| Objective(1) Using quantitative index of heart rate variability in the dynamic ECG analysis software to observe changes in autonomic nervous in bronchial asthma patients and healthy controls and discuss whether there is the autonomic nerve function in patients with asthma disorders.(2) Asthma patients were cured6weeks by using a long-acting anticholinergic drug tiotropium bromide. Using the quantitative indexes of heart rate variability to analysis the changes of autonomic nervous function.If there is a statistically significant compared with before using.At the same time observing the lung function of FEV1FEV1%indicator, the times of using a short-acting beta2-agonists (salbutamol aerosol) and the day and night asthma symptom scores and other related indicators.Discussing the long-acting anticholinergic drugs tiotropium bromide can consult from nerve on the regulating mechanism in the safe and effective for the treatment of asthma, as asthma prevention and control to provide a new way of thinking.Method(1)45patients aged30-45with non-acute exacerbation moderate asthma were randomly divided into three groups B, C, D,(group B ICS+LAMA; group C1CS+LABA; group D ICS+LAMA+LABA).Comparing group B with15healthy from the control group(A). Using Holter monitoring to draw the quantitative analysis index LF、HF、SDANN、PNN50of heart rate variability.Using the lung function measurements (Ms-PFT; Jaeger:Analyzer, Unit) to detect FEV1, FEV1%and get the daytime、nocturnal asthma symptom score and the number of using short-acting beta2-agonists each day. (2) Using the same method for the patients in groups C and D as (1)to draw the quantitative analysis index (LF、HF、SDANN、PNN50) of heart rate variability,lung function FEV1, FEV1%; daytime、nocturnal asthma symptom score and the number of using short-acting beta2-agonists each day.(3) Asthma patients(group B, C, D) were cured6weeks by using a long-acting anticholinergic drug tiotropium bromide. Using the quantitative indexes of heart rate variability to analysis the changes of autonomic nervous function again.Using the lung function measurements (Ms-PFT; Jaeger:Analyzer, Unit) to detect FEV1, FEV1%and get the daytime、nocturnal asthma symptom score and the number of using short-acting beta2-agonists each day.(4)ICS-alanine fluticasone propionate aerosol (trade name:flixotide, GlaxoSmithKline Co production, specifications:125ug)250ug bid, inhalation; ICS+LABA-Shah Mett e Lo and fluticasone propionate dry powder (trade name:Seretide, GlaxoSmithKline Co production, specifications50/250micrograms) oncee respectively each morning and evening,inhalation; LAMA:tiotropium bromide powder for inhalation (Zhejiang Xianju pharmaceutical company production, specifications:18micrograms)18ug qd,inhalatio n; salbutamol aerosol (trade name:Ventolin, GlaxoSmithKline Co production, specifi cations:100MCG) use as needed.Result(1) Bronchial asthma patients compared with healthy controls, namely A and B C D in any group, The HF and pNN50that showd the vice sympathetic tone in asthma subjects increased as compared with the normal group.while the LF and SDANN that mainly showed the sympathetic tone decreased(P<0.01))(2)Asthma patients(group B, C, D) were cured6weeks by using a long-acting anticholinergic drug tiotropium bromide. The HF and pNN50of group B decreased as compared with before medication. There was statistically significant difference. The LF and SDANN of group B increased as compared with before medication. There was no statistically significant difference. The HF and pNN50of group C decreased, the LF and SDANN increased, as compared with before medication. There was no statistically significant difference. The HF and pNN50of group C decreased the LF and SDANN increased, as compared with before medication. There was statistically significant difference. The daytime and nighttime symptom scores, the times of using a short-acting beta2-agonist of three groups were lowered as compared with before medication.The FEV1、FEV1%were improved as compared with before medication. There was statistically significant difference.(3) Asthma patients(group B, C, D) were cured6weeks by using a long-acting anticholinergic drug tiotropium bromide. The quantitative indexes of heart rate variability were compared between groups. There was statistically significant difference between group B and group C, group C and group D, there was no statistically significant difference between group B and group D.The FEV1and FEV1%showed no statistically significant group B and group C, but there was statistically significant difference between group B and group D,group C and group D.The daytime nighttime symptom scores%the times of using a short-acting beta2-agonist showed no statistically significant group B and group C, but there was statistically significant difference between group B and group D,group C and group D.Conclusion(1)Even in normal condition when patients are free of asthmatic attack, autonomic nervous function of asthmatics differ from that normal adults.The HF and pNN50that showd the vice sympathetic tone in asthma subjects increased as compared with the normal group,while the LF and SDANN that mainly showed the sympathetic tone decreased.(2) The addition of the long-acting anticholinergic drugs Tiotropium bromide powder to an inhaled glucocorticoid can reduce HF, PNN50and the vice sympathetic tone excitability. AS compared with the addition of the LABA to an inhaled glucocorticoid.Its effects appeared to be equivalent in improving lung function FEV1、 FEV1%values, reducing the times of using short-acting beta2-agonist and asthma symptom scores. All three of these drugs used in combination to improve lung function, reduce heart rate variability, drop the asthma symptom scores and the times of using a short-acting beta2-agonists are showed more obvious advantages。... |
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