Clinical trial of different doses of budesonide in the treatment of chronic obstructive pulmonary disease in the elderly
Objective To observe the clinical effects of different doses of budesonide combined with tiotropium bromide inhalation in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD).Methods Elderly patients with COPD were randomly divided into the control group,the low-dose group,the medium-dose group and the high-dose group.The control group was treated with tiotropium bromide powder inhalation(18 μg,qd).The low-dose,medium-dose and high-dose groups were treated with with budesonide suspension(1 mg,2 mg,3 mg each time,qd)on the basis of control group.All patients were treated for 15 days.Clinical efficacy was compared.The changes of pulmonary function,COPD assessment test(CAT)scores,immune function and quality of life before and after treatment were evaluated.Adverse drug reactions that occurred during treatment were recorded.Results Twenty-two cases were included in the high-dose group,the medium-dose group,the low-dose group,and the control group,respectively.After treatment,the total effective rates in the high-dose group,the medium-dose group,the low-dose group and the control group were 95.45％(21 cases/22 cases),72.73％(16 cases/22 cases),72.73％(16 cases/22 cases)and 40.91％(13 cases/22 cases).There were statistically significant differences between the high-dose group,medium-dose group and low dose group and the control group,and between the high dose group and the low and medium dose groups(all P＜0.05).After treatment,forced expiratory volume in 1 second(FEV1)in the four groups were(2.28±0.31),(2.07±0.33),(2.01±0.27)and(1.79±0.35)L;FEV1/forced vital capacity(FEV1/FVC)were(68.26±7.35)％,(63.48±7.12)％,(62.35±7.04)％and(57.92±6.79)％;CAT scores were 16.34±2.81,18.12±2.56,18.73±2.23 and 20.45±2.41;CD4+/CD8+were 1.38±0.25,1.15±0.18,1.12±0.23 and 0.96±0.21.Compared with high,medium,low dose groups and the control group,high dose compared with low,medium dose groups,the differences of the obove indicators were statistically significant all(all P＜0.05).The total incidence rates of adverse drug reactions in the high-dose group,the medium-dose group,the low-dose group,and the control group were 27.27％(6 cases/22 cases),27.27％(5 cases/22 cases),22.73％(6 cases/22 cases),and 18.18％(4 cases/22 cases),without statistically significant difference among the groups(all P＞0.05).Conclusion The combined treatment of high-dose budesonide and tiotropium bromide inhalation can effectively improve pulmonary function,immune function and clinical efficacy in elderly patients with COPD with high safety.
budesonidetiotropium bromidechronic obstructive pulmonary diseasedifferent dosesclinical efficacyimmune functionquality of life
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