单用扎鲁司特与联合吸入糖皮质激素治疗哮喘的比较研究

目的比较单用扎鲁司特、扎鲁司特联合吸入糖皮质激素及单用吸入性糖皮质激素治疗哮喘对肺功能、IL-12和IL—13的影响有无差别。方法将121例哮喘患者随机分为三组，单用扎鲁司特组（A组）：扎鲁司特（安可来）20mg，2次／d；扎鲁司特联合吸入型糖皮质激素组（B组）：丙酸倍氯米松气雾剂（必可酮）吸入250μg，3次／d，口服扎鲁司特20mg，2次／d；单用吸入型糖皮质激素组（C组）：必可酮吸入250μg，3次／d。疗程均为4周。治疗前后测量一秒用力呼出量（FEV1％）和呼气峰流速（PEF％），并检测血清中自细胞介素12、13（IL-12、13）的水平。结果三组治疗后的FEV1％及PEF％均高于治疗前（P〈0．05）。而治疗后B组肺功能高于A组和C组，差异有统计学意义；经治疗后三组哮喘患者血清中的IL-12升高而IL-13降低（P〈0．05）。治疗后B组的IL-12高于A组和C组，B组的IL-13低于A组和C组，且C组的IL-13低于A组。结论扎鲁司特联合吸入型糖皮质激素能有效地改善哮喘患者的肺功能、调节IL-12／IL-13失衡，且效果优于单用扎鲁司特及单用吸入型糖皮质激素。

The comparative study of treating asthma by Zafirlukast and Zafirlukast combination Glucocorticoid inhalation

Objective To compare the effects of pulmonary function, IL-12 and IL-13 in treating asthma by only using Zafirlukast, only using Glucocortieoid inhalation, and Zafirlukast eombination Glueoeortieoid inhalation. Methods 121 asthma patients were randomly allocated to three groups （A,B and C）. The patients in A group took orally Zafirlukast 20 mg and twice every day. The patients in B group take orally Zafirlukast 20 mg and twiee every day and inhaled Beelometasone Dipropionate Aerosol 250μg and three times every day. The patients in C group inhaled Beelometasone Dipropionate Aerosol 250μg and three times every day. Course of treatment of all patients were 4 weeks. Forced expired volume in a seeond （ FEV% ） , peak expired flow rate （PEF%）, and IL-12 and IL-13 in blood serum were respectively detected before and after accepting treatment. Results FEV1% and PEF% after treatment in three groups ware significantly higher than that before treatment（P 〈0. 05）. Pulmonary funetion after treatment is significantly higher in B group than that in A and C groups. After treatment, IL-12 in blood serum is higher, while IL-13 is lower in three groups（P 〈0. 05）. IL-12 after treatment in B group is higher than A and C groups. IL-13 after treatment is significantly different among three groups. The level of B group is lowest; and the level of A group is highest. Conclusion Zafirlukast combination Glueoeortieoid inhalation can efficiently improve pulmonary function and aeeommodate disequilibrium of IL-12/IL-13 for asthma patients, and the effect is surpass that of only using Zafirlukast or Glueocorticoid inhalation.