班布特罗改善吸入激素哮喘患者症状控制的观察

目的 :观察吸入糖皮质激素 (激素 )治疗症状控制不满意的哮喘患者加口服长效 β2 受体激动剂班布特罗的临床效果。方法 :3 7例慢性哮喘患者随机分为 2组 :班布特罗组在原吸入激素剂量的基础上加口服班布特罗 10mg每晚 1次 ,1周后改为 2 0mg每晚 1次 ;激素加量组 :原吸入激素的剂量增加。改变治疗后观察患者肺功能变化、症状的改善共 4周。结果 :改变治疗后第 4周末 ,两组患者的FEV1 和PEF均较改变治疗前明显增加 (P <0 0 1和P <0 0 5 ) ,但班布特罗组FEV1和PEF增加的变化值较激素加量组更为显著 (P <0 0 5 )。至第 4周 ,两组患者每周按需吸入短效 β2 受体激动剂的次数和每周夜间因出现症状被唤醒次数皆明显减少 (P <0 0 5 ) ,但班布特罗组患者夜间因哮喘症状被唤醒次数的减少比激量加量组更为明显 (P<0 0 5 )。结论 :吸入激素症状控制不满意的哮喘患者每日 1次口服班布特罗可明显改善肺功能和临床症状。对于吸入激素达一定剂量后症状仍未控制的哮喘患者 ,加服班布特罗不失为另一可供选择的治疗方案。

EFFECT OF ORAL BAMBUTEROL ON COTROL OF SYMPTOM IN ASTHMA PATIENTS WITH INHALED CORTICOSTEROIDS

Objective:To observe clinical effect of oral bumbuterol on control of symptom and improvement of lung function in asthma patients with inhaled corticosteroids.Methods:Thirty seven chronic asthmatic patients with inhaled corticosteroids were randomized into two groups:①Oral bumbuterol group:Nighteen patients receive oral bumbuterol 20mg QN in addition to inhale corticosteroids.②Higher-dose corticosteroids group:Eighteen patients received increased dose of inhaled corticostersids.The changes of lung function and improvement of symptom were observed in two group patients for four weeks.Results:After four weeks,FEV 1 and PEF increased markdely in both groups (P<0 01 and P<0 05).However,changed values of FEV1 and PEF in oral bumbuterol group were higher than those in the higher-dose corticosteroids group (P<0 05).The number of rescue inhaledβ 2-agonist and the number of awakenings in nights due to asthmatic symptoms weekly decreased significantly in both(P<0 05).The number of awakening in night in oral bambuterol group was markedly lower than that in higher-dose corticosteroids group (P<0 05).Conclusion:Once-daily oral bambuterol can significantly improve lung function and clinical symptom in patients with asthma, who still have symptoms on treatment with inhaled corticosteroids.Oral bambuterol provides a highly effective alternative to inhale higher-dose corticosteroids for relief of nocturnal symptom and improvement of lung function in patients with chronic asthma.