小剂量茶碱与西替利嗪口服联合小剂量激素吸入对哮喘的治疗作用

目的研究小剂量茶碱、西替利嗪口服联合小剂量激素吸入对哮喘的治疗效果。方法将48例轻、中度哮喘患者用抽签法随机分成2组，各2，4例，联合组每晚给予无水缓释茶碱200nag、西替利嗪15样口服，二丙酸倍氯米松（BDP）250μg吸入；对照组仅给予BDP500μg／d吸入，每晚给予安慰剂2片，疗程12周。测定2组患者血浆茶碱浓度、呼气峰流速值及其变异率、沙丁胺醇使用次数。结果治疗前后的呼气峰流速值及变异率：联合组分别为（301．12±80．46）L／min和（500．35±90．72）L／min以及（24．12±5．29）％和（5．08±1．30）％。对照组分别为（320．52±81．59）L／min和（452．33±93．09）L／min以及（25．48±6．12）％和（5．70±1．08）％，2组治疗前后比较差异有统计学意义（P〈0．01），2组间比较有统计学意义（P〈0．05）。治疗期间夜间使用B：受体激动剂的次数联合组（1．67±0．52）次与对照组（2．99±0．82）次比较，差异有统计学意义（P〈0．05）。结论小剂量茶碱、西替利嗪口服联合小剂量激素吸入对哮喘疗效优于同单纯大剂量激素吸入对哮喘的疗效，并减少了夜间使用β2受体激动剂的次数，且避免了因大量使用激素产生的药物不良反应。

Effect of small dose of oral theophylline and cetirizine combined with low dose of inhaled corticosteroid on bronchial asthma

Objective To investigate the effect of small dose of oral theophylline and cetirizine combined with low dose of inhaled beclomethasane dipropionate (BDP)on clinical symptoms. Methods Forty-eight patients with mild-moderate bronchial asthma were randomly divided into two groups. Twenty-four subjects in combined group were treated with oral sustained-release theophylline (200 mg/night)and eetirizine combined with inhaled BDP (250 μg/d). Twenty-One case in controlled group received inhaled BDP (500 μg/day) and oral placebo. Results Before and 12 weeks after the treatment, peak flow(PEF)and peak flow rate (PEFR)in group A were (301.12 ±80.46)L/min and (500.35 ± 90.72)L/min and (24.12 ± 5.29)% and (5.08 ± 1.30)% respectively (P < 0.01 ), and those in group B were (320.52±81.59 )L/min and (452.33 ± 93.09 )L/min and(25.48 ± 6.12 )% and (5.70 ± 1.08)% respectively(P < 0.01 ), showing a significant difference between two groups (P < 0.05 ). Frequency of using inhaled β2 agonist to relieve nocturnal as thematic at tacks in group B and group A were(1.67 ±0.52) times and(2.99 ± 0. 82)times. Frequency of using inhaled β2 agonist in group B was higher than that in group A(P <0.05). Conclusion Small dose of oral theophylline and cetirizine combined with low dose of inhaled BDP might have higher effect on relief of clinical symptoms and bronchial responsiveness comparing with relatively higher dose of inhaled BDP, meanwhile decrease the frequeney of using inhaled 132 agonies is decreased.