A Clinical Study of Nebulized Budesonide in the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Objective:To compare the efficacy of therapy with nebulized budesonide and oral prednisolone in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods:84 patients with acute exacerbations of COPD requi- ring hospitalization were randomly divided into Treatment group (43 subjects) and Control group (41subjects).All received standard treatment,including nebulized_2-agonists,antibiotics,and supplemental oxygen.Treatment group patients received from 0 h to 72h 2 mg Budesonide every 12 h,and 1 mg bid in the other 7 day.Control group was treated with oral prednisolone 20 mg every 12 hour for three days,and 25 mg per day in other 7day.Patients' lung function were assessed every 12 h during the first three days phase,and at hospital discharge.Arterial blood samples were taken at study entry,24,48,72 h,and be- fore discharge hospital.Complete blood cell counts,including eosinophils,were obtained at entry,and blood glucose,sodium, potassium,and chloride was measured.Results:Three patients required non-invasive ventilation in every two groups because of deterioration.The other patients mean change in post-bronchodilator FEV_1,PaO_2/FiO_2 was greater improving with active treatments than before treated,but no significant difference in two groups.Treatment group had less systemic activity than Control group as indicated by a higher incidence of hyperglycemia observed with prednisolone.Conclusion:No significant differ- ence Nebulized Budesonide improved airflow obstruction,and arterial-blood gas values in patients with acute exacerbations of COPD compare with oral prednisolone,and that had less side-effect.