小剂量布地奈德粉吸入剂治疗轻度支气管哮喘患者的远期疗效  

The long term effect of small dose budesonide turbuhaler on mild bronchial asthma

作　　者：翁俊良[1] 郑义珊 马琼凤[1] 

机构地区：[1]汕头大学医学院第一附属医院内科,515041 [2]汕头龙湖人民医院内科

出　　处：《中华结核和呼吸杂志》2005年第2期88-92,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：广东省科委资助项目(2003C33714)

摘　　要：目的 探讨小剂量布地奈德粉吸入剂(商品名：普米克都保)长期吸入治疗轻度支气管哮喘(简称哮喘)的远期疗效和不良反应。方法将52例轻度哮喘患者分为3组。吸入糖皮质激素组(A组)22例：每晚吸入布地奈德粉吸入剂200μg。口服糖皮质激素组(B组)15例：在哮喘发作期给予泼尼松5mg每天1次口服，茶碱控释片(商品名：舒弗美)0．2g每天2次口服；沙丁胺醇(商品名：喘乐宁)气雾剂2揿(每揿100μg)每天3次吸入。非糖皮质激素组(C组)15例：发作期只给茶碱控释片0．2g每天2次口服，沙丁胺醇气雾剂2揿每天3次吸入。全部病例连续治疗3年，停药后随访1年。在此4年间，检测各组患者治疗前、后一秒钟用力呼气容积(FEV1)、气道阻力(Raw)、气道传导率(Gaw)、气道高反应性(BHR)、临床疗效、血浆皮质醇浓度以及促肾上腺皮质激素(ACTH)刺激后的反应等。结果 (1)治疗前A、B、C3组绝大多数病例的BHR均在3—4级，分别为91％(20／22)、100％(15／15)、93％(14／15)。治疗后A组18例(82％)转为1—2级；B组13例(87％)仍为3～4级；C组15例(100％)病例为3～5级。A、B、C3组间比较差异有统计学意义(P均<0．01)。(2)A、B、C3组Raw治疗前分别为(623±103)％、(605±90)％、(638±108)％，治疗后分别为(158±24)％、(340±61)％、(420±81)％，3组间比较差异有统计学意义(P均<0．01)。(3)A、B、C3组Gaw治疗前分别为(22±4)％、(27±6)％、(27±5)％，治疗后分别为(83±15)％、(42±9)％、(31±6)％，3组间比较差异有统计学意义(P均<0．01)。(4)A组FEV．治疗前、后分别为(2．3±0．4)、(2．9±0．4)L，B组为(2．3±0．4)、(2．6±0．4)L，C组为(2．3±0．4)、(2．7±0．4)L。3组间比较差异有统计学意义(P均<0．01)。(5)以哮喘症状被控制作为疗效标准，A、B、C3组有效率分别为91％、530%，和330%，3组间比较差异有统计学意义(P均<0．01)。(6)A、B组治疗前、�Objective To investigate the long term efficacy as well as the side-effects of small dose budesonide turbuhaler in mild bronchial asthma. Methods Fifty-two patients with mild asthma were randomly divided into groups A,B and C. Twenty-two cases in group A received 200 μg budesonide turbuhaler by inhalation every night. Fifteen cases in group B received oral prednisone 5 mg/d and theophyllin control release tablet 0.2 g twice daily,as well as ventolin aerosol inhalation 200 μg three times daily during asthmatic attack. Fifteen cases in group C received no glucocorticoids,but theophyllin control release tablet 0.2 g twice daily as well as ventolin aerosol inhalation(200 μg/d) were given during asthmatic attack. All three groups received treatment consecutively for 3 years,and followed for one year after stopping treatment. During the total 4 years,pulmonary function measurements(FEV 1,Raw,Gaw),bronchial hyperreactivity(BHR),clinical effects,plasma cortisol level and the activated reaction of ACTH were evaluated. Results (1)Before the treatment,BHR of the three groups were similar,with most cases graded Ⅲ-Ⅳ,being 91%(20/22),100%(15/15) and 93%(14/15) respectively. After the treatment,the BHR of 18(82%) cases of group A was reduced to grades Ⅰ-Ⅱ. However,13 cases (87%) of group B still remained at grades Ⅲ-Ⅳ and 15 cases (100%) of group C were still at grades Ⅲ-Ⅳ. The results of the three groups showed a significant difference(P<0.01). (2)Compared to measurements before the treatment,Raw was (623±103)% s (158±24)% in group A,(605±90)% s (340±61)% in group B,and (638±108)% s (420±81)% in group C,the difference among the three groups being significant(P<0.01). (3)Compared to the measurements before the treatment,Gaw was (22±4)% s (83±15)% in group A,(27±6)% s (42±9)% in group B,and (27±5)% s (31±6)% in group C,the difference among the three groups being significant(all P<0.01 respectiely). (4)Compared with the measurements before the treatment,FE 1 was (2.3±0.4)L s (2.9±0.4)L in

关 键 词：用药剂量 布地奈德粉吸人剂 药物治疗 轻度支气管哮喘 肺功能 

分 类 号：R562.25[医药卫生—呼吸系统] R974.3[医药卫生—内科学]