Combined Treatment Of Salmeterol-fluticasone Powder Inhalant And Small Dose Of Azithromycin Clinical Research Of Children’s Chronic Moderate Persistent Asthma

Purpose: This research attempts to apply the salmeterol-fluticasone powder inhalant and small dose of azithromycin to cure children’s chronic moderate persistent asthma, and observes the children’s asthma control level after treatment through Children Asthma Control Test(C-ACT), Peripheral Blood Eosinophil count(EOS), lung function and the occurrence situation of adverse event for the purpose of judging the clinical therapeutic effect and the safety of this combined treatment.Methods: Divide randomly the 60 patients children range from 6 to 11 years old with chronic moderate persistent asthma treated by our hospital from Nov 2014 to Jan 2015 into two groups: the observation group and the control group. Both of the two groups apply the low dose inhaled corticosteroids combined with long-acting beta2 agonists as the control medicine of bronchial asthma long period treatment: salmeterol-fluticasone powder inhalant(50ug:100ug*60 spray/box, produced by U.K. GSK Company), one inhale each time, twice a day, lasting for 12 weeks; For children associated with mycoplasma pneumoniae infection, firstly take azithromycin dry suspension(Pfizer Pharmaceutical Co.Ltd. approval number: national quasi-word H10960112), 10mg/(kg.d), orally for 3 days and stop for 4 days, lasting for 2 weeks. While the observation group is continuously given the same medicines,5mg/(kg.d), take orally for 2 days and stop for 5 days, lasting for 8weeks. Observe the children’s asthma control level after treatment and Children Asthma Control Test(C-ACT), Peripheral Blood Eosinophilic Count(EOS), the percentage of expected value of EFV1, percentage of expected value of PEF and the adverse drug reaction on children during this period.Results: 1. Asthma control level comparison of two groups: after twelve-week of treatment, in observation group, there are 24 patients obtain asthma control(80.00%), 5patients get partially control(16.67%) and one patient gets no control(3.33%), the total efficiency is 96.67%; While in control group, 18 patients obtain asthma control(60.00%),4patients get partially control(13.33%) and 8 patients get no control(26.67%), the total efficiency is 73.33%. Therefore, the total efficiency of observation group is higher than control group with a difference has statistical meaning(p<0.05).2. C-CAT scores comparison before and after treatment between these two groups:before treatment, the C-CAT scores comparison between observation group and control group are 16.27±1.31 and 16.10±1.95 respectively(p>0.05) with no statistical meaning;after twelve-week treatment, internal comparison of observation group has statistical meaning(p < 0.05), meanwhile, the internal comparison of control group also has statistical meaning(p < 0.05). Scores comparison between two groups: the increase of scores in observation groups is more obvious(p<0.05) with significant difference.3. Peripheral blood EOS comparison before and after treatment between these two groups: before the treatment, the difference of peripheral blood EOS between observation group and control group is statistically meaningless(p>0.05); after twelve-week treatment,the internal comparison in observation group and the control group has statistical meaning(p<0.05); the peripheral blood EOS comparison between the two groups: the decrease of peripheral blood EOS in observation groups is more obvious(p < 0.05) with significant difference.4. Comparison of improvement on lung function before and after treatment between these two groups: FEV1% comparison before treatment: such comparison between observation group and control group is statistically meaningless(p > 0.05); after twelve-week treatment, the FEV1% in both groups increase significantly, the internal comparisons of both observation group and control group have significant difference before and after treatment with statistical meaning(p < 0.05), but the improvement in observation group is better than the one of control group with obvious difference(p<0.05).PEF% comparison before treatment: observation group and control group is statistically meaningless(p>0.05). After twelve-week treatment, the PEF % in observation group has a significant increase with statistical meaning(p<0.05), and the PEF % in control groups also has an obvious improvement(p < 0.05) with statistical meaning. However, thecomparison between observation group and control group(p < 0.05) indicates that observing group has better effect in improving PEF %.Conclusion: Both the inhalant treatment of salmeterol-fluticasone powder and the combined treatment of salmeterol-fluticasone powder inhalant with small dose of azithromycin in curing children’s chronic moderate persistent asthma have good therapeutic effect and high safety. while the latter has good compliance and safety, as well as a better therapeutic effect in improving the disease condition.