Clinical Study Of Different Routes Of Administration Of Glucocorticoid Treatment Effect Of AECOPD

Objective: To compare the clinical efficacy of inhalation, systemic corticosteroids or without corticosteroids in the different groups of COPD patients with acute exacerbation, We want to explore ideal glucocorticoid administration route of different severity in patients with acute exacerbation of COPD.Methods: collect 212 elderly AECOPD patients of Dongting hospital general internal medicine from January 2012 to July 2015, record all patients’ age, gender, BMI, history of COPD, smoking history and other basic information, records of all COPD patients with clinical symptoms, pulmonary function, on the basis of a year of acute exacerbation of hospitalized patients with COPD and life quality evaluation questionnaire(CAT questionnaire), dyspnea grade improved version the British Medical Research Council(mMRC), blood gas analysis and fasting blood glucose, potassium levels, according to the 2013 China "chronic obstructive pulmonary disease diagnosis and treatment guidelines", a comprehensive assessment of all file COPD patients who have been established, A group of 69 patients, 74 patients in the B group, C group of 69 patients. According to the different glucocorticoid the route of administration, divided into inhalation group and oral medication group, and was selected as the control group without the use of hormones. After 1 weeks, all patients(FEV1, FEV1%predicted), blood gas analysis(PaO2, PaCO2), CAT and fasting blood glucose, potassium levels and adverse reactions were evaluated.Results: 1, in patients with acute exacerbation ABC group, after three treatments for FEV1, FEV1% predicted value, PaO2 higher than before treatment, after treatment PaCO2, CAT score lower than before treatment, and the difference was statistically significant. 2, ABC group for patients with acute exacerbation, patients with glucocorticoids therapy, FEV1, FEV1% predicted value, PaO2 difference before and after treatment was higher, PaCO2, CAT scores were lower than the control group,and they were statistically significant.(p<0.05). 3, the one weeks of the use of glucocorticoids, patients in A and B groups with acute exacerbation There were no significant difference in FEV1, FEV1% predicted, PaO2, PaCO2, CAT Before and after treatment between the Inhalation and systemic treatment group(p>0.05). 4, After one glucocorticoids weeks, Patients in C group with acute exacerbation, Difference of FEV1, FEV1% predicted, PaO2, Pa CO2 of Inhalation group therapy before and after treatment is less than that in the systemic group(p<0.05). 5, Adverse reactions in Inhalation patients was significantly less than the systemic group, which is a significant difference(p<0.05).Conclusion: 1, three kinds of treatment methods were effective in patients with acute exacerbation of COPD, and it was more effective to improve the therapeutic effect of glucocorticoid on the basis of conventional therapy. 2, In group A and group B patients with acute exacerbation, glucocorticoid inhalation and systemic administration treatment had no significant difference, but atomization adverse reactions of the two groups was significantly lower than that of general group, so A group, B group of patients with acute aggravated suggested the use of nebulized corticosteroids. 3, patients in group C acute exacerbation, glucocorticoid inhalation and systemic administration treatment had significant difference, systemic therapy was superior to the atomization treatment, so patients in group C with acute exacerbation of suggested using of systemic steroid therapy. 4.After one weeks treatment of the use of corticosteroids of COPD patients with acute exacerbation the patients had a certain degree of adverse reactions, such as blood sugar, low potassium, stomach discomfort and oral ulcers, etc.