Nebulized Budesonide In The Treatment Of Acute Exacerbations Of Chronic Obstructive Pulmonary Disease

Objective: To evaluate the effect of Nebulized Budesonide(NB)in the treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD).Methods: From 2005.12 to 2007.2, 75 patients with acute exacerbations of COPD of FEV1 60%～25% were randomized to divide into 3 groups ,nebulized Budesonide(NB) groups ,injected Methylprednisolone groups and placebo-controlled groups .The dyspnea score,post-bronchodilator FEV1, arterial blood gases analysis in HO, H72,D5 were measured. And the adverse effect was evaluated at the same time. Data was statistically analyzed by SPSS 11.5 for windows software.Each of 3 groups was demonstrated as x ± s. p<0.05 was considered to be of significance.Results: The difference of HO in the age ,the dyspnea score, post-bronchodilator FEV1 and arterial blood gases analysis of 3 groups was no singnificant(F=0.347,P=0.089>0.05;F=1.879,P=0.160>0.05; F= 0.003,P=0.997>0.05;F=0.268,P=0.765>0.05;F=0.149,P=0.862>0.05). In dyspnea score and PaCO2,the changes of H72 in the patients with active treatments were greater than those with placebo (F=6.060, P=0.004<0.05; F=17.202,P=0.000<0.05),and the changes of D5 in the patients with active treatments were much greater than those with placebo in dyspnea score, post-bronchodilator FEV1, arterial blood gases analysis (PaO2,PaCO2) (F=16.916,P=0.000<0.05; F=4.282,P=0.017<0.05; F= 8.401,P=0.001<0.05;F=16.295,P=0.000<0.05). The difference between NB groups and Methylprednisolone groups was no singnificant(P>0.05). Budesonide had less systemic activity than Methylprednisolone as the placebo.Conclusion: Both NB and Methylprednisolone improved airflow obstruction in COPD patients with acute exacerbations when compared with placebo. NB may be an alternative to injected Methylprednisolone in the treatment of acute exacerbations of COPD.