A Comparative Study Of Inhaling Different Dose Of Budesonide And Intravenous Methylprednisolone On The Efficacy Of AECOPD

Objective:To observe the effect of nebulized with different doses budesonide and intravenous methylprednisolone on AECOPD..Methods:?1?hospitalized patients who were diagnosed as AECOPD and were in accordance with inclusion criteria from February 2015 to June 2016 in the Department of respiratory medicine of Nanhua Hospital of University of South China.?2?according to a randomized,controlled and single blind principle,according to the time of admission number,the patients were randomly divided into 3 groups.?3?the patients were treated with systemic corticosteroids?SCS?,low-dose budesonide?4mg BUD?and high-dose budesonide?8mg BUD?.?4?a total of 132 cases were collected in accordance with the standard,SCS group of a total of44 cases,male,24 cases;female,20 cases,4mg/d group BUD,a total of44 cases,male,25 cases;female,19 cases,and in 8mg/d group?n=BUD?,a total of 44 cases,male,23 cases;female 21 cases.?5?three groups of patients besides routine treatment,group SCS plus methylprednisolone intravenous infusion of 40mg/QD 4mg;BUD group,budesonide inhalation 2mg/BID;BUD 8mg group,budesonide inhalation 4mg/BID;three groups of patients with drug use were treated for 7 days.?6?pulmonary function?FEV1 and FEV1/FVC?,blood gas analysis?PH,PaO₂,PaCO₂?,inflammatory factors?IL-8 and TNF-a?and adverse reactions were recorded in all patients before treatment,after treatment for 3 days and on the 7 day of treatment.?7?the data were compared between the three groups before and after treatment for a period of 3 days,treatment for a period of 7 days,and the data before and after treatment in each group,to observe the efficacy of the treatment on AECOPD.?8?the data is analyzed using SPSS 22 statistical software.Results:?1?Patients in three groups after 3 days of treatment,pulmonary function?FEV₁ and FEV₁/FVC?,blood gas analysis?PH,PaO₂,PaCO₂?,inflammatory factors?serum IL-8 and TNF-??significantly improved than before treatment?P<0.01?;pulmonary function comparison between the three groups?FEV₁ and FEV₁/FVC?,blood gas analysis?PH,PaO₂,PaCO₂?have no obvious difference;there are significant differences between IL-8 were compared between the three groups?F=7.497,P<0.01?;LSD-t test was 22,there was significant difference between the SCS group and 4mgBUD group?P<0.01?,there was no significant difference between SCS group and 8mgBUD group?P=0.266?4mgBUD group and 8mgBUD group discovered that there is obvious difference?P<0.01?;there are obvious difference between TNF-?were compared between the three groups?F=10.798,P<0.01?.LSD-t test of 22,there is obvious difference in SCS group and 4mg BUD group?P<0.01?,there was no significant difference between SCS group and8mgBUD group?P=0.08?,4mgBUD group and 8mgBUD group discovered that there is obvious difference?P<0.01?.?2?after 7 days of treatment,pulmonary function?FEV₁ and FEV₁/FVC?,blood gas analysis?PH,PaO₂,PaCO₂?,inflammatory factors?serum IL-8 and TNF-??than before treatment and 3 days improvement were statistically significant?P<0.05?.In 7 days of treatment between three groups was 22 comparing pulmonary function(FEV₁ and FEV₁/FVC),blood gas analysis?PH,Pa O₂,PaCO₂?were not statistically significant,IL-8 there were significant differences between the three groups?F=14.695,P<0.01?,LSD-t test were 22,there was significant difference between the SCS group and4mgBUD group?P<0.01?,there was no significant difference between SCS group and 8mgBUD group?P=0.116?,compare 4mgBUD group with 8mgBUD group discovered that there is obvious difference?P<0.01?,TNF-?had significant differences compared between the three groups?F=8.095,P<0.01?,the LSD-t test in 22,there was significant difference between the SCS group and 4mgBUD group?P<0.01?,there was no significant difference between SCS group and 8mgBUD group?P=0.468?,compare 4mg BUD group with 8mgBUD group discovered that there is obvious difference?P<0.01?.Conclusion:?1?Budesonide and intravenous methylprednisolone were similar effect in improving lung function and arterial blood gas of patients with AECOPD;in the improvement of inflammatory factors?IL-8,TNF-??using 8mg/d budesonide and intravenous 40mg/d are the same effect,However,the effect of 4mg/d budesonide than 8mg/d budesonide and vein use o f methylprednisolone 40mg/d are worse.?2?Both intravenous methylprednisolone and budesonide inhalation,7days of treatment is more effective than the 3 day course of treatment of AECOPD.