普米克令舒、爱全乐和万托林三联雾化吸入治疗成人重症哮喘急性发作的疗效观察

目的 观察普米克令舒、爱全乐和万托林三联雾化吸入疗法治疗成人重症哮喘急性发作的临床疗效。方法 将46 例重症哮喘急性发作的成人患者随机分为对照组和观察组, 各组23 例。对照组给予静脉滴注甲基泼尼松龙、茶碱等常规治疗; 观察组在对照组治疗基础上雾化吸入普米克令舒、爱全乐和万托林。观察并比较两组患者的临床疗效, 日间与夜间哮喘症状评分, 症状、体征消失时间, 静脉激素使用量与使用天数, 以及药物不良反应。结果 治疗7 d 后, 观察组患者的临床疗效明显优于对照组, 其差异有统计学意义（ P 〈0. 05） 。治疗早期, 观察组患者的日间与夜间哮喘症状评分均较对照组低（ P 〈0. 05） 。除咳嗽外, 观察组患者喘息、气促、胸闷症状和肺内哮鸣音消失时间均小于对照组（ P 〈0. 05） 。观察组静脉使用甲基泼尼松龙用量与时间明显少于对照组（ P 〈0. 05） , 且不良反应较轻。结论 对于重症哮喘急性发作的成人患者, 在静脉全身用药的基础上给予普米克令舒、爱全乐和万托林三联雾化吸入疗法起效快, 疗效明显, 且能减少患者静脉使用激素量, 降低不良反应发生率, 值得临床推广。

Efficacy of Triple Aerosol Inhalation of Pulmicort Respules,Ipratropine and Ventolin in Treatmentof Severe Acute Asthma Exacerbations in Adults

Objective To observe the clinical efficacy of triple aerosol inhalation of pulmicortrespules, ipratropine and ventolin in treatment of severe acute asthma exacerbations in adults.Methods 46 cases of severe asthmatic patients with acute exacerbations admitted between May 2011 and May 2013were recruited in the study. They were randomly divided into a treatment group and a control group,23 casesin each group. The control group received aminophylline and methylprednisolone intravenously, while thetreatment group received triple aerosol inhalation of pulmicort respules, ipratropine and ventolin on the basictreatment of the control group. The clinical efficacy, the score of asthma symptom of the day and night, thetime of disappearance of symptoms and wheezing sound, the glucocorticoid dosage and the incidence ofadverse reactions of each group were compared.Results Comparison of clinical efficacy of two groups drewsignificant differences （ P 〈 0. 05） after 7 days. The score of asthma symptom of the day and night in thetreatment group was lower than that of the control group （ P 〈0. 05） . Except cough, the duration of wheezing,breathlessness, chest distress and extinction time of wheezing sound in the treatment group were shorter thanthose in the control group （ P 〈 0. 05） . The triple inhalation therapy can reduce the dosage and shorten theperiod of intravenous glucocorticoid treatmentwith slight adverse reactions （ P 〈0. 05） .Conclusions In thetreatment of severe asthmatic patients with acute exacerbations, the clinical efficacy of triple aerosol inhalationof pulmicort respules, ipratropine and ventolin on the base of intravenous treatment is satisfactory with rapidonset, which can also reduce the glucocorticoid dosage and the incidence of adverse reactions. So thecombination therapy is worthy of clinical use.