小剂量吸入激素治疗支气管哮喘疗效评价

目的探讨控制哮喘的最小吸入糖皮质激素(ICS)剂量。方法42例哮喘患者随机分成2组:A组22例应用全球哮喘防治创议(GINA)推荐的最低剂量,轻度予布地奈德(BUD)200μg,每日1次;中度予BUD 200μg,联合缓释茶碱(SRT)0.1 g,每日2次;重度予BUD400μg,联合SRT 0.1 g,每日2次。B组20例予相应级别双倍剂量,轻度予BUD 200μg,中度予BUD 400μg,重度予BUD 800μg,均每日2次。2组均按需使用沙丁胺醇气雾剂,疗程6个月,比较治疗前后临床疗效、肺功能的变化。结果治疗后2组患者症状评分较治疗前明显降低,肺功能明显改善,2组比较无显著性差异。结论多数轻度哮喘患者应用GINA推荐的ICS最低剂量及中重度患者应用最低剂量联合缓释茶碱治疗,可取得与双倍剂量相似的疗效,而治疗费用明显减少。

Curative effect evaluation of small dose corticosteroids inhaled on bronchial asthma

Objective It is to discuss the lowest doses of inhaled corticosteroids to control bronchial asthma.Methods 42 patients with bronchial asthma were randomly divided into two groups.Group A(22 cases) were given ICS with the lowest doses recommended by Global Initiative for Asthma(GINA) in which mild ones were given inhaled budesonide(BUD) 200 μg once a day,moderate ones were given BUD 200 μg combined with SRT 0.1 g twice a day and severe ones were given BUD 400 μg combined SRT 0.1 g twice a day.Group B were given double of the above doses of BUD(200 μg twice a day for mild ones,400 μg twice a day for moderate ones and 800 μg twice a day for severe ones).Each group added inhaled salbutamol needed.Both treatment courses were six months.Clinical effects and lung function were compared before and after treatment.Results After treatment,symptom scores of the two groups were obviously decreased and lung functions of the two groups were significantly improved.There was no significant difference between the two groups.Conclusion Similar therapeutic effect and less treatment cost were achieved by using the lowest dose of ICS that GINA recommended in most of mild asthma and the lowest doses of ICS combined with SRT in moderate and severe asthma compared with those receiving the double doses of ICS.