小剂量皮质类固醇吸入合并小剂量茶碱口服对支气管哮喘的治疗作用  

Effect of low dose of inhaled corticosteroid combined with small dose of oral theophylline on treatment of bronchial asthma

作　　者：李靖[1] 莫红英 黄海露 罗定芬[1] 安嘉颖[1] 欧阳铭[1] 钟南山[1] 

机构地区：[1]广州呼吸疾病研究所,510120

出　　处：《中华结核和呼吸杂志》2000年第6期336-339,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：广州市科委科研基金资助!(96258)

摘　　要：目的　研究小剂量茶碱合并小剂量皮质类固醇对哮喘患者的疗效及对下丘脑 垂体 肾上腺轴的影响。方法　 43例轻、中度的哮喘患者随机分成两组。茶碱激素组 (A组 ) 2 1例 :给予无水缓释放茶碱口服 ,每晚 2 0 0mg,加二丙酸倍氯米松 (BDP)每天 30 0 μg吸入 ;单纯激素组 (B组 ) 2 2例 :仅给予BDP每天 6 0 0 μg吸入及每晚口服安慰剂 ,疗程 13周。结果　治疗前、后的症状计分、呼气峰流速值 (PEF)及其变异率 (PEFR) :A组分别为 (1 8± 0 9)L/min和 (0 10± 0 30 )L/min、(2 95± 98)L/min和(4 44± 15 0 )L/min以及 (2 2± 8) %和 (9± 3) % ,B组分别为 (1 90± 0 70 )L/min和 (0 10± 0 30 )L/min、(32 8± 12 9)L/min和 (4 41± 146 )L/min以及 (2 4± 7) %和 (9± 3) % ,两组前、后比较差异均有显著性(P <0 0 1) ,两组治疗前、后的气道高反应性 (BHR)比较 ,差异有显著性 (P <0 0 1) ,两组间比较差异无显著性 (P >0 0 5 ) ;13周时夜间使用 β2 激动剂的次数A组 (1 3± 1 0 )与B组 (3 9± 1 7)比较差异有显著性 (P <0 0 5 ) ;B组治疗前后的血浆促肾上腺皮质激素 (ACTH)水平为 (31± 13)ng/L和 (2 0± 8)ng/L、基础血浆皮质醇浓度为 (95± 5 0 ) μg/L和 (86± 48)Objective To investigate the effect of small dose of oral theophyllin combined with low dose of inhaled beclomethasone dipropionate (BDP) on clinical symptoms, bronchial responsiveness and hypothalamic pituitary adrenal axis (HPAA) Methods 43 patients with mild moderate bronchial asthma were randomly divided into A and B groups 21 subjects in group A were treated with oral substained release theophyllin (Protheo) (200 mg/night) and inhaled BDP (300 μg/day); 22 cases in group B received inhaled BDP (600 μg/day) and oral placebo Result Before and 13 weeks after the treatment, symptom scores, peak flow(PEF), and peak flow rate (PEFR) for group A were (1 8±0 9) and (0 10±0 30), (295±98) L/min and (444±150) L/min, (22±8)% and (9±3)% respectively, and those for group B were (1 90±0 70) and (0 10±0 30), (328±129) L/min and (441±146)L/min, (24±7)% and (9±3)% respectively, which were remarkably improved in both groups ( P <0 01), and bronchial provocation responsiveness to histamine tests (BHR) in both groups were also improved significantly ( P <0 01) There were no differences between two groups ( P <0 05) Frequency of using inhaled β 2 agonist to relieve nocturnal asthmatic attacks in group B (3 9±1 7) was significantly greater than that in group A (1 3±1 0, P <0 05) Plasma ACTH concentrations, basic cortisol levels and cortisol responses to ACTH before and 13 weeks after the treatment in group B were (31±13) ng/L and (20±8) ng/L, (95±50) μg/L and (86±48) μg/L, (156±98)% and (74±46)% respectively, which were decreased significantly after the treatment ( P <0 05) There were no such changes in group A Conclusions It was suggested that small dose of oral theophylline combined with low dose of inhaled BDP might have the same effect on relief of

关 键 词：皮质类固醇 茶碱 支气管哮喘 药物疗法 

分 类 号：R562.25[医药卫生—呼吸系统]