| Objective: The article discusses using salmeterol/ Assigned propionate and theophylline zyban respectively to treat patients with chronic obstructive pulmonary disease(COPD),observing patients’ quality of life scores, lung function, the changes of C- reactive protein and IL-8 In the plasma before and after the treatment, comparing two kinds of the curative effect of the treatment.Then to choose more effective,safer and cheaper treatment options to the patients of COPD in slationary phase of level Ⅲ.Method: Choose 47 patients of COPD in slationary phase of level Ⅲ,who treatment in our hospital from November 2013 to February 2014. According to randomized double-blind principle,the patients divided into theophylline treatment group, nimesulide treatment group. Giving two groups of patients the foundation treatment,such as,home oxygen therapy,giving up smoking positively, nutritional support. Theophylline treatment group in the foundation treatment with Aminophylline Sustained Release Tablets 0.1g 1 piece/time, 2 times/day. Nimesulide overlapping treatment group on the foundation treatment given inhaled nimesulide lap 50/500(50/salmeterol assi- gned 500) propionate, 1 suction / time, 2 times/day. The treatment cycle is six momths altogether, Before treatment, after treatment for 3 months, 6 months were measured respectively in the patients with pulmonary function as a result, the life quality assessment(CAT),CRP in the plasma and the change of IL- 8 indicators of change and do statistical analysis.Result: Forty-five patients complete the treatment among the forty-seven patients.Two patients of theophylline treatment group quit the experiment because of that they can’t stand drug side effects1 In the two groups before and after treatment the CAT score changes: Seretide lap before the treatment, treatment group after treatment for 3 months, 6 months after treatment the CAT score(23.8±2.562)score,(21.7 ±1.952)score,(18.3±2.006)score。Aminophylline Sustained Release Tablets groups before treatment, after treatment for 3 months, 6 months after treatment the CAT, average score, respectively.(23.6±2.15)score,(22.4±1.76)score,(21.8±1.76)score. Prompt nimesulide overlapping patient’s quality of life and prognosis of treatment group was obviously better than that of aminophylline in treatment group, showed that there was a significant difference between two groups before and after treatment(P<0.01),2 Three phase change of FEV1 % of expected value and FEV1/FVC%: Seretide lap before the treatment, treatment group after treatment for 3 months, 6 months after treatment of FEV1 % is expected value, respectively:(36.62± 3.52),(42.66±2.14),(48.53±2.14). FEV1/FVC% respectively:(39.93± 3.61),(52.19±4.63),(57.79±5.27)。 Aminophylline Sustained Release Tablets groups before treatment, after treatment for 3 months, 6 months after treatment of FEV1%is expected value, respectively:(36.75±4.24),(40.85±3.21),(42.35± 3.17).FEV1/FVC% respectively:(38.65±4.78),(48.78±3.45)(52.95± 4.37). Contrast to the two groups before and after treatment, nimesulide overlapping treatment group patients with lung function improved significantly, there was a significant difference between two treatment group before and after treatment(P<0.01).3 Three phase change of CRP: Seretide group blood CRP prior to treatment(13.78±1.35 ㎎/L), therapy for 3 months(10.14±1.03 ㎎/L), therapy for 6 months(4.35±1.37 ㎎/L). Aminophylline Sustained Release Tablets group blood CRP prior to treatment(13.95±1.69 ㎎/L), therapy for 3 months(11.62±1.56 ㎎/L),, therapy for 6 months(6.56±1.256 ㎎/L). Adopt the repeated measurement design analysis of variance, respectively, show that two groups of bursting there are differences between before and after treatment between the two groups but not significant(P<0.05).4 Three phase change of IL-8: Seretide group before IL- 8 treatment for blood(8.89±1.78ng/L), therapy for 3 months(6.12±1.642ng/L),therapy for 6 months(5.26±1.54ng/L),.Aminophylline Sustained Release Tablets group blood CRP prior to treatment(13.95±1.69 ㎎ /L), therapy for 3 months(6.56±1.584ng/L),therapy for 6 months(6.09±1.32ng/L). Shows that the two groups after treatment than before treatment in plasma IL- 8 decreased, but nimesulide overlapping treatment group is IL- 8 aminophylline treatment group IL- 8 is more apparent, and comparing the two groups have significant difference(P<0.01).5 The number of three stages of acute episode and the changes of rehospitalization rate and treatment effect:there are 2 patients having acute episode during the whole treatment within Seretide group,and the rate of acute is 8%.3 courses hospitalized again and the rate hospitalized is 12%.There is one case having acute episode during the whole treatment within the Aminophylline group,and the rate of acute is 4.7%.2 cases hospitalized again and the rate hospitalized is 9.1%.According to the comparion between the two groups,it is clearly that they are different in the number of acute episode and hospitalized rate but not significant(P<0.05).Seretide group effects totally 88%,while Aminophylline group effects totally 77.3%.Through the comparison in efficiency of the two,it can not found that differences are significant(P<0.01).Conelusio: Long-term joint inhaling salmeterol with flutieasone(Seretide) could obviously alleviate stabilization moderately severe deterioration of lung function in COPD patients, improving the quality of life, reducing the number of acute curative effect is better than that of theophylline treatment of the control group, Combined inhaling salmeterol with flutieasone(Seretide) is long-term stability moderately severe COPD patients in the choice of safe effective treatment. |
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