OBJECTIVE: To explore the intervention measures to maintain clinical control in children with asthma in the remission stage when concomitant with acute upper respiratory infection (AURI). METHODS: A total of 100 asthmatic children who had achieved clinical control were randomly divided into observation group and control group. The two groups were both treated with a combination of inhaled corticosteroids and long-acting β2 receptor agonist (ICS/LABA) at the lowest dose every night. Conventional therapies were used for the two groups when suffering from AURI. In addition to conventional therapies, the observation group was given early short-term upgrade therapy, i.e., on the basis of maintenance therapy, the same amount of ICS/LABA complex preparation was inhaled every morning, which lasted for 7-10 days. Both groups were treated following asthma guidelines according to the severity of the disease at the time of acute attacks. The control rate of asthma, severity of acute attacks, changes in pulmonary function indices, and occurrence of adverse events were evaluated after 3, 6, 9, and 12 months of treatment. RESULTS: At each time point of follow-up, the rate of asthma control in the observation group was significantly higher than that in the control group (90% vs 80%; P<0.05). The severity of acute attacks in the observation group was significantly lower than that in the control group at all follow-up time points (P<0.05). Compared with the control group, the observation group had significantly improved pulmonary function indices of large and small airways (P<0.05) and significantly reduced mean amount of inhaled glucocorticoids and impact on family life (P<0.01). CONCLUSIONS Early short-term upgrade therapy for children with asthma in the remission stage when concomitant with AURI can prevent acute attacks of asthma, raise the rate of asthma control and improve pulmonary function.
Administration, Inhalation ; Adrenal Cortex Hormones ; Adrenergic beta-Agonists ; Anti-Asthmatic Agents ; Asthma ; Child ; Drug Therapy, Combination ; Humans

Administration, Inhalation ; Adrenal Cortex Hormones ; therapeutic use ; Adrenergic beta-Agonists ; therapeutic use ; Anti-Asthmatic Agents ; therapeutic use ; Antibodies, Monoclonal, Humanized ; therapeutic use ; Asthma ; prevention & control ; therapy ; Guideline Adherence ; Humans ; Molecular Targeted Therapy ; Muscarinic Antagonists ; therapeutic use ; Omalizumab ; therapeutic use ; Practice Guidelines as Topic ; Primary Prevention ; Quality Improvement ; Sublingual Immunotherapy

Adrenergic beta-2 Receptor Agonists ; administration & dosage ; pharmacokinetics ; therapeutic use ; Asthma ; drug therapy ; Bronchitis ; drug therapy ; Bronchodilator Agents ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Delayed-Action Preparations ; Drug Synergism ; Drug Therapy, Combination ; Glucocorticoids ; administration & dosage ; therapeutic use ; Humans ; Infant ; Leukotriene Antagonists ; administration & dosage ; therapeutic use ; Respiratory Sounds ; drug effects ; Terbutaline ; administration & dosage ; analogs & derivatives ; pharmacokinetics ; therapeutic use ; Transdermal Patch

OBJECTIVETo compare tulobuterol patch and oral salbutamol sulfate in terms of efficacy and safety in children with mild or moderate acute attack of bronchial asthma.

METHODSA total of 92 children with mild and moderate acute asthmatic attack were randomly divided into salbutamol group (n=46) and tulobuterol group (n=46). Both groups received routine treatment with antihistamine, selective leukotriene receptor antagonist and glucocorticoid. In addition, the salbutamol group was given slow-release capsules of salbutamol sulfate, and the tulobuterol group was treated with tulobuterol patch. The two groups were compared with respect to symptom scores of cough, wheeze, respiratory rate, wheezing sound, three depression sign and peak expiratory flow, as well as adverse events.

RESULTSAs the treatment proceeded, symptom scores decreased in both groups; on the third day of treatment, all symptom scores except cough score showed a significant decrease in both groups (P<0.05), but the tulobuterol group had significantly lower symptom scores than the salbutamol group (P<0.05). On the fourteenth day of treatment, both groups had a significant decrease in cough score (P<0.05), but the tulobuterol group had a significantly lower cough score than the salbutamol group (P<0.05). One child developed hand trembling in the salbutamol group, while no adverse event occurred in the tulobuterol group.

CONCLUSIONSCompared with oral salbutamol sulfate, tulobuterol patch has a better therapeutic efficacy and a higher safety in children with mild or moderate acute asthmatic attack.

Acute Disease ; Administration, Oral ; Adrenergic beta-2 Receptor Agonists ; therapeutic use ; Albuterol ; administration & dosage ; adverse effects ; therapeutic use ; Asthma ; drug therapy ; Female ; Humans ; Terbutaline ; administration & dosage ; adverse effects ; analogs & derivatives ; therapeutic use

BACKGROUND/AIMS: There is a need for new anti-asthmatic medications with fewer side effects. NDC-052, an extract of the medicinal herb Magnoliae flos, which has a long history of clinical use, was recently found to have anti-inflammatory effects. Herein, we evaluated the effects of NDC-052 as an add-on therapy in patients with mild to moderate asthma using inhaled corticosteroids (ICS). METHODS: In a non-comparative, multi-center trial, 148 patients taking ICS received NDC-052 for eight weeks. We evaluated their forced expiratory volume in one second (FEV1), morning and evening peak expiratory flow rate (AM and PM PEFR), AM/PM asthma symptom scores, visual analogue symptom (VAS) scores, night-time wakening, frequency of short-acting beta2-agonist usage, and adverse events. RESULTS: After eight weeks, both AM and PM PEFRs were significantly improved. Asthma symptom scores, VAS scores, the frequency of nights without awakening, and the frequency of beta2-agonist use were also reduced. Most of the adverse drug reactions were mild and resolved spontaneously. CONCLUSIONS: The addition of NDC-052 to ICS had a beneficial effect on asthma control in patients with mild to moderate asthma, with good tolerability and fewer side effects. Further studies are necessary to evaluate the effects of NDC-052 in patients with severe and/or refractory asthma.
Administration, Inhalation ; Adrenal Cortex Hormones/*administration & dosage ; Adrenergic beta-2 Receptor Agonists/therapeutic use ; Adult ; Anti-Asthmatic Agents/administration & dosage/*therapeutic use ; Asthma/diagnosis/*drug therapy/physiopathology ; Drug Therapy, Combination ; Drugs, Chinese Herbal/*therapeutic use ; Female ; Forced Expiratory Volume ; Humans ; Lung/drug effects/physiopathology ; *Magnolia ; Male ; Middle Aged ; Peak Expiratory Flow Rate ; Prospective Studies ; Republic of Korea ; Severity of Illness Index ; Time Factors ; Treatment Outcome

Adrenergic beta-2 Receptor Agonists ; administration & dosage ; therapeutic use ; Asthma ; diagnosis ; etiology ; therapy ; Child ; Child, Preschool ; Chronic Disease ; Glucocorticoids ; administration & dosage ; therapeutic use ; Humans ; Infant ; Pediatrics ; Seasons ; Time Factors

PURPOSE: Combination treatment of inhaled corticosteroid (ICS) plus long-acting beta2-agonist (LABA) is widely used as a maintenance regimen for the management of asthma. This study evaluated the effect of the beta2-adrenergic receptor (ADRB2) polymorphism on lung function and asthma control with regular use of combination treatment of an inhaled ICS plus LABA. MATERIALS AND METHODS: 43 Korean asthmatics who were symptomatic despite regular ICS use for at least 3 months were enrolled. For a 2-week run-in period, they received ICS (budesonide 800 microgram/day) plus terbutaline (5 microgram prn). as needed. During the 24-week active treatment period, they received budesonide 160 microgram and formoterol 4.5 microgram b.i.d. as maintenance and rescue medication. Pulmonary function and quality of life scores were monitored every 8 weeks; morning/evening peak expiratory flow meter (PEFR) was recorded daily. Patients were genotyped for ADRB2 Arg16Gly using single base extension methodology. RESULTS: During the run-in period, there were no significant between-group differences in lung function; after 8 weeks of active treatment, Arg/Arg patients had significantly higher forced expiratory volume in 1 secord (FEV1) and maximal mid-expiratory flow (MMEF) (p = 0.023 and p = 0.021, respectively), and better asthma control and quality of life after 24 weeks (p = 0.016 and p = 0.028, respectively). During treatment, there was a greater improvement in morning/evening PEFR in Arg/Arg patients. CONCLUSION: Asthmatic patients with the Arg/Arg genotype at codon 16 of ADRB2 achieve better asthma control with long-term regular use of combined budesonide and formoterol treatment, suggesting that the ADRB2 genotype may dictate choice of treatment strategy.
Administration, Inhalation ; Adrenal Cortex Hormones/*administration & dosage ; Adrenergic beta-Agonists/*administration & dosage ; Adult ; Asthma/*drug therapy/*genetics ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Receptors, Adrenergic, beta-2/*genetics ; Young Adult

Administration, Inhalation ; Adrenergic beta-Agonists ; adverse effects ; Child ; Extremities ; Humans ; Male ; Paralysis ; chemically induced ; Terbutaline ; administration & dosage ; adverse effects

OBJECTIVETo explore the effect of ligustrazine injection (LI) on serum levels of interleukin-4 (IL-4) and interferon-gamma (IFN-gamma) in patients with bronchial asthma and determine the mechanism of action of LI in preventing and treating asthma.

METHODSSixty-eight patients with mild or moderate bronchial asthma were assigned to two groups equally according to their sequence number, odd or even. The conventional treatment was administered to both groups, and LI was given to the treatment group by ultrasonic spray inhalation twice a day but not to the control group. The therapeutic course for all was 2 weeks. Further, 30 healthy subjects who had no history of smoking were enrolled as the normal control group. The clinical condition scores, frequency of attacks and dosage of Terbutaline inhaled were scored and recorded on the first day of hospitalization (before treatment) and after treatment. At the same time, the indexes of lung function, including forced expiratory volume in one second (FEV1), forced expiratory volume in one second to forced vital capacity ratio (FEV1%) and the peak expiratory flow (PEF) were determined before treatment. The levels of IL-4 and IFN-gamma in peripheral blood were detected by ELISA before and after treatment, and compared with that of the healthy control group.

RESULTSAfter treatment, the clinical condition scores were found to be lower, indexes of lung function were elevated, but serum level of IL-4 and ratio of IL-4/IFN-gamma were reduced in both groups, showing significant differences as compared to those before treatment (P<0.05). However, the changes in all the indexes were more significant in the treatment group than in the control group, also showing statistical significance (P<0.05). No significant difference was revealed when IFN-gamma levels were compared before and after treatment in both groups, though a lowering trend could be seen, significant difference could not be found in the comparison of IFN-gamma levels between groups after treatment (P>0.05).

CONCLUSIONLI shows good clinical effect in treating bronchial asthma, and its mechanism might be related to the suppression of the synthesis of IL-4, thus leading to the inhibition of TH2 cell subset preponderant response and immune equilibrium regulation.

Adrenergic beta-Agonists ; administration & dosage ; therapeutic use ; Aged ; Aged, 80 and over ; Asthma ; blood ; drug therapy ; physiopathology ; Case-Control Studies ; Female ; Humans ; Injections ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Male ; Middle Aged ; Pyrazines ; administration & dosage ; therapeutic use ; Respiratory Function Tests ; Terbutaline ; therapeutic use

Adrenal Cortex Hormones ; administration & dosage ; Adrenergic beta-Agonists ; therapeutic use ; Bronchodilator Agents ; therapeutic use ; Humans ; Pulmonary Disease, Chronic Obstructive ; drug therapy