The symptom scores, the additional use of inhaled terbutaline, FEV|, and FVC were analyzed by Friedman test and Wilcoxon rank sum test for paired data. Nonparametric analysis was used because of the small number of data, which did not follow a symmetric gaussian distribution, and the symptom score belonged to an ordinal scale. Cheap Diskus Advair
The daily PEF measurements were numerous and were analyzed by paired t test and analysis of multivariance (AN OVA) in order to evaluate both the influence of time and the influence of treatment.
Results
Asthma Symptom Scores
The symptom scores were significantly different during the three treatment periods (Table 2). Dyspnea score was lowest during “terbutaline” whereas sputum score was significantly lowest during “terbutaline-PEP” and cough score was lower during “terbutaline-PEP” compared with “PEI*” but not significantly different from “terbutaline”. No side effects were reported.
Beak Expiratory Flow (PEF)
PEF before and after aerosol inhalations are shown in Figures 2 and 3. PEF after inhalation was significantly (p<0.0001 for all) higher than before inhalation during all treatment periods (Fig 2). PEF showed similar diurnal variation during all treatments with lower values in the morning (Fig 3).
The increase in PEF was significantly different between the treatments (p = 0.008, ANOVA). The mean increase in PEF with “terbutaline-PEP” was 32 L/min (Cl, 29 to 36 L/min) which was significantly higher (p = 0.005, t test) than during “terbutaline.” Mean increase in PEF during “terbutaline” was 25 L/min (Cl, 21 to 28 L/min) and significantly higher than the increase in PEF of 18 L/min (Cl, 14 to 22 L/min) during “PEP” (p = 0.03, t test). The percentage increase in PEF during the day was minimum and maximum 4 and 6 for “PEI?’ 6 and 14 for “terbutaline,” and 9 and 12 for “terbutaline-PEP”
Table 2—Mean Daily Symptom Scores during Two Weeks of Treatment with Positive Expiratory Pressure (PEP), Terbutaline Inhalation (TerbX and PEP Combined with TbrbutaUne Inhalations) Terb-PEPX
| Treatment | Dyspnea | Cough | Sputum |
| PEP | 1.5 (1.3-1.7) | 1.1 (0.9-1.4) | 1.3 (1.0-1.5) |
| Terb | 1.3 (1.1-1.5) | 1.0 (0.8-1.2) | 1.1 (1.0-1.4) |
| Terb-PEP | 1.6 (1.4-1.9) | 0.9 (0.7-1.2) | 1.0 (0.8-1.3) |
| p<0.01 | p<0.05 | p<0.01 |
Figure 2. PEF before and after inhalation during the treatment periods (mean and SEM).
Figure 3. PEF before and after inhalation during the day (mean and 95% confidence intervals).