大剂量皮质激素吸入治疗高原地区重症哮喘发作的研究

目的 探讨大剂量皮质激素吸入是否有助于β激动剂对高原地区重症哮喘发作的治疗。方法 采用随机双盲对照方法，将４２例高原地区重症哮喘发作患分为布地奈德组和对照组，每组２１例。两组先吸入特布他林气雾剂２．５ｍｇ，然后布地奈德组 布地奈德气雾１．２ｍｇ，对照组吸入安慰剂。１０ｍｉｎ后各重复１次。所有受试给药前、后检查肺功能、辅助呼吸肌少支，并观察患呼吸困难、哮鸣音变化。后３项依据严重程度计分，平均值

Inhaled budesonide for severe asthma at high altitude]

OBJECTIVE: To determine the benefit of inhaled high dose budesonide combined with terbutaline in patients with severe asthma at high altitude. METHODS: 42 patients with severe asthma at high altitude were assigned in a randomized, double-blind fashion to receive either budesonide combined with terbutaline (budesonide group, 21 cases) or terbutaline with placebo (control group, 21 cases). Both groups received terbutaline delivered by a metered-dose inhaler in a dose of 2.5 mg. Budesonide delivered by a metered-dose inhaler in 1.2 mg in budesonide group and placebo managed by a specially prepared metered-dose inhaler in control group were administered after terbutaline treatment above procedures. Repeated once after 10 min. Before and after therapy, the scores of the activity of accessory respiratory muscles, dyspnea, wheezing (clinical index) and lung function were documented. RESULTS: At 1, 2, 4, 6 h after therapy, FEV1% [(43 +/- +/- 5)%, (50 +/- 5)%, (57 +/- 5)%, (67 +/- 6)%], PEF% [(47 +/- 5)%, (55 +/- 6)%, (62 +/- 7)%, (69 +/- 7)%], clinical index (5.1 +/- 0.8, 4.3 +/- 0.6, 3.5 +/- 0.6, 2.5 +/- 0.4) in budesonide group and FEV1% [(42 +/- 5)%, (44 +/- 5)%, (45 +/- 5)%, (45 +/- 5)%], PFE% [(46 +/- 5)%, (47 +/- 5)%, (49 +/- 6)%, (49 +/- 6)%], clinical index (5.3 +/- 0.7, 5.0 +/- 0.5, 4.9 +/- 0.7, 4.8 +/- 0.7) in control group were difference markedly compared with before therapy [budesonide group was (35 +/- 5)%, (38 +/- 5)%, 8.3 +/- 1.0, and control group was (33 +/- 5)%, (38 +/- 5)%, 8.3 +/- 1.1, respectively], all (P < 0.01). CONCLUSIONS: High dose of inhaled budesonide combined with terbutaline should be an effective therapy for patients with severe asthma at high altitude. Budesonide inhaled in high dose produces therapeutic effects as soon as 2 h after therapy.