氮卓斯汀鼻喷剂联用吸入激素对控制不良的中重度哮喘的治疗作用  

Effects of azelastine nasal spray and inhaled corticosteroids on poor-controlled moderate to severe asthma

作　　者：王虹[1] 杨淑玲 关向群[1] 张少卿[1] 毛锐[1] 谢燕清[3] 邹威凤[3] 谭杰[1] 

机构地区：[1]广东药学院附属第一医院呼吸科,广州510080 [2]广州市白云区第一人民医院内科,广州510410 [3]广州医学院第一附属医院广州呼吸疾病研究所,广州510120

出　　处：《安徽医科大学学报》2012年第12期1439-1442,共4页Acta Universitatis Medicinalis Anhui

基　　金：广东省医学科研基金(编号:A2010304)

摘　　要：目的观察氮卓斯汀鼻喷剂联用吸入激素对控制不良的中重度哮喘患者诱导痰中黏附分子的强化抑制作用及其治疗效果。方法采用随机、单盲、多中心方法,61例中、重度哮喘伴变应性鼻炎患者在规律经口吸入沙美特罗(50μg)及氟替卡松粉吸入剂(250μg),每天2次,每次1吸的基础上随机给予下列治疗:A组(22例)氮卓斯汀鼻喷剂每日2次,每次两鼻孔各一喷;B组(20例)布地奈德鼻喷剂每日2次,每次两鼻孔各一喷;C组(19例)氮卓斯汀联合布地奈德每日2次,每次两鼻孔各1喷,疗程3个月。观察患者的哮喘症状评分、按需吸入β2激动剂的次数和测定血清中及诱导痰中细胞间黏附分子1(ICAM-1)的变化。结果治疗后3组的哮喘症状评分、按需吸入β2激动剂的次数和诱导痰中ICAM-1浓度均较治疗前显著改善(P<0.05)。治疗后A组哮喘症状评分、按需吸入β2激动剂的次数和诱导痰中ICAM-1浓度与B组比较差异无统计学意义,C组治疗后哮喘症状评分和按需吸入β2激动剂的次数与A组比较差异有统计学意义(P<0.05)。而血清中ICAM-1值比较,差异无统计学意义。结论在吸入糖皮质激素的基础上联合应用氮卓斯汀鼻喷剂可有效治疗变应性哮喘、抑制气道ICAM-1的分泌。Objective To evaluate the therapeutic effects of azelastine nazal spray in combination with inhaled cor- ticosteroid on allergic asthma. Methods A randomized, single blind, multi-center study was conducted in 61 pa- tients with moderate to severe allergic asthma. Patients were randomized to receive either azelastine nazal spray 1 spray per nostril twice daily （group A）or beelomethasone nazal spray 1 spray per nostril twice daily （group B）or combination with azelastine nazal spray and beclomethasone nazal spray 1 sprays per nostril twice daily （group C） on the basis of inhaled sameltero 50 μg and iluticasone 250 μg for 3 months. Symptom scores of asthma and doses of inhaled salbutamol as rescue drug were recorded, serum ICAM-1 and induced sputum ICAM-1 were measured be- fore and after the treatment. Results After treatment, there was significant improvement in symptom score, aver- age doses of inhaled 62 agonist as rescue medication and induced sputum ICAM-1 level in all three groups as com- pared with before the treatment（P 〈 0.05 ） ; there was no significant difference in symptom score, average doses of inhaled 2 agonist as rescue medication and induced sputum ICAM-1 level between group A and group B; there was much better improvement in symptom score and average doses of inhaled 62 agonist as rescue medication in group C as compared with group A（P 〈0.05 ）. However, there was no significant change in serum ICAM-1 levels after treatment in all 3 groups as compared with before the treatment. Conclusion On the basis of inhaled cortico- steroid, azelastine nazal spray improves asthma symptom significantly and reduces induced sputum ICAM-1 level in patients with asthma and allergic rhinitis.

关 键 词：H1阻滞剂鼻喷剂 支气管哮喘 变应性鼻炎 

分 类 号：R562.25[医药卫生—呼吸系统]