不同剂量布地奈德雾化与强的松口服治疗哮喘急性发作的疗效比较  

Effects of different dosing regimens of inhaled budesonide suspension and oral prednisone on acute attacks of asthma

作　　者：李兰英[1] 王洪云[2] 郭雨青[2] 危智盛[1] 陈艳波[2] 关向群[1] 王虹[1] 毛锐[1] 刘华[2] 

机构地区：[1]广东药学院附属第一医院呼吸内科,广东广州510080 [2]广东药学院附属第一医院干保科,广东广州510080

出　　处：《广东药学院学报》2010年第6期639-644,共6页Academic Journal of Guangdong College of Pharmacy

基　　金：广东省医学科学技术研究基金项目(A2008333)

摘　　要：目的探讨雾化吸入布地奈德混悬液(BIS)治疗支气管哮喘急性发作的起始剂量及量效关系,以及BIS雾化与强的松(PRED)口服的疗效差异。方法 86例支气管哮喘急性发作患者随机分为4组。BIS1、BIS2、BIS3组分别予定量雾化吸入BIS 6 mg/d、4 mg/d、2 mg/d;PRED组予以30 mg强的松片每日顿服。以哮喘急性发作临床指标评分、肺功能指标FEV1(%pred)、PEF(%pred)、FEF(25-75)%(%pred)以及SpO2等为评价指标,观察治疗前和治疗4 h后、第2天、第7天等不同时段评价指标的改善情况。结果雾化吸入BIS及口服PRED均能迅速改善病情;治疗4 h后以及第2天时各组间临床评分、肺功能、SpO2改善的差值无统计学意义;第7天时各组间临床评分、SpO2改善的差值无统计学意义,FEV1(%pred)、PEF(%pred)、FEF(25-75)%(%pred)改善的差值呈BIS1>BIS2>BIS3,在BIS1及PRED组间差异无统计学意义。结论增大BIS雾化吸入剂量在一定程度上能提高疗效;雾化吸入BIS 6 mg/d与口服PRED 30 mg/d疗效相当。Objective To investigate the initial dose of nebulized budesonide inhalation suspension（BIS） and the dose-response in treating asthma,and compare the efficacy of BIS with oral prednisone（PRED）.Methods 86 patients suffered from acute attacks of bronchial asthma were randomly divided into four groups.Group BIS1,BIS2 and BIS3 received nebulized BIS 6 mg/d,4 mg/d,2 mg/d respectively;Group PRED received oral prednisone 30 mg/d.Then,the clinical score,pulmonary function including FEV1（%pred）,PEF（%pred）,FEF（25-75）%（%pred） and SpO2 were detected to evaluate the therapeutic effects at the time of 4 hours,second day and 7 days after treatment.Results BIS and oral prednisone presented rapid effects on the acute attacks of asthma.There were similar improvements in the clinical score,FEV1（%pred）,PEF（%pred）,FEF（25-75）%（%pred） and SpO2 in the four groups at the time of 4 hours and the second day after treatment;7 days after the beginning of treatment,similar improvements in the clinical score and SpO2 were observed in the four groups,and the difference of the improvements in FEV1（%pred）,PEF（%pred）,FEF（25-75）%（%pred） between the group of BIS1 and PRED was not significant,but these pulmonary function parameters were well improved in the group of BIS1BIS2BIS3.Conclusion Expanding the dosage of BIS could improve the efficacy to some degrees;the efficacy of BIS 6 mg/d may be equivalent to oral prednisone 30 mg/d.

关 键 词：支气管哮喘 糖皮质激素 布地奈德 雾化吸入 强的松 

分 类 号：R562.25[医药卫生—呼吸系统]