Effect Of Fluticasone/Salmeterol On Exhaled Nitric Oxide In Cough Variant Asthma Patients

Objective:To observe the clinical effects of fluticasone250μg/salmeterol50μg on exhaled nitric oxide in cough variant asthma patients, by analyzing the change of cough symptom scores and exhaled nitric oxide before and after treatment, we can evaluate the clinical value of FeNO.Methods:63subjects with cough variant asthma were recruited from the outpatient clinic of the respiratory department in Shandong Provincial Hospital affiliated to Shandong University,from April2011to March2012.All patients were received fluticasone250μg/salmeterol50μg for4weeks.The cough symptom scores and exhaled nitric oxide were compared separately before and after treatment, and their correlations were analyzed.To observe the adverse effects of the drug.Results:1. CVA patients have repeatedly and persistently troublesome cough symptom, especially in night, so they can not sleep well. The pulmonary function tests results were that bronchodilate test were positive or bronchial provocation test were positive. They were usually wrongly diagnosed of acute upper respiratory affection etc.2. Clinical efficacy:after4weeks’treatment of fluticasone250μg/salmeterol50μg, the clinical symptoms of CVA patients were significantly improved, and cough symptom scores and exhaled nitric oxide were decrease significantly(P<0.01).3. Correlation analysis:before treatment, FeNO levels had significant correlations with cough symptom scores(r2=0.516, P<0.01). After treatment, there were significant correlations between the percentage of FeNO decrease and the percentage of cough symptom scores decrease (r=0.146, P<0.01)4. Adverse events in treatment were4cases,2were hoarseness,1was candida infections,1was palpitations. It was totally safe.Conclusions:1. CVA is a special form of asthma, fluticasone250μg/salmeterol50μg can relieve cough symptom quickly and decrease airway inflammation, its adverse effect is few.2. After treatment of inhaled corticosteroids, there are significant correlations between the percentage of FeNO decrease and the relieve of cough symptom.3. To some extent, measuring exhaled nitric oxide can be monitoring indicator of the treatment of cough variant asthma. It is non-invasive, simple, safe and quick.