Observation of Sequential Therapy on Patients of AECOPD with Glucocorticosteroid

Objective To evaluate the effect and the side effect of sequential therapy on patients of morderate or severe acute exacerbation of chronic obstructive pulmonary disease( AECOPD) with glucocorticosteroid. Method 64 patients with morderate or severe AECOPD were separated into group A and group B randomly. All patients were given intravenous drip methylprednisolone 40mg,twice a day for 3 days,The group A were given inhaled budesonide 2 mg,twice a day for 7 days,Group B were given oral prednisone pills 30 mg per day for 7 day. Both group A and group B were given O2 inhalation,antibiotics,bronchodilators,apophlegmatisant and nutrition support therapy simultaneously. The symptomatic score,pulmonary function and side effect were observed in two groups. Result Compared with pretreatment the symptomatic score,FEV1,FEV1%,PaO2 and PaCO2 were improved in both group A and group B after the 10 days therapy( P 0. 05). There were no significant difference between two groups( P 0. 05). The improved time of the symptom of dyspnea in A froup is shorter than in B group. There were slight raise up of serum glucose in 4 patients in group B and none in group A. Conclusion Glucocorticosteroid are operative the treatment of patients with AECOPD,After the systemic administration are in effect,local application of inhaled glucocorticosteroid may have the resemble effect to systemic administration and can be a substitution therapy of systemic administration on AECOPD.