Emami Mohammad, Tayebi Azadeh, Gharipour Mojgan, Farzamnia Somayeh, Temyarti Akbar Kargari
Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Metabolic Syndrome, Isfahan Cardiovascular Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2014 Feb 28;3:86. doi: 10.4103/2277-9175.127999. eCollection 2014.
Recently, higher efficacy of the combination of long-acting beta2-adrenoceptor agonist and inhaled corticosteroids on controlling asthma symptoms has been hypothesized. This study aimed to examine the clinical effects of the combination of Budesonide with formoterol (Symbicort) and Budesonide (Pulmicort) alone in persistent asthma.
In a randomized double-blinded clinical trial, 76 patients with definite diagnosis of moderate-to-severe asthma were randomized to receive Pulmicort 180 mcg/inhalation two puffs twice daily, or receive Symbicort 80/4.5 mg/inhalation two puffs twice daily, or receive Symbicort 160/4.5 mg/inhalation two puffs twice daily for 3 months. All participants were initially evaluated by spirometry for assessing respiratory parameters and also the level of asthma control was assessed by Asthma Control Test (ACT).
More significant improvement in spirometry parameters, including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, as well as in peak expiratory flow (PEF) in both groups of Symbicort with the regimens 80/4.5 mg/inhalation or 160/4.5 mg/inhalation 2 puffs twice daily compared with Pulmicort group, ACT score was significantly improved in Symbicort group with the regimens 160/4.5 mg/inhalation compared with both Symbicort groups with lower dosage and Pulmicort group. Response to treatment in PEF parameter and also in ACT level was significantly more in those who received Symbicort with the regimens 160/4.5 mg/inhalation compared with other two interventional groups adjusted for gender and age.
Symbicort with the regimens 160/4.5 mg/inhalation has higher efficacy in reducing asthma symptom and improving its control compared with low doses of this drug and with Pulmicort.
最近,有人推测长效β2肾上腺素能受体激动剂与吸入性糖皮质激素联合使用在控制哮喘症状方面具有更高的疗效。本研究旨在探讨布地奈德与福莫特罗(信必可都保)联合使用以及单独使用布地奈德(普米克)在持续性哮喘中的临床效果。
在一项随机双盲临床试验中,76例确诊为中度至重度哮喘的患者被随机分为三组,分别接受每日两次、每次两吸的普米克180微克/吸,或每日两次、每次两吸的信必可都保80/4.5毫克/吸,或每日两次、每次两吸的信必可都保160/4.5毫克/吸,为期3个月。所有参与者最初均通过肺活量测定法评估呼吸参数,并通过哮喘控制测试(ACT)评估哮喘控制水平。
与普米克组相比,信必可都保80/4.5毫克/吸或160/4.5毫克/吸每日两次方案的两组在肺活量测定参数方面有更显著改善,包括1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC比值以及呼气峰值流速(PEF)。与低剂量信必可都保组和普米克组相比,信必可都保160/4.5毫克/吸方案组的ACT评分显著改善。在根据性别和年龄进行调整后,与其他两个干预组相比,接受信必可都保160/4.5毫克/吸方案的患者在PEF参数和ACT水平方面对治疗的反应明显更大。
与低剂量的信必可都保及普米克相比,信必可都保160/4.5毫克/吸方案在减轻哮喘症状和改善哮喘控制方面具有更高的疗效。