Clinical Effects Of Inhaling Budesonide, Terbutaline, Ipratropium Bromide And Ambroxol For Treatment Of Acute Exacerbation Of COPD

ObjectiveTo observe clinical effects and adverse reactions of inhaling budesonide, terbutaline, ipratropium bromide and ambroxol for treatment of acute exacerbations of COPD(AECOPD). And to investigate the risk factors of COPD.MethodsCollection data of 68 patients with AECOPD in Respiratory Medicine of Shandong Provincial Hospital affiliated to Shandong University, from November 2010 to March 2011. All patients were received conventional medical therapy, including continuous inhalation of oxygen(1-2L/min), anti-infection, antispasmodic and othetr supportive treatment. According to the order of admission,68 patients with AECOPD were randomly divided into 2 groups:(1) Treatment group:who received conventional medical therapy plus inhalation of budisonide 2mg, terbutaline 2.5mg, ipratropiium bromide 500μg and ambroxol 30mg,34cases, including 21 males and 13 females, mean age 68.3. (2)Control group:who received conventional medical therapy without inhalation,34 cases, including 20 males and 14 females, mean age 64.8. To observe the clinical effects of inhalation, the levels of clinical symptoms, signs, PEF and average hospital charges before and after treatment were compared in two groups. And the smoking history, gender and age-related factors were analyzed to study the risk factors of COPD.Results1. Risk factors:through analysis, smoking and age were the major risk factors, and PEF and the smoking index had the negative correlation. According to the proportion of people, COPD prevalence was also increasing with age increasing. Through there were significantly difference in gender, we considered that the reason was male smoking rate significantly higher than women.2. Clinical efficacy:after treatment, the clinical symptoms(cough, sputum, dyspnea and rales) and PEF in two groups were significantly improved(P<0.01).3. Compare to control group cases, the difference of treatment group cases had been significantly increased after treatment(P<0.05), and the average hospital charges were lower than the control group. The diffenrence was significant(P<0.05).4. The quit rates of the treatment groups(namely for mortality) were 8.1%, lower than control group (12.8%), but the difference was not statistically significant (χ2= 0.087, P>0.05).5. Adverse events in treatment group and control group were 4 cases and 1 case, there was no significant difference between the total (χ2=1.943,P>0.05). The main side effects in treatment group were nausea and oropharyngeal discomfort, the control group's main adverse reactions was stomach discomfort.Conclusions1. Smoking and age were the major risk factors. Controling of smoker can significantly improve pulmonary function.2. Inhalation of four drugs can significantly improve the clinical effects in acute exacerbation of COPD.2.1 Inhalation can be obviously better than the control group in relieving the clinical symptoms of AECOPD.2.2 Compared with the control group, united inhalation can be more significant improvement in hypoxia, increased arterial blood gas analysis.2.3 PEF difference before and after inhalation was significantly increased compared with the control group, indicating that the united inhalation can increase lung function and improve the prognosis.3. Inhalation of four drugs can obviously reduce the treatment days and cost.4. Inhalation of four drugs is easy to use, safety. It can be used for the conventional treatment in AECOPD.