哮喘症状评分及PEF评价普鲁司特治疗支气管哮喘的临床疗效

目的：用哮喘症状评分及峰速仪测量PEF评价国产普鲁司特胶囊治疗支气管哮喘的临床疗效。方法：双盲、随机、平行、对照方法观察225例支气管哮喘患者用药前、后哮喘自觉症状、肺功能指标、实验室指标及不良反应。结果：两组患者治疗后第1、2、3、4周的平均晨间、夜间PEF值较治疗前均有显著改变（P〈0.001）。治疗4周后，两组患者的平均日间、夜间哮喘症状评分均明显减少，日间、夜间无症状天数的百分数明显增加。两组患者的全天无症状天数的百分数增加，日间、夜间两组患者用喘乐宁气雾剂喷数减少；两组患者治疗期间全天未用喘乐宁气雾剂天数的百分数增加，两组组间均无显著差异（P〉0.05）。结论：哮喘症状评分及PEF能很好地评价国产普鲁司特胶囊的临床疗效，该药能改善支气管哮喘患者的PEF值、减轻哮喘症状，不良反应轻微，有良好的临床疗效及安全性。     

异丁司特治疗支气管哮喘的临床疗效

目的:评价白三烯受体拮抗剂异丁司特治疗支气管哮喘的临床疗效及其安全性。方法:观察72例支气管哮喘患者用药前后临床症状、肺功能指标、实验室指标及不良反应。结果:患者治疗后哮喘症状评分明显减少,无症状天数明显增加。治疗后的FEV1值较治疗前明显改善(P<0.0001),平均PEF值较治疗前有显著的改变(P<0.001),不良反应主要为胃肠道反应且较轻微。结论:异丁司特可改善支气管哮喘患者的肺功能,减轻症状,不良反应轻微,临床疗效良好。     

布地奈德莫特罗干粉吸入剂对中重度持续性哮喘的疗效观察

目的：评估布地奈得福莫特罗干粉吸入剂治疗中重度持续性哮喘的临床疗效和耐受性。方法：采用自身对照研究方法，39例患者吸入布地奈得福莫特罗干粉吸入剂（160μg／4．5μg）每日2次，每次1吸，持续3个月，每个月复诊1次，观察临床症状（日间症状评分、夜间症状评分、全天无症状天数、速效13：受体激动剂使用次数的变化等）、肺功能（FEV1、PEF）变化和不良事件发生情况。结果：患者治疗后1、2、3个月FEV1、PEF明显增加。日间症状评分、夜间症状评分、速效β2受体激动剂使用次数显著减少，全天无症状天数明显增加（P〈0．001）。仅有1例患者出现声音嘶哑。结论：布地奈得福莫特罗干粉吸入剂对于中重度持续性哮喘患者具有良好的疗效和安全性     

吸入舒利迭治疗哮喘的疗效分析

目的:观察舒利迭(氟替卡松加沙美特罗)治疗成人中重度哮喘的疗效和安全性。方法:吸入舒利迭50/250(每泡含沙美特罗50μg,氟替卡松250μg),1泡/次,每日2次,连续用3个月,自身对照观察最大呼气峰流速值(PEF)、第1秒用力呼气容积(FEV1)、日间症状和夜间症状的评分、夜间憋醒次数、全天无症状天数、速效β2受体激动剂使用次数的变化和生命质量(AQLQ)问卷评分及不良反应。结果:48例患者吸入舒利迭治疗1、4、8、12周后,PEF分别增加11.4%、24.6%、25.7%、26.4%;FEV1分别增加15.7%、17.9%、18.7%、19.6%;日间症状评分分别减少58.3%、64.6%、78.4%、79.1%;夜间症状评分分别减少51.0%、59.9%、67.2%、68.6%;夜间憋醒次数分别减少62.1%、77.2%、75.7%、76.5%;全天无症状天数分别增加42.4%、68.3%、71.3%、72.3%;使用速效β2受体激动剂(喘乐宁)的次数分别减少61.4%、73.9%、75.1%、75.9%;生命质量综合评分显著改善。结论:舒利迭能够控制大多数成人中重度缓解期哮喘患者的症状,改善肺功能...     

布地奈德福莫特罗粉吸入剂治疗儿童哮喘疗效观察

目的探讨吸入布地奈德福莫特罗粉吸入剂（信必可都保）治疗儿童哮喘的疗效及不良反应。方法子26例6—14岁确诊为儿童哮喘患儿吸入信必可都保（80／4．5μg／吸）1吸，2～3次／d，连续应用3个月，分别于治疗后第1、4、8及12周，观察其日、夜间哮喘症状评分、咳嗽评分、最大呼气峰流速值（PEF）、吸入β2受体激动剂喷数及无症状天数。结果经吸入信必可都保治疗后12周，患儿日、夜间哮喘症状评分、咳嗽评分显著减少（P〈0．01）；PEF增加35．5％；应用β2激动剂的喷数均显著减少（P〈0．01），无症状天数显著增加（P〈0．01），且未见明显不良反应。结论信必可都保能够控制绝大多数儿童哮喘患儿的症状，改善其肺功能，具有良好的依从性和安全性。     

扎鲁司特对轻、中度哮喘的临床疗效观察

目的：探讨扎鲁司特（zafirlukast，商品名，安可来）在轻，中度哮喘患者中的临床疗效及其安全性。方法：哮喘患者口服扎鲁司特20mg，每天2次，持续4周，结果：哮喘患者口服扎鲁司特后日间和夜间症状计分，夜间憋醒次数，无症状天数，吸入β2－受体激动剂用量及肺通气功能指标FEV1 ，PEFam,PEFpm均有显著改善，不良反应2例（3．8％），痰状轻微。结论：扎鲁司特对轻，中度哮喘具有缓解症状和改善肺功能的作用，具有副作用少，耐受性好的优点。     

孟鲁司特、布地奈德及硫酸特布他林治疗支气管哮喘患儿

目的:探讨白三烯受体拮抗剂联合吸入用糖皮质激素及硫酸特布他林气雾剂在小儿支气管哮喘(BA)急性发作期治疗中的临床价值。方法:按不同治疗方案将2017年10月～2019年1月我院收治的88例BA急性发作患儿分为观察组与对照组各44例。在常规治疗基础上,对照组予吸入用糖皮质激素(吸入用布地奈德混悬液)+硫酸特布他林气雾剂,观察组在对照组基础上联合白三烯受体拮抗剂(孟鲁司特钠咀嚼片),两组均治疗7 d。比较两组哮喘症状改善情况、肺功能改善情况以及治疗安全性。结果:两组治疗后夜间、日间哮喘症状评分及PEF、FEV_1/FVC均较治疗前改善,且观察组哮喘症状评分低于对照组,PEF、FEV_1/FVC高于对照组(P0.05);治疗期间,观察组不良反应发生率与对照组比较无显著性差异(P0.05)。结论:布地奈德及硫酸特布他林气雾剂基础上联合孟鲁司特治疗小儿BA急性发作期效果显著,有利于缓解哮喘症状,改善患儿肺功能,且具有一定安全性。     

自拟方辨证治疗支气管哮喘伴胃食管反流病对患者肺功能的影响

目的 :观察运用中医药治疗支气管哮喘伴胃食管反流病对患者肺功能指标的影响。方法 :将 41例患者随机分成 2组 ,对照组常规吸入普米克气雾剂治疗支气管哮喘 ;观察组在此基础上自拟方辨证治疗支气管哮喘伴有的胃食管反流病。 2组均治疗 5周 ,治疗前后分别测定肺功能 (FEV1、PEF)。结果 :观察组FEV1、PEF的增加与对照组比较 ,差异有显著性意义 (P <0 .0 1 )。结论 :运用中医药治疗支气管哮喘伴胃食管反流病 ,能显著提高患者的肺功能。     

扎鲁司特对哮喘患者肺功能和心理情绪的作用

目的探讨白三烯受体拮抗剂扎鲁司特对成人哮喘患者心理情绪的作用。方法40例哮喘患者随机分为治疗组和对照组各20例。治疗组口服扎鲁司特20mg,2次/d,疗程4周。对照组不用扎鲁司特。试验期间两组按需使用β2-激动剂,停用口服或吸入糖皮质激素。服药前及4周后测血常规、尿常规、肝肾功能和肺功能,采用医院内焦虑、抑郁评分表(HAD)进行心理情绪评估。结果治疗组口服扎鲁司特4周后日间及夜间症状计分、夜间憋醒次数、无症状天数和吸入β2-激动剂用量及肺功能肺活量、第1秒用力呼气量、呼气流量峰值率以及焦虑抑郁评分有显著改善。结论扎鲁司特能有效控制哮喘症状,改善肺功能和心理情绪。     

孟鲁司特联合布地奈德治疗重度哮喘的临床研究

目的了解孟鲁司特联合吸入布地奈德治疗重度哮喘的疗效。方法盂鲁司特联合吸入布地奈德治疗30例重度哮喘患者，根据纳入和排除标准筛选病例。据疗效判断标准进行临床疗效的判断。结果孟鲁司特联合吸入布地奈德治疗30例重度哮喘6周后，治疗前早、晚间PEF，治疗前早、晚间喘乐宁气雾剂喷数，治疗前日、夜间哮喘症状评分和治疗后相比具有显著性差异（P〈0．01）。结论盂鲁司特联合吸入布地奈德治疗重度哮喘有效。     

放松疗法改善哮喘儿童的心身症状

背景放松疗法可减轻成人哮喘患者的不良情绪反应,降低哮喘发作次数,但缺乏对于哮喘儿童作用的评估数据.目的探讨放松疗法对学龄哮喘患儿的焦虑、抑郁和咳嗽、气喘等症状的影响.设计以诊断为依据,随机对照研究.单位中南大学湘雅二医院儿科和中南大学精神卫生研究所.对象2001-01/2004-01中山市博爱医院儿科就诊的1 438名哮喘患儿中筛选出符合标准578例,再随机抽取64例作为研究对象,随机分配到实验组31例,对照组33例.干预在两组药物治疗相同的基础上,实验组每晚睡前给予放松治疗,持续4周.治疗前后评估两组患儿的焦虑、抑郁症状,治疗期间评估哮喘症状、记录计算哮喘控制参数.主要观察指标焦虑和抑郁评分,日间和夜间哮喘症状记分、无哮喘症状的天数、哮喘发作与加重次数等指标.结果治疗前两组焦虑和抑郁症状评分无统计学差异(P＞0.05),两组患儿的焦虑和抑郁评分在治疗结束时均明显降低(P均＜0.01),但实验组较对照组下降更明显,差异具有统计学显著性(P均＜0.01).日间哮喘症状记分,夜间哮喘症状记分,无哮喘症状的天数比率,≥1次哮喘发作的比率,两组比较差异均有显著性意义(P＜0.05～0.01).结论放松疗法可以减轻学龄哮喘患儿的不良情绪反应,并改善多项哮喘控制参数,是一种较好的辅助治疗手段.     

Effects of six-week clarithromycin therapy in corticosteroid-dependent asthma: A randomized, double-blind, placebo-controlled pilot study

Background: Although corticosteroids such as prednisone are efficacious for the treatment of severe asthma, chronic administration of oral corticosteroid therapy is associated with significant adverse effects. Previous studies have shown that clarithromycin is effective in reducing bronchial hyperresponsiveness and allergen-induced bronchoconstriction. However, the effect of long-term clarithromycin therapy in patients with prednisone-dependent asthma is uncertain.Objective: This study was conducted to determine the effects of oral clarithromycin on prednisone daily dosage, pulmonary function, quality of life (QOL), and asthmatic symptoms in patients with corticosteroid-dependent asthma.Methods: This 14-week, prospective, randomized, double-blind, placebo-controlled pilot study was conducted at Pulmonary Associates (Phoenix, Arizona) and the University of Illinois at Chicago Medical Center (Chicago, Illinois). Patients aged 18 to 75 years with an established diagnosis of asthma and who had been receiving ≥5 mg/d of prednisone for the preceding 6 months were enrolled. After a 4-week data-collection period, patients received clarithromycin 500 mg BID for 6 weeks, followed by a 4-week follow-up period. The effects of clarithromycin therapy on prednisone dosage requirements, pulmonary function (as assessed using spirometry), QOL, and asthmatic symptoms (nocturnal asthma, shortness of breath, chest discomfort, wheezing, and cough) were assessed.Results: Fourteen patients (9 men, 5 women; mean [SD] age, 62 [13] years) completed the study and were included in the final analysis. One patient withdrew from the study due to clarithromycin-related nausea. After 6 weeks of clarithromycin therapy, patients were able to tolerate a significant reduction in mean (SD) prednisone dosage from baseline (30% [18%]; P- 0.020). Pulmonary function, QOL, and asthmatic symptoms did not significantly worsen despite reduction in prednisone dose. All patients who completed the study tolerated clarithromycin therapy.Conclusions: In this pilot study of patients with corticosteroid-dependent asthma, 6-week clarithromycin 500 mg BID was clinically effective in allowing a reduction in prednisone dosage, without worsening pulmonary function, QOL, or asthmatic symptoms. In addition, clarithromycin was well tolerated, with only 1 patient discontinuing therapy due to treatment-related nausea.     

Correlations of health-related quality of life questionnaire results in asthma and allergic rhinitis: effects of a leukotriene receptor antagonist

Bronchial asthma and allergic rhinitis frequently coexist. This study investigated correlations of health-related quality of life (QOL) questionnaires for these diseases, assessing whether the selective leukotriene receptor antagonist (LTRA), pranlukast, had additional benefits to overall asthma control when there was concomitant allergic rhinitis. Patients with asthma-associated allergic rhinitis were randomly allocated to either LTRA(+) (n = 21, treated for 3 months with pranlukast), or LTRA(-) (n = 8, no pranlukast). At study start and at 3 months, pulmonary function was evaluated and QOL assessments were made using the Asthma Health Questionnaire-Japan (AHQ-Japan) and the Japan Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ). Total scores were significantly correlated both before and after therapy. After 3 months' therapy, pulmonary function and total AHQ-Japan and JRQLQ scores significantly improved in the LTRA(+) group, but not in the LTRA(-) group. A significant correlation between change at 3 months in the AHQ-Japan and JRQLQ scores from baseline values was seen in the LTRA(+) group. LTRA therapy improved allergic rhinitis symptoms, asthma symptoms and pulmonary function.     

兰索拉唑对20例哮喘病人应用糖皮质激素所致胃肠道不良反应的预防效果

目的：了解兰索拉唑对哮喘病人应用糖皮质激素治疗所致的胃肠道不良反应的预防效果。方法;选择住院应用糖皮质激素治疗的哮喘病人５８例,在应用糖皮质激素治疗的同时,治疗组２０例口服兰索拉唑３０ｍｇ,每晚１次,对照１组１３例口服Ｈ２受体阻滞药雷尼替丁１５０ｍｇ或西咪替丁４００ｍｇ,每日２次,对照２组２５例口服安慰剂肌苷２００ｍｇ,每日３次,随诊共３个月,观察病人有我出现胃肠道不良反应。结果 治疗组,对照组,     

A multinational, 12-week, randomized study comparing the efficacy and tolerability of ciclesonide and budesonide in patients with asthma

BACKGROUND: Ciclesonide is a new lung-activated inhaled corticosteroid (ICS) that has shown efficacy in previous placebo-controlled and comparative studies in patients with persistent asthma. It is important to compare new treatments with existing ICSs to obtain relative data concerning their efficacy and tolerability. OBJECTIVE: This study compared the efficacy and tolerability of ciclesonide QD with budesonide BID in patients with asthma. METHODS: This 12-week, randomized study was conducted at 62 study sites across Europe. Male and female patients aged 12 to 75 years with primarily mild to moderate asthma were enrolled. This study was double blind with respect to the ciclesonide dose and open label for budesonide, as placebofor budesonide was not available. Patients were randomly assigned to receive inhaled ciclesonide 80 or 320 microg QD (morning) or budesonide 200 microg BID for 12 weeks. Efficacy and tolerability assessments were performed at weeks 0 (baseline), 4, 8, and 12. The primary end point was the change from baseline in forced expiratory volume in 1 second (FEV1) at 12 weeks. Secondary end points were changes from baseline in morning peak expiratory flow (PEF), asthma symptom scores, and rescue medication use. Tolerability was assessed throughout the study by monitoring of standard laboratory variables (hematology and biochemistry); physical examination, including vital signs; reporting of adverse events (AEs); and 24-hour urinary cortisol as a measure of hypothalamic-pituitary-adrenal-axis function. RESULTS: Five hundred fifty-four patients were randomized (301 men, 253 women; mean age, 41.3 years; ciclesonide 80 microg QD, 182 patients; ciclesonide 320 microg QD, 195; budesonide 200 microg BID, 177). Demographic and baseline clinical characteristics, including age, sex, weight, and (FEV1) were similar between the 3 groups. Compared with baseline values, week-12 FEV1 (least squares mean [LSM] [SEM] A, +0.267 [0.035], +0.256 [0.033], and +0.355 [0.034] L, respectively; all, P<0.001) and morning PEF (LSM [SEM] Delta, +12 [5], +17 [4], and +21 [4] L/min, respectively; all, P相似文献   

环索奈德气雾剂治疗成人支气管哮喘的有效性和安全性评价

目的:评价环索奈德气雾剂治疗成人支气管哮喘的临床疗效和安全性.方法:72例轻、中度支气管哮喘患者随机分成两组,进行单盲、平行、阳性药(布地奈德)对照试验,治疗12周,以晨间PEF值作为主要评价指标,辅以夜间PEF值、FEV1值、ACQ评分、哮喘症状评分、缓解症状所需的万托林剂量等评价环索奈德的有效性;通过心电图、口咽部检查、实验室检查及不良事件数据评价环索奈德的安全性.结果:治疗前、后试验组和对照组的晨间PEF值变化差异均有显著性(P ＜ 0.05),但组间差异无统计学意义(P ＞ 0.05);试验组和对照组夜间PEF、FEV1和ACQ数据有明显改善,所需万托林的剂量显著减少,哮喘症状评分明显好转,但组间差异无统计学意义(P ＞ 0.05).试验组不良事件发生率为16.67%,对照组为13.89%,组间比较无统计学意义(P ＞ 0.05).结论:本研究证实环索奈德气雾剂1次/d,2喷/次(200 μg)治疗成人哮喘有效而且安全.     

Model-Based Prediction of Expiratory Resistance Index in Patients with Asthma

Objectives. Develop a sensitive algorithm and index for detection of asthma patients using forced expiratory flow curves. Methods. A lumped-parameter model of forced expiration was developed. The model can predict the flow-volume curve during forced expiratory maneuver. The flow-volume curves generated by the model depend on values of resistance parameters (FER). Use of flow-volume curves recorded from normal subjects and from patients with asthma before and after ventolin inhalation as inputs for the inverse model, yielded the resistance parameters for each case. These parameters are based on the entire information presented in the flow-volume curve and on the reduction in flow at all lung volumes. Results. Forced Expiratory Resistance (FER _N ) indices were estimated at different percent of lung volumes using the inverse model. The index was significantly affected by inhalation of ventolin in asthmatic patients and was insensitive to ventolin inhalation in normal patients. In asthmatic patients, the FER index at five lung volumes (out of eight), was two–five times greater than in normal subjects with p ≪ 0.05 (three of them with p ≪ 0.01). Conclusions. The estimated parameters were sensitive indicators of the degree of lung function impairment and were able to accurately distinguish between healthy and asthmatic patients. Barnea O, Abboud S, Guber A. Model-based prediction of expiratory resistance index in patients with asthma     

放松训练对哮喘患儿临床症状和肺功能的影响

目的　探讨放松训练对学龄哮喘患儿临床症状和肺功能的影响。方法　将 6 0例诊断为哮喘 ,并符合入组条件的学龄哮喘患儿随机分为实验组 30例 ,对照组 30例。两组在应用相同药物治疗的基础上 ,实验组每晚睡前实施放松训练 ,持续4w。实验前后评估两组患儿的焦虑、抑郁分值和肺功能 ,实验期间评估哮喘控制参数。结果　实验组焦虑和抑郁评分在实验结束时显著降低 (P <0 .0 1) ,哮喘控制参数和肺功能指标与实验前比较或与对照组比较有显著性差异 (P <0 .0 1)。结论　放松训练可以减轻学龄哮喘患儿的不良情绪 ,改善临床症状和肺功能 ,是一种简便有效的哮喘辅助治疗方法     

Severe exacerbation of asthma: a new side effect of interferon-alpha in patients with asthma and chronic hepatitis C

Interferon-alpha is used by physicians to treat numerous common medical disorders; however, therapy is often limited by side effects. Pulmonary complications, such as interstitial pneumonitis and bronchiolitis obliterans organizing pneumonia, have been described in patients receiving interferon-alpha therapy. Exacerbation of asthma induced by subcutaneous administration of interferon-alpha has not been previously reported. We describe two patients with mild asthma in whom treatment with interferon-alpha for chronic hepatitis C resulted in exacerbation of the underlying asthma. The severe asthmatic symptoms resolved promptly after use of interferon-alpha was discontinued and corticosteroid therapy was initiated. Repeated treatment with interferon-alpha several months later resulted in a rapid, more severe exacerbation of asthma in both patients. Patients undergoing therapy with interferon-alpha, especially those with chronic asthma, should be monitored closely for pulmonary symptoms. If these symptoms develop, patients should be instructed to discontinue use of interferon-alpha and seek medical attention immediately.     

雾化吸入布地奈德与沙丁胺醇治疗支气管哮喘的效果

目的探讨雾化吸入布地奈德与沙丁胺醇治疗支气管哮喘的效果。方法选择我院58例支气管哮喘患者,随机将其分为对照组和观察组,每组29例。对照组实施沙丁胺醇雾化吸入治疗,观察组实施布地奈德与沙丁胺醇雾化吸入治疗。比较两组治疗效果。结果观察组治疗总有效率高于对照组(P<0.05)。治疗后,两组用力肺活量、高迁移率蛋白1表达量、晨间呼气峰流量和晚间呼气峰流量均有所改善,且观察组改善程度优于对照组(P<0.05)。观察组咳嗽缓解时间、气急症状消失时间、胸闷消失时间和喘息消失时间均短于对照组(P<0.05)。两组不良反应总发生率无显著差异(P>0.05)。结论布地奈德与沙丁胺醇雾化吸入治疗支气管哮喘效果确切,可缩短症状改善时间,改善患者肺功能,且无明显雾化吸入不良反应,安全性高。