A Comparison of the Efficacy and Safety of Salmeterol Accuhaler and Ipratropium in Patients with Chronic Obstructive Pulmonary Disease

比較Salmeterol accuhaler和Ipratropium在慢性阻塞性呼吸道疾病使用之效能及安全性

潘信宏(Hsin-Hung Pan) ； 許正園(Jeng-Yuan Hsu) ； 江自得(Chi-Der Chiang)

《胸腔醫學》 17卷1期 (2002/03) Pp. 19-25

摘要

背景：支氣管擴張劑是目前處置慢性阻塞性呼吸道疾病症狀的主軸，這包括了副交感神經拮抗劑及長效乙二型交感神經刺激劑，但僅有少數文獻比較這兩者單獨使用之療效及安全性。
目的：本研究的目的是比較交叉使用Salmeterol accuhaler 50毫克一天兩次和Ipratropium MDI 40毫克一天四次三個月後兩者之療效及安全性。
方法：我們一共搜集了35位中度至重度的慢性阻塞性呼吸道疾病的病人，隨機地分成兩組然後分別接受Salmeterol accuhaler 50毫克一天兩次或Ipratropium MDI 40毫克一天四次，三個月後兩組交換藥物再使用三個月。完成後比較兩組之肺功能、收縮壓、舒張壓、心跳速率及器具使用等之差異。
結果：兩組病人使用了Salmeterol accuhaler 50毫克一天兩次或Ipratropium MDI 40毫克一天四次三個月後，FEV1及FVC昇高之值變化不大。在各使用這兩種藥物三個月後，Salmeterol accuhaler的這一組病人與Ipratropium MDI這一組病人其FEV1和FVC上昇之值相當，且沒有統計學上的意義。兩者藥物使用後對心跳速率、收縮壓、舒張壓均沒有明顯改變。
結論：比較使用三個月後肺功能的改善，Salmeterol accuhaler與Ipratropium MDI 兩者效果相當；但是器具之使用方面，accuhaler則比MDI來得容易。

關鍵字

慢性阻塞性呼吸道疾病

並列摘要

Background: At the present time, bronchodilator medications, including anticholinergics and long-acting β2-agonists, are central to symptom management in chronic obstructive pulmonary disease, but few studies have compared the Salmeterol accuhaler with the Ipratropium metered-dose inhaler alone.
Objectives: To compare their efficacy and safety, 50mcg bid with the Salmeterol accuhaler, and 40mcg qid with the Ipratropium metered-dose inhaler, were administered over two three-month treatment periods to patients with chronic obstructive pulmonary disease.
Methods: Thirty-five patients with well-controlled chronic obstructive pulmonary disease were randomized to undergo three months of a crossover and comparative study with two episodes of the treatment modalities. Either the Salmeterol accuhaler 50mcg bid or the Ipratropium metered-dose inhaler 40mcg qid were administered daily. Then, the forced expiratory volume in one second (FEV1), systolic blood pressure, diastolic blood pressure, heart rate, and device usage, were compared.
Results: Both the Salmeterol accuhaler 50 mcg bid, and the Ipratropium metered-dose inhaler 40 mcg qid, demonstrated clinical efficacy in increasing FEV1 and forced vital capacity (FVC). The Salmeterol group showed the same improvement in net change of FEV1 and FVC as the Ipratropium group after 3 months’ use, with no statistical difference. No significant changes in pulse rate, or systolic and diastolic pressure were found between the two groups.
Conclusion: The Salmeterol accuhaler was equal to the Ipratropium metered-dose inhaler in improving lung function at the recommended doses over the 3-month period, but the accuhaler was easier to use than the metered-dose inhaler.

並列關鍵字

Salmeterol ； Ipratropium ； chronic obstructive pulmonary disease