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Introduction:Adenoidectomy is currently considered the treatment of choice for relief of the nasal airway obstruction due to adenoid hypertrophy. Evidence suggests that topical nasal steroid sprays can cause a reduction in adenoid size. We aim to compare the effectiveness of fluticasone propionate, mometasone furoate (MF) and saline nasal sprays in relieving the signs and symptoms of adenoid hypertrophy and in reducing the size of the adenoids. MaterialsandMethods: We conducted a randomized comparative study on 60 patients divided into three groups A, B, C (20 each). Group A patients treated with fluticasone propionate nasal spray (400 μg/day), Group B patients treated with MF nasal spray (100 μg/day), and Group C patients treated with saline spray (0.65% w/v in purified water which is made isotonic and buffered). Treatment was given up to 12 weeks with follow‑up at 4, 8, and 12 weeks and at each follow‑up visit assessment was done. Final data were analyzed using SPSS software version 21 and numerical variables associated with different groups were analyzed and analysis of variance test was used. Results: Diagnostic nasal endoscopy and X‑ray grades at day 1 among the study groups were not statistically significant, whereas, at 12 weeks results among fluticasone and mometasone groups were significantly better (P < 0.001) as compared to the saline group. There was a significant improvement in the symptoms under all the categories with the use of fluticasone and mometasone. Conclusion: In our study, both fluticasone propionate and MF were able to effectively reduce symptoms and signs of adenoid hypertrophy as well as help in reducing the size of the enlarged adenoid. Both these drugs were well tolerated by the patients
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Objective:To evaluate short-term efficacy and safety of fluticasone propionate 0.05% cream alone or in combination with calcipotriol 0.005% ointment in the treatment of mild to moderate plaque psoriasis.Methods:From October 2020 to January 2021, a randomized, open-labeled, self-controlled clinical trial was conducted among 30 patients with mild to moderate plaque psoriasis in Beijing Friendship Hospital. Skin lesions on the extremity of one side were topically treated with calcipotriol 0.005% ointment in the morning and fluticasone propionate 0.05% cream in the evening (combination group) , and lesions on the contralateral extremity were topically treated with fluticasone propionate 0.05% cream twice a day (fluticasone propionate group) . The treatment lasted 4 weeks. Before and 1, 2, 4 weeks after the start of treatment, the patients were followed up, clinical indices including static physician′s global assessment (sPGA) and psoriasis area and severity index (PASI) were evaluated, and adverse events were recorded. Efficacy and safety were evaluated by using repeated measures analysis of variance, multivariate analysis of variance, Mann-Whitney rank sum test and two-independent-sample t test. Results:Before the treatment, there was no significant difference in sPGA or PASI score between the combination group and fluticasone propionate group (both P > 0.05) . After 1-week treatment, the fluticasone propionate group showed significantly decreased sPGA (1.10 ± 0.31 points) and PASI scores (1.05 ± 0.51 points) compared with the combination group (1.73 ± 0.45 points, 1.38 ± 0.69 points, F= 40.74, 4.38, respectively, both P < 0.05) ; after 2- and 4-week treatment, the combination group showed significantly decreased sPGA (0.83 ± 0.46 points, 0.23 ± 0.43 points, respectively) and PASI scores (0.53 ± 0.47 points, 0.23 ± 0.50 points, respectively) compared with the fluticasone propionate group (sPGA: 1.03 ± 0.18 points, 0.97 ± 0.32 points, F= 4.88, 56.14, respectively, both P < 0.05; PASI: 1.03 ± 0.51 points, 0.92 ± 0.54 points, F= 15.20, 26.36, respectively, both P < 0.05) . After 1-week treatment, the infiltration/hypertrophy severity score was significantly lower in the fluticasone propionate group than in the combination group ( U= 165.00, P < 0.05) ; after 2- and 4-week treatment, the erythema and scaling severity scores were significantly lower in the combination group than in the fluticasone propionate group (erythema: U= 540.00, 765.00, respectively, both P < 0.05; scaling: U= 825.00, 795.00, respectively, both P < 0.05) . Conclusion:Fluticasone propionate 0.05% cream alone exhibited a rapid onset of efficacy in the treatment of psoriasis, while fluticasone propionate 0.05% cream combined with calcipotriol 0.005% ointment was more effective after 2- and 4-week treatment, and both regimens showed a favorable safety profile.
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Abstract This study investigatedthe efficacy and safety offluticasone propionate nasal spray in treatment of adenoidal hypertrophic snoring in children.Fifty-six children with adenoidal hypertrophic snoring were enrolled. According to adenoidal-nasopharyngeal ratio (ANR) in lateral nasal X-ray examination,the children were assigned in moderategroup (23 cases) and severegroup (33 cases).The fluticasone propionate nasal spray was used for all patientsfor 4 weeks.In 56 patients, after treatment, compared with before treatment, the snoring, sleep apneaand nasal obstruction scores in moderategroupand the nasal obstruction score in severegroupwere significantly decreased,respectively (P < 0.05).The decreases of snoring, sleep apnea, mouth breathing and nasal obstruction scores after treatment in moderate group were significantly higher than those in severe group, respectively (P <0.001).After treatment, in 18 patients with ateral nasal X-ray examination,the adenoid size was obviously reduced, and the nasopharynx airway was obviously enlarged. The meanANRdropped from 0.76±0.10 to 0.72±0.09(P <0.001).Duringtreatment, only 2 of 56 patients were reported with intranasal dryness and occasional epistaxis, which were self-healed without treatment.Fluticasone propionate nasal spray is effective and safe for treatment of children's snoring caused by adenoidal hypertrophy.
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Background: Amongst the common problems facedglobally, Allergic Rhinitis (AR) is very distressing attimes. This is an inflammatory response to either knownor unknown allergen. The symptomatic relief in ARusing topical steroid Fluticasone propionate andantihistaminic Azelastine Hydrochloride in acombination has been studied. Very few studies showingcomparison between these two drugs in a combinationand steroid alone are available in the literature. Aim andObjectives: To study the effectiveness of topicaltreatment using corticosteroid Fluticasone propionateand antihistaminic in a combination versus Fluticasonepropionate alone in patients of AR. Material andMethods: The cases presented with symptoms ofallergic rhinitis were randomized in two groups at startof treatment. All cases of Group I were treated withFluticasone propionate whereas of Group II withFluticasone propionate and Azelastine hydrochloridecombination. In each group, the individual symptomscores were recorded pre-treatment and post-treatmentat the end of four weeks with the help of symptomevaluation scale. Based on these individual symptomscores, the Total Symptom Score (TSS) was calculated.The effectiveness of group specific drugs was evaluatedby comparing individual and TSS. Results: After fourweeks, both TSS and individual symptom score werereduced in either group (p<0.05). Further, Group IIspecific drug was found more effective than Group-I inrelieving symptoms of AR. Conclusion: TSS decreasedby an average of 84.14% in Group-I (i.e. treated withFluticasone propionate) and by 91.16% in Group–II (i.e.treated with Fluticasone propionate and Azelastinehydrochloride I in a combination).
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Objective:To observe the effect of warm-unblocking acupuncture plus fluticasone propionate nasal spray on the pulmonary ventilation, level of interferon-γ (IFN-γ) and sleep quality in patients with allergic rhinitis (AR). Methods: A total of 112 AR patients were enrolled between January 2013 and August 2018 and were divided into an observation group and a control group by the random number table method, with 56 cases in each group. Patients in the observation group received warm-unblocking acupuncture plus fluticasone propionate nasal spray, and patients in the control group only received fluticasone propionate nasal spray. The nasal symptom score, pulmonary function indexes, the levels of IFN-γ and interleukin (IL)-4 in serum, and sleep quality in the two groups were compared. Results: After treatment, the total effective rate in the observation group was higher than that in the control group (P＜0.05). The nasal symptom score dropped in both groups after treatment (both P＜0.05), and the score in the observation group was lower than that in the control group (P＜0.05). The pulmonary ventilation indexes all increased significantly after treatment in the observation group (all P＜0.05); the forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) ratio (FEV1/FVC) and the forced expiratory flow at 50%, 75% and 25%-75% of the vital capacity (FEF50%, FEF75%, FEF25%-75%) increased after treatment in the control group (all P＜0.05); the pulmonary ventilation indexes were higher in the observation group than those in the control group (all P＜0.05). The level of IFN-γ increased significantly after treatment in the two groups (both P＜0.05) and the level of IL-4 dropped significantly (both P＜0.05); the observation group had a higher IFN-γ level (P＜0.05) and a lower IL-4 level (P＜0.05) compared with the control group. Regarding the Pittsburgh sleep quality index (PSQI), the scores of subjective sleep quality, habitual sleep efficiency and sleep disturbances and the general PSQI score decreased significantly after treatment in both groups (all P＜0.05), and the scores in the observation group were significantly lower than those in the control group (all P＜0.05). Conclusion: Warm-unblocking acupuncture plus fluticasone propionate nasal spray can effectively control the clinical symptoms and improve pulmonary function in the treatment of AR; this approach can regulate the levels of IFN-γ and IL-4 towards the normal range in AR patients; it can also improve patient’s sleep quality. This method can produce more significant efficacy than fluticasone propionate nasal spray used alone.
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OBJECTIVE: To investigate the effects of Yupingfeng granules on immune function and related indexes of children with allergic rhinitis (AR) complicated with bronchial asthma (BA). METHODS: Clinical information of 101 children with AR complicated with BA during Feb. 2014-Sept. 2017 were analyzed retrospectively, and they were divided into control group (47 cases) and observation group (54 cases) according to treatment plan. Control group was given Salmeterol xinafoate and fluticasone propionate powder for inhalation through mouth, one inhalation, twice a day+Mometasone furoate nasal spray 50 μg each nostril. Observation group was additionally given Yupingfeng granules 5 g orally, 3 times a day, for consecutive 2 weeks, drug withdrawal at 2 weeks interval, recycled 3 times. Both groups received treatment for consecutive 3 months. Clinical symptom and sign scores, the levels of T-lymphocyte subgroup (CD4+, CD8+, CD4+/CD8+), IL-4, IFN-γ and IgE before and after treatment, the occurrence of ADR were observed in 2 groups. RESULTS: Before treatment, there was no statistical significance in clinical symptom and sign scores, levels of T-lymphocyte subgroup, serum levels of IL-4, IFN-γ or IgE between 2 groups (P＞0. 05). After treatment, clinical symptom and sign scores, CD4+, CD4+/CD8+, serum levels of IL-4 and IgE in 2 groups were all significantly lower than before treatment; observation group was significantly lower than control group. CD8+ and serum levels of IFN-y in 2 groups after treatment were significantly higher than before treatment; observation group was significantly higher than control group, with statistical significance (P＜0. 05). There was no statistical significance in the incidence of ADR between 2 groups (P＞0. 05). CONCLUSIONS: Yupingfeng granules can effectively improve immune function of children with AR complicated with BA, and relieve clinical symptom without increasing the occurrence of ADR.
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Objective To explore the clinical effect of fluticasone propionate combined with noninvasive positive pressure ventilation in the emergency treatment of AECOPD .Methods 88 AECOPD patients were selected, and they were divided into two groups by digital random method ,44 cases in each group.The control group received conventional treatment, the observation group received fluticasone propionate and noninvasive positive pressure ventilation treatment.The curative effect of the two groups was compared .Results The total effective rate of the observation group was 100.0%,which was higher than 70.5% of the control group (χ2 =10.827,P =0.000).After treatment,in the observation group,the FVC was (2.50 ±0.32)L,forced expiratory volume in one second (FEV1 ) was (1.36 ±0.20) L,the first second forced expiratory solvent percentage of predicted value ratio (FEV1%) was (51.23 ±4.32),the arterial oxygen pressure(PaO2 ) was (10.51 ±2.10) kPa,arterial partial pressure of carbon dioxide(PaCO2 ) was (5.15 ±1.19) kPa,and in the control group,the FVC was (2.00 ±0.30) L,FEV1 was (1.08 ±0.12)L,FEV1% was (40.6 ±4.03),PaO2 was (9.32 ±2.11) kPa,PaCO2 was (6.06 ±1.23) kPa,the differences between the two groups were statistically significant (t =7.940,9.192,8.102,8.920,9.920,P =0.023, 0.006,0.011,0.008,0.005).The readmission rate of the observation group was 4.5%,which was significantly lower than 13.6% of the control group (χ2 =9.298,P =0.000).Conclusion Fluticasone propionate combined with noninvasive positive pressure ventilation in the treatment of AECOPD patients can effectively improve lung function , reduce the relapse rate of the disease.
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Objective To investigate the therapeutic effects of salmeterol xinafoate and fluticasone propio-nate powder(seretide) in combination with montelukast on children with cough variant asthma (CVA),and its effect on pulmonary function and serum inflammatory cytokines .Methods 200 patients with CVA were enrolled ,and they were randomly divided into two groups according to the random number table ,100 cases in each group .The control group was treated with seretide ,while the observation group was treated with seretide and montelukast sodium ,both two groups were treated for 3 months.The clinical efficacy,pulmonary function and serum inflammatory cytokines were compared between the two groups .Results The total effective rate of the observation group ( 88.3％) was significantly higher than that of the control group (70.3％;χ2 =9.146,P<0.05).The duration of remission and disappearance of cough symptoms in the observation group were (5.45 ±1.32) d,(8.63 ±1.96) d,respectively, which were significantly shorter than those in the control group [(7.33 ±2.46) d,(12.61 ±1.84) d;t =6.505, 14.229,all P<0.05].There were no statistically significant differences in FEV 1,FEV1/FVC,PEF,IgE,TNF-αand IL-17 between the two groups before treatment (all P>0.05).After treatment,the levels of FEV1,FEV1/FVC, PEF were all significantly higher than those before treatment [(2.11 ±0.34) L,(73.71 ±11.44)％,(86.34 ± 7.85)％,t=18.149,7.664,19.196,all P<0.05;(1.82 ±0.35)L,(69.36 ±10.79)％,(81.66 ±8.03)％,t=9.312,5.418,13.627,all P <0.05],and IgE,TNF -α,IL -17 levels were significantly decreased [(141.3 ± 38.2)ng/L,(624.7 ±213.2) ng/L,(6.1 ±2.1) ng/L,t =15.200,13.708,15.881,all P <0.05;(191.5 ±41.9) ng/L,(835.5 ±326.3)ng/L,(9.4 ±2.7) ng/L,t=6.784,6.206,8.550,all P<0.05].The differences between the two groups were statistically significant(t=5.717,2.659,4.008,8.521,4.842,9.296,all P<0.05). Conclusion Salmeterol xinafoate and fluticasone propionate powder in combination with montelukast sodium has excellent clinical effect in the treatment of children with CVA ,which can improve the pulmonary function and reduce inflammatory cytokines .
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Objective To observe the effect of Fufei Gushen Decoction on the BODE index, an index for body mass index(BMI), airflow obstruction, dyspnea, and exercise capacity, in severe and extremely severe chronic obstructive pulmonary disease (COPD) patients with lung-kidney deficiency interweaved with phlegm and blood stasis at stable stage. Methods Eighty qualified COPD patients were randomly divided into treatment group and control group, 40 cases in each group. Both groups were given inhalation of Seretide (Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation) , and the treatment group was given oral use of Fufei Gushen Decoction additionally. The treatment for the two groups lasted for 3 months. Before and after treatment, BMI, the percentage of forced expiratory volume in one second of the predicted value (FEV1%) , dyspnea index of modified British Medical Research Council (MMRC), and exercise performance index of 6-min walking test (6MWT) in the two groups were observed. Results (1) After treatment, FEV1%, MMRC dyspnea index, 6MWT scores and BODE index overall scores of severe and extremely severe patients in the treatment group were much improved(P 0.05). MMRC dyspnea index, 6MWT scores and BODE index overall scores of severe and extremely severe patients inthe control group were much improved (P 0.05).(2) Except for BMI, the parameters of FEV1%, MMRC dyspnea index, 6MWT scores and BODE index overall scores of the treatment group were much improved as compared with those of the control group after treatment(P < 0.05). Conclusion Fufei Gushen Decoction combined with inhalation of Seretide exerts certain effects on decreasing the BODE index scores, relieving symptoms, and improving pulmonary function, exercise performance and the quality of life of COPD patients with lung-kidney deficiency interweaved with phlegm and blood stasis at stable stage.
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Objective To compare the effects of salmeterol and fluticasone propionate combined montelukastin the treatment of patients with bronchial asthma.Methods Ninety-eight bronchial asthma patients from April 2014 to March 2016 in the Fourth People's Hospital Sichuan Province were selected anddivided into observation group and control group with 49 patients in each group according to the above principles by prospective study.The control group was given salmeterol treatment,and the observation group was added given montelukast treatment based on the control group.The treatment days were 15 d recorded the prognosis of the two groups.Results The total effective rates of the observation group and the control group were 95.9％ and 81.6％ respectively,the total effective rate of the observation group was significantly higher than that of the control group (P ＜ 0.05).The FEV1 and FVC values after treatment in the observation group and control group were significantly higher than before treatment (P ＜ 0.05),while the FEV1 and FVC values in the observation group after treatment were significantly higher than those in the control group (P ＜ 0.05).The scores of ACT scale after treatment of two groups were obviously higher than before treatment,and the score of observation group was statistically higher than control group after treatment (P ＜ 0.05).During treatment,there was no statistical significance on adverse reaction between two groups.Conclusion Salmeterol and fluticasone propionate combined montelukast in the treatment of patients with bronchial asthma can promote the improvement of lung function,so as to improve the quality of life and clinical treatment.
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Objective To observe the effect of of Jiuweiqianghuo pill combined with salmeterol fluticasone propionate on chronic obstructive pulmonary disease.Methods136 patientswith chronic obstructive pulmonary disease from January 2016 to December 2016 were grouped two groups by admission sequence.Two groups were treated with routine treatment and observation group was treated another with Jiuweiqianghuo pill to analyse its effect.ResultsThe total effective rate of observation group was 94.12%,higher than control group 79.41%(P<0.05).FEV1/ expected value and FEV1/FVC of observation group were(66.32±4.27),(71.15±4.41)%,higher than that of control group(58.37±4.19,65.16±4.30)%(P<0.05).6MWT and CAT score of observation group were(319.1±19.5m,19.15±2.97points),better than that of control group(287.4±18.0)m,(23.01±3.08)points(P<0.05).IL-8,TNF-α and hs-CRP level of observation group were(13.40±4.05)ng/L, (18.64±4.21)ng/L, (10.91±2.59)mg/L,lower than that of control group(18.92±4.27)ng/L, (25.13±4.48)ng/L, (14.67±2.75)mg/L(P<0.05).Adverse reactions rate of observation group was 2.94%,slightly lower than control group with 5.88%.ConclusionJiuweiqianghuo pill can decreased serum inflammation and improve lung function to improve the therapeutic effect of chronic obstructive pulmonary disease and it does not increase adverse reactions.
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Objective To investigate the clinical effect of fluticasone propionate combined with noninvasive positive pressure ventilation in the treatment of chronic obstructive pulmonary disease (COPD).Methods 88 cases of COPD patients from October 2014 to October 2016 in our hospital were selected and randomly divided into two groups of the control group observation group with 44 cases in each group.The control group was treated with conventional treatment, the observation group was treated with fluticasone propionate plus noninvasive positive pressure ventilation, and then the curative effect of the two groups was compared.Results The total effective rate of observation group was 100% higher than that of the control group 70.5%, the difference was statistically significant (P<0.05), after treatment, the observation group of FVC (2.50 +0.32) L, FEV1 (1.36 +0.20) L, FEV1%(51.23+4.32), PaO2(10.51+2.10) kPa, PaCO2(5.15 +1.19) kPa, compared with the control group, the difference was statistically significant (P<0.05), the observation group recurrence rate 4.5% was lower than the control group 13.6%, the difference was statistically significant (P <0.05).Conclusion COPD patients with fluticasone propionate combined noninvasive positive pressure ventilation, can effectively improve lung function, reduce disease recurrence rate, a significant effect.
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Objective To explore the clinical efficacy of tiotropium and salmeterol xinafoate and fluticasone propionate powder for inhalation combined with noninvasive ventilator in the treatment of respiratory failure, and to provide reference for clinical treatment.Methods 72 patients with respiratory failure were randomly divided into treatment group (n=36) and control group (n=36).The patients were randomly divided into treatment group and control group.Patients in the control group were treated with conventional noninvasive ventilators and treatment group were treated with tiotropium and salmeterol xinafoate and fluticasone propionate powder for inhalation on the basis of control group.Then compare the exercise tolerance, arterial carbon dioxide partial pressure, heart rate, pH, respiratory rate, blood oxygen pressure between two groups.Results After the treatment, condition of the patients in the two groups have different degrees of improvement.The final results showed that the average hospital stay was significantly reduced, respiratory frequency was(28 ±5) times/min in treatment group, heart rate was(98 ±16) times per minute, PaO2 also increased to(72 ±3) mmHg, PaCO2 was(57 ±17) mmHg, pH value increased to (7.42 ±0.03), compared with the control group, with statistically significant difference (P<0.05).Conclusion In patients with clinical implementation of tiotropium and seretide combined with non-invasive ventilator treatment of respiratory failure, can significantly improve the patient's condition, so that patients with respiratory function was significantly improved, so that the indicators of patients tend to normal.Its can effectively reduce PaCO2 , increased PaO2 and speed up its cure rate.
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The apparent degradation rate constant of fluticasone propionate (FLT) in 0.1 M NaOH:methanol=1:1 at 37 ℃ was previously reported to be 0.169 ± 0.003 h?1, and four degradation products (products 1–4) were observed in the solution. The aims of the present study were to assess the degradation rates of FLT in other alkaline solutions and clarify the chemical structures of the four degradation products in order to obtain basic data for designing an enema for inflammatory bowel disease. The apparent degradation rate constants in 0.05 M NaOH and 0.1 M NaOH:CH3CN=1:1 were 0.472 ± 0.013 h?1 and 0.154 ± 0.000 h?1 (n=3), respectively. The chemical structures of products 1–4 in 0.1 M NaOH:methanol=1:1 were revealed by nuclear magnetic resonance (NMR) and mass spectrometry data. The chemical structure of products 2 was that the 17-position of the thioester moiety of FLT was substituted by a carboxylic acid. The degradation product in 0.1 M NaOH:CH3CN=1:1 was found to be product 2 based on 1H NMR data. The degradation product in 0.05 M NaOH was considered to be product 2 based on the retention time of HPLC. These results are useful for detecting the degradation products of FLT by enzymes of the intestinal bacterial flora in the large intestine after dosing FLT as an enema.
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Objective To investigate the clinical effect of salmeterol fluticasone propionate combined with montelukast in the treatment of moderate and severe bronchial asthma. Methods 112 patients with moderate and severe bronchial asthma in Taizhou hospital from January 2014 to December 2016 were selected and divided into the control and the study group according to the time of visiting hospital, 56 cases in each group. The control group were given salmeterol fluticasone propionate for treatment, the study group were treated with salmeterol fluticasone propionate combined with montelukast .Keep a record of the asthma control test (ACT), forced expiratory volume (FEV1) percentage expected index changes of pre-treatment and 8 weeks after treatment. Results ACT score and FEV1 percentage expected index changes of two groups there was no significant difference before the treatment. After treatment, ACT score and FEV1 percentage expected index changes of the study group was better than the control group(P<0.05). Conclusion Salmeterol fluticasone propionate combined with montelukast in the treatment can significantly improve the clinical efficacy of patients.
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The apparent degradation rate constant of fluticasone propionate (FLT) in 0.1 M NaOH:methanol=1:1 at 37 ℃ was previously reported to be 0.169 ± 0.003 h?1, and four degradation products (products 1–4) were observed in the solution. The aims of the present study were to assess the degradation rates of FLT in other alkaline solutions and clarify the chemical structures of the four degradation products in order to obtain basic data for designing an enema for inflammatory bowel disease. The apparent degradation rate constants in 0.05 M NaOH and 0.1 M NaOH:CH3CN=1:1 were 0.472 ± 0.013 h?1 and 0.154 ± 0.000 h?1 (n=3), respectively. The chemical structures of products 1–4 in 0.1 M NaOH:methanol=1:1 were revealed by nuclear magnetic resonance (NMR) and mass spectrometry data. The chemical structure of products 2 was that the 17-position of the thioester moiety of FLT was substituted by a carboxylic acid. The degradation product in 0.1 M NaOH:CH3CN=1:1 was found to be product 2 based on 1H NMR data. The degradation product in 0.05 M NaOH was considered to be product 2 based on the retention time of HPLC. These results are useful for detecting the degradation products of FLT by enzymes of the intestinal bacterial flora in the large intestine after dosing FLT as an enema.
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Objective To investigate the clinical effect of salmeterol fluticasone propionate combined with montelukast in the treatment of moderate and severe bronchial asthma. Methods 112 patients with moderate and severe bronchial asthma in Taizhou hospital from January 2014 to December 2016 were selected and divided into the control and the study group according to the time of visiting hospital, 56 cases in each group. The control group were given salmeterol fluticasone propionate for treatment, the study group were treated with salmeterol fluticasone propionate combined with montelukast .Keep a record of the asthma control test (ACT), forced expiratory volume (FEV1) percentage expected index changes of pre-treatment and 8 weeks after treatment. Results ACT score and FEV1 percentage expected index changes of two groups there was no significant difference before the treatment. After treatment, ACT score and FEV1 percentage expected index changes of the study group was better than the control group(P<0.05). Conclusion Salmeterol fluticasone propionate combined with montelukast in the treatment can significantly improve the clinical efficacy of patients.
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OBJECTIVE:To observe the clinical effect of tiotropium bromide combined with salmeterol xinafoate and fluticasone propionate in the treatment of medium and severe COPD. METHODS:119 patients with medium and severe COPD were divided into control group(54 cases)and observation group(65 cases)according to admission order. Control group was treated with Salmeterol xi-nafoate and fluticasone propionate powder for inhalation 50 μg,bid;observation group was additionally given Tiotropium bromide powder for inhalation 18μg,qn. Both groups received 1 month of treatment. Lung function indexes as FEV1,FVC and IC,blood gas indexes as SaO2,PaCO2 and PaO2 and inflammatory factors as IL-8 and TNF-α,COPD assessment test(CAT)score were observed in 2 groups,and the occurrence of ADR was also observed. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). After treatment,FEV1,EVC,IC of observation group were increased significantly,SaO2 and PaO2 of observation group were increased significantly,while PaCO2,IL-8 and TNF-αlevels was decreased significantly;those index-es of observation group were significantly better than those of control group,with statistical significance(P<0.05). CAT score of 2 groups were decreased significantly compared to before treatment,and the observation group was significantly lower than control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Tiotropium bromide com-bined with salmeterol xinafoate and fluticasone propionate shows good clinical efficacy and safety in the treatment of medium and se-vere COPD.
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Objective:To observe the effects of salmeterol and fluticasone combined with the conventional treatment on the airway remodeling and bone metabolism in the patients with severe chronic obstructive lung disease ( chronic obstructive pulmonary disease, COPD. Methods:Totally 90 patients with severe COPD were divided into the observation group and the control group according to the order of admission. The control group was received the conventional treatment, and the observation group was treated with salmeterol and fluticasone additionally. The course of treatment was 8 weeks. Before the treatment and in the 3rd and 12th month after the treat-ment, the changes in the levels of bone mineral density ( BMD) in femoral neck bone, serum osteocalcin ( BGP) , alkaline phosphatase (AKP), the total number of induced sputum cells, neutrophils percentage, forced expiratory volume in one second (FEV1), leukocyte mediated element 8 (IL-8), matrix metalloproteinase 9 (MMP-9) and other indicators were detected and compared. Results: BGP, AKP and BMD of the two groups in the 3rd month after the treatment were not significantly changed (P>0. 05), while in the 12th month after the treatment, BMD in the observation group was significantly lower than that in the control group and that before the treat-ment, and BGP and AKP in the observation group were significantly higher than those in the control group and that before the treatment (P<0. 05). The total number of induced sputum cells, the percentage of neutrophils, FEV1, MMP-P and IL-8 in the two groups were significantly improved in the 12th month after the treatment (P<0. 05), and the difference between the two groups was statistically sig-nificant except IL-8 (P<0. 05). Conclusion:Salmeterol and fluticasone propionate can effectively improve airway remodeling in the patients with COPD. Short time use of salmeterol and fluticasone propionate shows no adverse effect on the bone metabolism, while long-term use would lead to reduced bone mineral density.
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OBJECTIVE:To compare the clinical efficacy and safety of salmeterol-fluticasone alone versus fluticasone propio-nate combined with montelukast sodium in the treatment of children with moderate persistent asthma. METHODS:275 children with moderate persistent asthma were randomly divided into inhaled corticosteroids(ICS)+ long acting β2 receptor agonist(LABA) group (139 cases) and ICS+ leukotriene receptor antagonists (LTRA) group (136 cases). ICS+LABA group was given Salmeter-ol-fluticasone powder inhalant,1 inhalation,bid;ICS+LTRA was given Fluticasone propionate inhalation aerosol,bid+Montelu-kast sodium chewable tablet 5 mg,before bedtime,qd. Both groups received more than 12 weeks of treatment. Body indexes of 2 groups were observed after treatment,such as asthma control degree,asthma score,the percentage of peak expiratory flow(PEF) in estimated value,aberration rate of PEF,the levels of eosinophi cationic protein(ECP)and leukotrienes E4(LTE4)in peripheral blood,the times of taking short acting β2 receptor agonist (SABA) during treatment,asymptomatic days,compliance,the inci-dence of ADR,etc. RESULTS:Total effective rate of ICS+LABA group(86.33%)after 4 weeks treatment was higher than that of ICS+LTRA group(58.09%),with statistical significance(P0.05). The day and night asthma score of 2 groups decreased significantly and the percentage of PEF in estimated value increased significantly after treatment,there was statisti-cal significance compared to before treatment(P0.05). The levels of ECP and LTE4 decreased significantly in 2 groups after treatment,there was statistical signif-icance compared to before treatment(P0.05). CONCLUSIONS:Salmeterol-fluticasone alone versus fluticasone propionate combined with montelukast sodi-um in the treatment of children with moderate persistent asth-ma both have good therapeutic efficacy and safety,while thelatter one has stronger inhibition effect on ECP and LTE4,and to control asthma symptoms more rapidly.