罗红霉素与布地奈德干粉吸入剂联用治疗哮喘的临床研究

目的：通过与单纯吸入布地奈德干粉吸入剂（普米克都保）组比较，观察口服罗红霉素联用布地奈德干粉吸入剂治疗哮喘的疗效及对血清可溶性IL-2受体（sIL-2R）、IL-8和血嗜酸性粒细胞（EOS）计数水平的影响。方法：选择门诊轻、中度急性发作哮喘患者45例，随机分组。治疗组口服罗红霉素联合吸入布地奈德干粉吸入剂，对照组吸入布地奈德干粉吸入剂，疗程4周。治疗前、治疗4周后检测肺功能、血sIL-2R、IL-8和EOS计数水平，并按临床症状记分。结果：40例完成了试验。治疗4周后临床症状记分、肺功能一秒钟用力呼气量（FEV1）、FEV1占预计值百分比（FEV1／pred％）、最大呼气流量（PEF）和PEF占预计值百分比（PEF／pred％）改善，血sIL-2R、IL-8和EOS计数水平较治疗前降低，且治疗组较对照组改善更为明显，两组副作用相似。结论：罗红霉素具有抗炎和免疫调节作用，罗红霉素与布地奈德干粉吸入剂联用可以提高疗效。

Clinical study on efficacy of roxithromycin combined with inhaled budesonide dry powder inhalation on asthma

AIM： To evaluate the therapeutic effect and to observe the changes of levels of serum cytokine soluble interleukin-2 receptors （sIL-2R） and interleukin-8 （IL-8） and the absolute number of eosinophil in blood （EOS） of roxithromycin combined with inhaled budesonide （BUD） dry powder inhalation （pulmicort turbuhaler） on asthma, comparing with the inhaled pulmicort turbuhaler group. METHODS： 45 asthmatic subjects were randomly treated with either roxithromycin combined with pulmicort turbuhaler （treatment group ） or pulmicort turbuhaler （control group）. The treatment course was 4 weeks. Before the treatment and after 4 weeks of the treatment, the levels of sIL-2R, IL-8, EOS and lung function were detected, as well as the scoring of clinical symptoms. RESULTS： There were 40 subjects who fulfiled their trials. Both clinical symptoms scores and lung function, FEV1, FEV1/pred%, PEF and PEF/pred% were significantly improved in both groups after treatment. The levels of sIL-2R, IL-8 and EOS were significantly decreased in both groups after treatment. Moreover, the indexes in treatment group were significantly improved than those in control group. The side effects in both groups were similar. CONCLUSION： Roxithromycin has anti-inflammatory and immunoregulatory effects on treating asthma. Roxithromycin associated with pulmicort turbuhaler can enhance curative effect on asthma,