不同方法治疗慢性轻中度哮喘效果比较  

A COMPARISON AMONG HIGH-DOSE INHALED CORTICOSTEROID,LOW-DOSE INHALED CORTICOSTEROID PLUS SALBUTAMOL AND LOW-DOSE INHALED CORTICOSTEROID PLUS IPRATROPIUM BROMIDE IN THE TREATMENT OF MILD-TO-MODERATE CHRONIC ASTHMA

作　　者：兰克涛[1] 

机构地区：[1]青岛大学医学院第二附属医院,山东青岛266042

出　　处：《青岛大学医学院学报》2010年第5期449-451,454,共4页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的评价3种方法治疗轻中度哮喘的效果。方法 2004年1月—2008年3月,选择就诊于我院门诊的慢性哮喘病人155例,随机分为高剂量布地奈德吸入组(A组)、低剂量布地奈德联合沙丁胺醇吸入组(B组)、低剂量布地奈德联合异丙托溴胺吸入组(C组)。研究持续9个月,比较治疗前后病人的治疗反应、药物不良反应以及呼气峰流速(PEF)。结果共130例病人完成全部研究项目。3组晨起PEF、PEF日变异率和夜间PEF值比较差异无统计学意义。组内治疗前后比较,A组晨起PEF的改善、B组晨起PEF的改善和夜间PEF的改善均有统计学意义(t=2.47～2.60,P<0.01)。各组治疗前后以及各组之间不良反应比较差异均无统计学意义。结论对于单纯吸入小剂量糖质皮激素控制不佳的轻中度哮喘,采用大剂量糖质皮激素吸入可改善病人晨起肺功能,采用小剂量糖质皮激素联合短效β2受体激动剂规律吸入可改善晨起和夜间肺功能。Objective To evaluate the effect of high-dose inhaled corticosteroid（HDIC）,low-dose inhaled corticosteroid plus salbutamol（LDICS）and low-dose inhaled corticosteroid plus ipratropium bromide（LDCIB）in the treatment of mild-to-moderate chronic asthma.Methods In Jan.2004-Mar.2008,155 patients with chronic asthma treated in our hospital were assigned to receive HDIC（group A）,LDICS（Group B）and LDCIB（group C）.The study lasted for nine months.The therapeutic reactions before and after therapy,drug adverse reactions and peak expiratory flow rate（PEF）were compared among the three groups.Results A total of 130 patients completed the study.Morning PEF,diurnal variation of PEF and night PEF were not statistically different among the three groups.The differences within the same group among the three items showed statistically significant（t=2.47-2.60,P〈0.01）.The differences between before and after treatment and adverse reactions among the three groups showed no statistical significance.Conclusion For mild-to-moderate asthma that does not respond well to low-dose corticosteroid,a high-dose can be used to improve the lung function in the morning;co-therapy with low-dose hormone plus short-acting β2 receptor agonist may improve lung function at daybreak and night.

关 键 词：哮喘 布地奈德 沙丁胺醇 异丙托溴胺 治疗结果 

分 类 号：R562.25[医药卫生—呼吸系统]