采用联合治疗哮喘患者的现况调查研究  

Cross-sectional studies of combination therapy for patients with asthma

作　　者：周为[1] 柯会星[1] 李洋[1] 

机构地区：[1]卫生部北京医院呼吸与危重症医学科,北京100730

出　　处：《中华保健医学杂志》2015年第3期193-195,共3页Chinese Journal of Health Care and Medicine

基　　金：北京市自然科学基金(7132220)

摘　　要：目的了解门诊使用不同种类吸入糖皮质激素及长效β2受体激动剂联合治疗哮喘患者的控制现状,以期为更好地控制哮喘提供一定的理论依据。方法采用现况调查的研究方式,纳入2013年5月~2014年3月期间于卫生部北京医院门诊就诊,且曾接受过布地奈德/福莫特罗或沙美特罗/替卡松粉吸入剂吸入治疗超过3个月的支气管哮喘患者。通过问卷调查的方式记录患者的人口学特征、哮喘控制水平、肺功能水平、药物使用情况、药物不良反应、吸入装置掌握情况以及患者用药依从性的数据,从而评价不同联合治疗药物对哮喘控制的影响。结果共入选符合要求的支气管哮喘患者125例,其中布地奈德/福莫特罗治疗组72例,沙美特罗/替卡松治疗组53例。上述患者按照支气管哮喘控制水平分级,达到哮喘控制、部分控制和未控制的患者比例分别为19.2%、36.8%和44.0%。不论采用何种联合治疗药物,患者用药的依从性均影响哮喘的控制水平。两组患者在用药依从性、吸入装置的使用、肺功能水平、急性发作次数以及哮喘控制水平方面均无显著差异。在达到相同控制水平的前提下,布地奈德/福莫特罗治疗组的激素用量小于沙美特罗/替卡松治疗组的激素用量,但两组的不良反应发生率并无显著差异。结论即使采用了吸入激素及长效β2受体激动剂的联合治疗,但哮喘的控制水平仍较低,药物使用的依从性不佳是重要原因。以布地奈德/福莫特罗吸入剂为基础的联合治疗方案与使用沙美特罗/替卡松粉吸入剂相比,疗效与安全性相当。Objective To evaluate the asthma control level of the outpatients with combined treatment of inhaled corticosteroids and long-acting bronchodilator,and provide valuable data for optimal disease control. Methods The research was designed as a cross-sectional,retrospective study,and enrolled asthma outpatients from May 2013 to March 2014 in Beijing Hospital Ministry of Health who had received treatment of Budesonide/Fomoterol or Salmeterol/Fluticasone for more than 3 months. The demographic features,asthma control level,lung function,prescriptions,adverse effects,mastery of the inhaler and compliance of the patients were recorded by face-to-face interviews with a structured questionnaire to evaluate the effect of the different treatments on the asthma control level. Results 125 asthma patients were enrolled,of whom 72 patients were assgiend to Budesonide/Fomoterol Group,and 53 patients were assigned to Budesonide/Fomoterol Group. According to GINA,the proportion of patients who achieved control,partial control or remained uncontrolled were 19.2%,36.8% or 44.0% respectively. The absence of compliance account for the failure to achieve control no matter which combined treatment the patients received. And there was no difference in the compliance of the patients,mastery of the inhaler,lung function,acute exacerbation and asthma control level between the two groups. Combined treatment based on Budesonide/Fomoterol required lower dose of ICS than Salmeterol/Fluticasone to achieve the same control level,but there was no difference between the adverse effects of the two treatments. Conclusion Despite the prescription of the combined treatment of inhaled corticosteroids and long acting β2 agonist,the asthma control level is still low due to poor compliance of patients.The combined treatments based on Budesonide/Fomoterol and Salmeterol/Fluticasone can overall achieve equal levels of asthma control.

关 键 词：哮喘 吸入糖皮质激素 长效Β2受体激动剂 控制 

分 类 号：R562.25[医药卫生—呼吸系统]