吸入糖皮质激素联合茶碱对未控制吸烟支气管哮喘患者的临床研究  

A clinical observation of smokers with moderate bronchial asthma treated with inhaled corticosteroids plus theophylline

作　　者：陈卓昌[1] 丁娟娟[2] 钱皓瑜[2] 林香花[2] 冯可青[2] 王静[1] 

机构地区：[1]郑州大学第一附属医院呼吸与危重症医学科,450000 [2]郑州大学人民医院呼吸与危重症医学科,450003

出　　处：《中华哮喘杂志（电子版）》2013年第5期9-12,共4页Chinese Journal of Asthma(Electronic Version)

基　　金：2011年度河南省医学科技攻关计划项目(2011020124)

摘　　要：目的观察小剂量吸入糖皮质激素(inhaled corticosteroids,ICS)联合小剂量茶碱对未控制吸烟支气管哮喘(简称哮喘)患者的治疗效果。方法筛选门诊未控制吸烟哮喘患者80例,随机分为试验组和对照组,试验组为吸烟患者,对照组为不吸烟患者。两组每日吸入布地奈德,每吸200μg,每天2吸,联合口服氨茶碱片0.1g,每天3次,疗程3个月。比较治疗前后的哮喘控制测试(asthma control test,ACT)评分,呼气峰流速(peak expiratory flow,PEF),第1秒用力呼气容积占预计值百分比(FEV1%pred),外周静脉血IL-4、IL-5、IgE值的变化。结果两组治疗前、治疗3个月后的ACT评分、PEF、FEV1%pred、IL-4、IL-5、IgE值:试验组分别为:(14.3±2.4)和(21.7±2.0),(255.9±99.7)L/min和(290.3±105.2)L/min,(66.5±4.7)和(72.9±5.4),(14.5±3.2)ng/L和(12.3±3.4)ng/L,(27.2±6.4)ng/L和(24.2±5.8)ng/L,(82.7±16.8)IU/ml和(67.1±14.3)IU/ml,对照组分别为:(13.8±2.2)和(21.5±1.4),(279.1±103.3)L/min和(321.3±110.4)L/min,(68.8±5.8)和(74.8±5.5),(13.4±2.9)ng/L和(11.4±2.8)ng/L,(26.5±6.9)ng/L和(22.8±6.2)ng/L,(78.8±18.2)IU/ml和(66.4±17.8)IU/ml,两组组内比较差异有统计学意义(P<0.05),组间比较差异无统计学意义(P>0.05)。结论小剂量ICS联合小剂量茶碱,在改善吸烟哮喘患者症状、提高肺功能、控制气道炎症方面与不吸烟患者有相同的疗效。Objective To investigate the therapeutic effect of low-dose inhaled corticosteroids plus low-dose theophylline to the smokers with moderate bronchial asthma （asthma）. Methods To screen 80 asthma cases in the clinic, and they were randomized to two groups： the observed group and the control group. The observed group consisted of smokers and the observed group consisted of non-smokers. They all accepted inhalation budesonide 200 μg/d plus aminophylline tablet （0.1 g rid po） for 3 months. The ACT, PEF, FEV1 % predicted, IL-4,IL-5 and IgE of peripheral blood were compared before and after treatment. Results Before and 3 months after the treatment, the ACT, PEF, FEV1 }/00 predicted, IL-4, IL-5, IgE value for the observed group were （14.3±2.4） and （21.7±2.0）, （255.9±99.7） L/min and （290.3± 105.2） L/rain,（66.5±4.7） and （72.9±5.4）,（14.5±3.2） ng/L and （12.3±3.4） ng/L, （27.2± 6.4） ng/L and （24.2± 5.8） ng/L, （82.7 ± 16.8） IU/ml and （67.1 ± 14.3） IU/ml, respectively, and those for the control group were （13.8 ± 2.2） and （21.5 ± 1.4）, （279.1 ± 103.3） L/ minand （321.3±110.4） L/min,（68.8±5.8） and （74.8±5.5）, （13.4±2.9） ng/L and （11.4±2.8） ng/L, （26.5±6.9） ng/L and （22.8±6.2） ng/L, （78.8±18.2） IU/ml and （66.4±17.8） IU/ml, respectively, which were remarkably improved in both groups（ P dO. 05）. There were no differences between two groups （ P 〈0.05）. Conclusions Compared with non-smokers, the smokers with moderate bronchial asthma treated with ICS plus low-dose theophylline showed similar therapeutic effects in the improvement of clinical symptoms, increasing of lung function and control of the airway inflammation.

关 键 词：吸入糖皮质激素 茶碱 支气管哮喘 吸烟 

分 类 号：R562.25[医药卫生—呼吸系统]