甲氨碟呤联用卡介苗多糖核酸治疗激素依赖型哮喘的临床研究

Clinical study of methotrexate and Bacille Calmette Guerin-polysaccharide nucleic acid in the treatment of steroid dependent asthma

目的研究甲氨喋呤(MTX)联用卡介苗多糖核酸(BCG-PSN)治疗激素依赖型哮喘的疗效和安全性。方法将68例激素依赖型哮喘随机分为治疗组和对照组,治疗组给予MTX、BChG-PSN;对照组单用MTX,治疗期均为3个月。记录试验前、后患者的临床症状评分、PEF、FEV1、强的松每日用量。检测药物不良反应。结果两组临床症状评分、强的松日用量均较治疗前有显著减少(P<0.05),治疗组的减少更为明显,且与对照组相比,差异具有显著性(P<0.05);治疗组治疗后PEF、FEV1较治疗前明显增加(P<0.05),对照组治疗后PEF、FEV1无显著性改变(P>0.05);两组治疗过程中均未发现严重的不良反应,不良反应发生率两组无差别(P>0.05),但对照组有2例患者发生呼吸道感染。结论MTX联用BCG-PSN治疗激素依赖型哮喘疗效可靠,不良反应少,优于单用MTX,是一种安全有效的治疗方案。

Objective To investigate the efficacy and adverse effects of methotrexate （MTX） and Bacille Calmette Guerin-polysaccharide nucleic acid （BCG-PSN） in the treatment of steroid dependent asthma. Methods Sixty-eight patients with steroid dependent asthma were divided into therapy group and control group. The patients in therapy group were treated with MTX and BCG-PSN, while the control group was given only MTX. The dose of oral steroid daily, symptom scores, peak flow rates （PEF） and expiratory volume in one second （ FEV1 ） were monitored. Results Compared with before treatment, daily steroid dosage and symptom scores of two groups significantly decreased （ P 〈 0.05 ）. The decrease in therapy group was more significant than that in control group （ P 〈 0. 05 ）. There was no difference on PEF and FEV1 in control group between before and after the treatment （ P 〉0. 05 ）, while PEF and FEVI significantly increased in therapy group （ P 〈 0. 05 ）. The two groups had no significant difference in adverse events （ P 〉 0. 05 ）. Conclusion The combined use of MTX and BCG-PSN may be more beneficial than the single use of MTX for the treatment of steroid - dependent asthma.