The Effect Of Salmeterol/fluticasone On The BODE Index Of COPD Patients

ObjectivesAnalysis and comparison of the effects of moderate and severe in stable period Chronic Obstructive Pulmonary disease (COPD) patients using Salmeterol/Fluticasone before and after on BODE index (body mass index, airflow obstruction, dyspnea, and exercise capacity index), and also discuss the Salmeterol/Fluticasone treatment.Method1. Select number of 42 out-patient and hospitalized COPD patients in First Affiliated Hospital of Dalian Medical University from August 2009 to December 2010, divided into two groups. GroupⅠis a control group with 19 cases, GroupⅡis a drug group with 23 cases which using Salmeterol/Fluticasone twice a day by inhalation treatment.(1). Selection criteria: according to chronic obstructive pulmonary disease global initiative GOLD standards, with stable period moderate and severe COPD clinical symptom adult male and female patients (age between 40 to 80 years old), who has two times history of acute exacerbation at least in two years, and the interval time between last exacerbation and current stable period has four weeks are selected.(2). Exclusion criteria:1) Diagnosed with bronchial asthma, Active tuberculosis, Pneumonia, Bronchial Pneumonia, Pulmonary cystis fibrosis, bronchodilatation, Lung cancer or Metastatic lung cancer, and other progressive fatal disease patients.2) Using Mechanical ventilation treatment or Long-term oxygen therapy: one day > 12 hours or above, or need Respiratory Rehabilitation treatment patients.3) Severe Cardiovascular disease, severe nervous system diseases, and severe liver and kidney dysfunction patients. 4) Currently hospitalized or from other Institutional care facilities patients, such as geracomium.5) Gestational period and lactation female, or who used unacceptable medical contraceptive device at reproductive ages.6) Immunologic deficiency patients.7) History of Gastric Ulcer patients.8) Rare Hereditary fructose Intolerance, Glucose– Galactose Malabsorption or Sucrase– Maltose enzyme deficiency patients.9) Poor reliability and compliance patient, i.e. who has history of drug abuse or alcohol abuse, poor mental state and be unable to complete return visit on time.10) 3 months before selected, the patient had received any other investigational drug.2. The two groups has to be took a Lung function test to evaluate the degree of airflow obstruction at first and end visits during a one-year; according Modified Medical Research Council (MMRC) to evaluate the degree of dyspnoea; to evaluate the exercise capacity by 6-minutes walking distance (6MWD); to evaluate the nutritional status by calculate the body mass index (BMI); and finally grading and classification are based on BODE index grading standard.3. According to Demographic Characteristics, Experience in clinical diagnosis and treatment and Global initiative for chronic obstructive lung disease (GOLD) grade to analyse the patients. Furthermore, the other factors might affect the BODE index are investigated and analysed, such as the patient of age, gender, related diseases and other history of combined with drug application.4. Using SPSS version 17.0 statistical software to statistically analyse the experimental data, and analyse how the BODE index are affected by Salmeterol/ Fluticasone based on statistical basis and treatment.Results1. In the experiment, there are 37 patients took lung function test, 30 patients took 6-minutes walking distance test, 42 patients were evaluated degree of dyspnoea and body mass index, and 24 patients completed the final BODE index grading.2. After a period of one year of Salmeterol/Fluticasone inhalation treatment, the predicted lung function index FEV1% and the index of 6 MWD and BMI has not changed obviously when compare with untreated group (GroupⅠ).3. In contrast with the untreated group, the drug group (GroupⅠI) using Salmeterol/Fluticasone has a significant improvement in dyspnoea index, P < 0.01. After one year treatment, the dyspnoea index of drug group has improved when compared with its initial treatment; the difference between them has a statistically significance, P<0.05.4. In constrast with the initial treatment, the BODE index of drug group after one year treatment has improved and the difference has a statistically significance, P<0.05.Conclusion1. After Salmeterol/Fluticasone inhalation treatment, the COPD patients has improved on dyspnoea.2. After Salmeterol/Fluticasone inhalation treatment, the BODE index of COPD patients has been decreased obviously.3. After Salmeterol/Fluticasone inhalation treatment, the 6MWD and BMI of the COPD patients has not been changed clearly.