant difference between budesonide suspension group and dexamethasone group,but both of two groups showed slight difference with normal group.Compared with normal group,the level of serum IL-5 in asthma group raised obviously,and there was significant difference(P0.05).Conclusions The treatment of inhalation of budesonide suspension can inhibit rats′ pneumonic anaphylacticitis,ameliorate rat anaphylactic asthma symptom.
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Objective To explore the effect of inhaled ambroxol hydrochloride(mucosolvan) and budesonide suspension(pulmicort respules) on the prevention and treatment of neonatal respiratory distress syndrome(NRDS).Methods Ninty-two preterm infants without asphyxia and mother suffered from illness,were selected from neonatal intensive care unit(NICU) in Jiangyin hospital from Oct.2003 to Mar.2006.Their gestational age ranged from 29 to 33 weeks and they were all cured within 2 hours after birth.They were divided randomly into treatment group(group A) and control group(group B) at equal number.All of them were given oxygen treatment,aminophylline,VitK1,nutrition support treatment and kept in infant incubator.Every 8 hours,inhaled ambroxol hydrochloride(10 mg/kg) and budesonide suspension(0.25 mg) driven by oxygen were given to group A.Meanwhile,only ambroxol hydrochloride(10 mg/kg) were given to group B.After 3 days,the data of p(O2) and p(CO2) of premature were detected at d1,2,3 in 2 groups.Result At d2,d3,the arterial blood P(O2) in group A were(8.01?0.62),(9.25?0.76)kPa respectively;At d2,d3,arterial blood P(O2) value in group B were respectively(7.63?0.59)kPa,(8.75?0.63)kPa.By that statistics handles two set of preemie d2,d3 arterial blood P(O2)value,difference had notable.Group A preemie d2,d3 arterial blood P(CO2) value were respectively:(4.55?0.58),(4.20?0.51)kPa;group B preemie d2,d3 arterial blood P(CO2) value were(4.87?0.67)kPa,(4.44?0.59)kPa respectively.By that statistics handles two set of preemie d2,d3 arterial blood P(CO2) value,difference had notable.Conclusion Inhaled ambroxol hydrochloride and budesonide suspension treatment has be well effect in NRDS.
