Kyrgyz State Medical Academy Department of Internal Diseases Effect of 6 month therapy with "Seretid" in COPD patients

One of the aims in treatment of COPD is long time bronchodilator therapy which causes decrease in intensity of disease symptoms, lower down the frequency and severity of disease, tolerance to physical activity and improvement in life quality.. In last some decades many facts were collected according to which it is proved that in broncholytic therapy, corticosteroids can be added to treat COPD. To study the effect of 6 month therapy with "Seretid" were observed 20 patients suffering from chronic obstructive pulmonary disease (COPD), registered in center of family medicines № 7 Bishkek. During 6 months, patients took “Seretid” in dose of 500 micrograms 2 times a day, using inhalers. The effect of treatment was estimated by decrease in dyspnoea, cough and sputum production, tolerance to physical activity. Except this after 6 months seretid treatment, observed decrease in cough syndrome, significantly increasing rates OFV1, and the distance in 6 minutes walk test. The purpose of our study was to examine the effect of 6 - month therapy with "Seretid" in chronic obstructive pulmonary disease patients.

Generally lung function values in obstructive disease Lung function test Result as predicted for age, height, sex, weight, or race Forced vital capacity (FVC) Normal or lower than predicted value Forced expiratory volume (FEV1) Lower FEV1 divided by FVC Forced expiratory flow 25% to 75% Peak expiratory flow (PEF) Maximum voluntary ventilation (MVV) Slow vital capacity (SVC) Normal or lower Total lung capacity (TLC) (VT) Normal or higher Functional residual capacity (FRC) Higher Residual volume (RV) Expiratory reserve volume (ERV) RV divided by TLC ratio

Material and Methods We examined 20 patients with COPD medium sever and sever who were registered in CFM no. 7 Bishkek. The average age of patients was 55 ± 7,0 years. During 6 months, patients took seretid in a dose of 500 micrograms 2 times a day, using inhalers. Before and after treatment, all patients were examined “forced expiratory flow” by "M aster-Lab" (Germany). Tolerance to physical load was estimated by “six minutes walk test” distance measured in meters, dyspnoea according to scale Borge and saturation with help of Spiro meter. Cough and sputum were estimated by scale 4-points: 0-no symptoms; 1-mild cough, mild sputum production; 2-moderate cough; 3-moderate sputum production; 4-marked cough, big sputum production. Improvement in life quality was measured according to SGRQ, according to that estimated domain “symptoms”, “activeness”, “action” and “general life quality”.

Lung volume calculate Lung Capacity test

Results and Discussion At the end of third month, treatment with Seretid (table 1), observed improvement in cough (from 2.03 to 1.23), sputum production (from 0.85, p< 0.05) and dysponea (from 1.48 to 0.93, p<0.01).

The dynamics of symptoms after 6 months, treatment of COPD patients with Seretid (In points) Before Treatment After 3 months After 6 months Cough 2,03 ± 0,14 1,23 ± 0,17* 1,05 ± 0,15* Sputum 1,25 ± 0,14 0,85 ± 0,11* 0,78 ± 0,08* Dyspnoea 1,48 ± 0,22 0,93 ± 0,17* 0,80 ± 0,17*

After three months treatment with Seretid there was decrease in cough syndrome (from 2.03 to 1.05 points, p<0.001) persisted throughout treatment period, except this at the end of 6 month seretid therapy sputum was absent totally (from 1.25 to 0.78), decrease in dyspnoea period (from 0.48 to 0.80 points, p< 0.01), FEV1was increased and FEV1%(from 2.07 to 2.54 points and from 66.4 to 61.13 points, p<0.01). With improvement in FEV1 and FEV1 %, there was also improvement in physical load. In 6 minutes walk test (table 2) improvement was noted (at end of treatment distance was 40.1 m, p< 0.05) with decrease in dyspnoea according to scale of Borge from 5.7 to 3.9 points.

Dynamics showing Forced expiratory volume and tolerance to physical load in COPD patients in 6 month Seretid therapy process No. Activities Before treatment (n -20) After 3 months (n - 20) After 6 months 1. lung vital capacity (l) 3,35 ± 0,20 3,51 ± 0,24 3,70 ± 0,20 2. lung vital capacity 88,22 ± 4,81 88,56 ± 4,26 96,06 ± 4,04 3. FEV 2,07 ± 0,14 2,30 ± 0,19 2,54 ± 0,15* 4. Forced expiratory volume (% proper) 66,44 ± 4,16 72,08 ± 5,14 81,13 ± 4,62* 5. FEV1/lung vital capacity 61,01 ± 2,64 69,56 ± 3,15 68,9 ± 2,92 6. maximum voluntary ventilation 3,21 ± 0,19 3,80 ± 0,37 3,70 ± 0,22 7. FEV1/maximal expiratory flow volume 57,92 ± 5,14 68,50 ± 1,51 69,40 ± 2,61 8 6 minutes walk test (m) 336,4 ± 11,0 357,4 ± 13,7 376,4 ± 13,6* 9 Dyspnoea during walk test 5,72 ± 0,50 4,42 ± 0,37 3,90 ± 0,32*

Activities Initial After 6 months The results, improvement in life quality, estimated with help of SGRQ before and after 6 month treatment with Seretid are shown in table no. 3 Activities Initial After 6 months Symptoms 78.1 57.0* Activeness 52.1 39.4* Ascendancy 45.6 35.6* Total points 53.0 40.3*

Conclusion Prolonged “Seretid” therapy causes decrease in cough syndrome and improvement in bronchial passage in COPD patients. After 6 month of Seretid therapy, tolerance to physical load increased which was observed in 6 minutes walk test. Seretid caused improvement in life quality according to all scales of SGRQ

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