| Objective: To observe clinical efficacy and safety of different combination atomization inhalation terbutaline and budesonide in the treatment of patients with moderate bronchial asthma acute.Methods: 100 cases ofpatients with moderate bronchial asthma acutewere randomly divided into 2 groups. Both groups were given conventional clinical therapy, including oxygen inhalation, correct electrolyte disorder, antispasmodic etc. Experimental group was additionally first given aerosol inhalation of(terbutaline atomized liquid 5mg mixed in 3ml 0.9% sodium chloride injection), 5 minutes after the interval, then atomizing inhalation(budesonide suspension 1mg mixed in 3ml 0.9% sodium chloride injection); The control group was given inhalation terbutaline combined with budesonide mixture(terbutaline atomized liquid 5mg combined with budesonide suspension 1mg mixed in 3ml 0.9% sodium chloride injection); Both groups were given wall type oxygen driven atomizer atomized inhalation therapy, twice a day, 10-15min/time, after atomization gargle and wash. Treatment course of two groups lasted for 7days. Clinical symptom scores of two groups were observed, and lung function index, the change of laboratory indices, the occurrence of adverse reactions were observed before and after treatment.Results:(1)Comparison of cough score and dyspnea score: The cough score in the experimental group from 1.74±0.78 points before treatment to 0.88±0.69 points after the treatment, the control group from 1.76±0.77 points to 0.90±0.74 points, compare with the same group before treatment the cough had improved. There was no significant difference in cough scores between the experimental group and the control group after treatment(P=0.913, P>0.05); The dyspnea score in the experimental group from 1.84±0.71 points before treatment to 0.56±0.54 points after the treatment, the control group from 1.92±0.83 points to 0.88±0.72 points, the decrease of dyspnea score was statistically significant difference between the two groups after treatment(P=0.025, P<0.05), the experimental group than the control group dyspnea improved more obviously.(2)Comparison of lung function index: lung function index(FEV%, PEF%) of two groups had no statistically significant difference before treatment(P=0.117, 0.076, P>0.05). After treatment, FEV1% in the experimental group increased from 64.82±1.65 to 75.64±3.99, PEF% increased from 66.98±1.52 to 82.72±5.24; FEV1% in the control group increased from 64.12±2.66 before treatment to 69.74±3.69, PEF% increased from 66.4±1.71 to 74.90±3.23; The lung function index of two groups after treatment were all significantly higher than before, and the experimental group was higher than the control group, there was statistically significant difference(P=0.000, P<0.01).(3)The change of laboratory indices: IL-6 in the experimental group from 302.72±47.14ng/l before treatment decreased to 138.44±40.18ng/l after treatment, in the control group from 302.02±49.15ng/l decreased to 167.40±57.88ng/l; After treatment, the two groups of IL-6 were significantly lower than before treatment, the experimental group was significantly lower than that of the control group(P=0.005, P<0.01). BNP in the experimental group from 578.26±57.97pg/ml before treatment decreased to 372.68±66.77pg/ml after treatment, in the control group from 580.74±65.87pg/ml decreased to 411.40±72.03pg/ml; After treatment, two groups of BNP were significantly lower than before treatment, the experimental group was significantly lower than that of the control group, there were statistically significant differences between the two groups(P=0.006, P<0.01). C-reactive protein in the experimental group from 4.87±1.03mg/l before treatment decreased to 2.00±1.22mg/l after treatment, in the control group from 5.10±1.13mg/l decreased to 2.65± 0.84mg/l; After treatment, the comparision of the experimental group and the control group had statistical significance(P=0.003, P<0.01), the experimental group was significantly lower than that of the control group. EOS in the experimental group from 0.63±0.09(10*9/L) before treatment decreased to 0.12± 0.13(10*9/L) after treatment, in the control group from 0.61±0.13(10*9/L) decreased to 0.23±0.17(10*9/L); After treatment, the comparision of the experimental group and the control group had statistical significance(P=0.001, P<0.01), the experimental group was significantly lower than that of the control group. WBC in the experimental group from 7.43±1.24(10*9/L) before treatment decreased to 6.16±0.86(10*9/L) after treatment, in the control group from 7.42±1.20(10*9/L) decreased to 5.89±0.93(10*9/L); Compared with the same group before treatment and after treatment the WBC had improved(P<0.05), but the two groups after treatment difference no statistical significance(P=0.136, P>0.05). Sa O2% in the experimental group from 91.68±1.33 before treatment increased to95.82±2.03 after treatment, in the control group from 91.90±1.69 increased to 94.38±2.34; Both groups after treatment were all significantly higher than before, and the experimental group was higher than the control group, there was statistically significant difference(P=0.001, P<0.01).(4)Adverse reaction conditions: in the experimental group only one palpitation occurred, 3 cases occurred pharyngeal discomfort; Meanwhile the control group in slight fingers vibrate in 1 case, Pharyngeal discomfort in 2 cases, oral fungal infection 1 case. And these adverse reactions improved after intervention treatment, with not affect the original drug administration.Conclusion:(1)Interval atomization inhalation tubertaline and budesonide suspension is more effective than simultaneously inhalation both mixture in the treatment of patients with moderate bronchial asthma acute, and safety. Can provide reference for clinical treatment.(2)Interval atomization inhalation tubertaline and budesonide suspension can effectively reduce the acute asthma patients with inflammatory factor levels, thereby reducing the inflammatory factor on the body damage and control of patients with asthma symptoms. |
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