银杏内酯雾化吸入治疗支气管哮喘的临床研究

目的观察银杏内酯雾化吸入对支气管哮喘治疗作用.方法对轻、中度哮喘患者随机分为3组,分别给予色甘酸钠20 mg/10 ml,每天2次,共6周(30例);银杏内酯10 mg/10 ml,每天2次,共6周(30例)及生理盐水10 ml,每天2次,共4周(10例)雾化吸入治疗,观察治疗前后各组哮喘患者的症状评分(根据Chetta A的方法)、血嗜酸细胞计数、血嗜酸性粒细胞阳离子蛋白(ECP,RIA法)、肺功能(FEV1、PEF)、对蒸馏水气道激发试验的反应性变化及不良反应.结果银杏内酯和色甘酸钠治疗组在用药6周后症状评分分别由治疗前的(5.1±2.3)分、(6.0±2.6)分降至(1.6±1.7)分(P＜0.01)、(1.6±1.7)分(P＜0.01);银杏内酯组的ECP由6.7μg/L降至4.3μg/L(P＜0.05),FEV1、PEF有所提高(P＜0.05,P＜0.01),而色甘酸钠组仅表现为FEV1的改善(P＜0.05);两个治疗组对蒸馏水气道激发试验的反应性亦均降低(P＜0.01);生理盐水组虽然有症状评分的降低,但ECP、肺功能及气道反应性均无改善(P＞0.05).治疗的不良反应以胸闷、刺激性咳嗽为主,在银杏内酯组尤其多见,但大部分患者可耐受.结论银杏内酯具有抗哮喘气道炎症的作用,为哮喘治疗提供了新的手段.

Clinical Study on Ginkgolide Nebulised Inhalation in Treating Bronchial Asthma

OBJECTIVE: To observe the effect of ginkgolide nebulised inhalation in treating bronchial asthma. METHODS: Asthma patients of mild to moderate degree were randomly divided into three groups: the treated group treated by ginkgolide nebulised inhalation 10 mg/ml, twice daily, for 6 weeks in total, the positive control group, treated by cromlyn sodium nebulised inhalation 20 mg/10 ml, twice daily, for 6 weeks in total and the negative control group treated by normal saline 10 ml, twice daily, for 4 weeks in total. The changes on symptomatic scoring (Chetta' s method), pulmonary function (FEV1, PEF), serum eosinophil count, eosinophil cationic protein (ECP, determined by RIA), as well as airway response to ultrasonically nebulised distilled water (UNDW), and adverse reaction occurred in patients were observed. Results The symptomatic scorings in the treated and the positive control group were reduced from 5.1+/-2.3 and 6.0+/-2.6 to 1.6+/-1.7 and 1.6+/-1.7, respectively (both P<0.01) after 6 weeks of treatment. In the treated group, ECP was reduced from 6.7 microg/L to 4.3 microg/L (P<0.05), FEV1 and PEF were improved (P<0.05, P<0.01), while in positive control group, only improvement of FEV1 was found (P < 0.05). UNDW in the above two groups were reduced (P<0.01). Although decrease of symptomatic scoring was found in the negative control group, yet ECP, pulmonary function and airway response showed no improvement (P >0.05). Adverse reactions revealed were mainly chest stuffiness, stimulating cough, especially in the treated group, but were tolerable to most patients. Conclusion Ginkgolide has the action of fighting against asthmatic airway inflammation, which provides new means for treating bronchial asthma.