大环内酯类抗生素联用吸入类固醇治疗哮喘的临床研究

Clinical study on the efficacy of macrolides combined with inhaled corticosteroids on asthma

目的通过与小剂量茶碱联用吸入类固醇比较,观察罗红霉素联用吸入类固醇治疗支气管哮喘的疗效。方法选择40例中、重度哮喘患者并随机分为两组:20例患者为罗红霉素联用布地奈德干粉吸入剂组(简称A组),另20例患者为小剂量茶碱联用布地奈德干粉吸入剂组(简称B组)。观察指标为1s用力呼气量(FEV1)、晨晚最大呼气流速(PEFR)及其变异率等。结果第1～12周治疗期间,两组治疗后FEV1均明显高于治疗前,治疗第8周时B组FEV1明显高于A组,但第12周时两组差异无统计学意义,治疗12周时两组平均晨晚PEFR及其变异率差异无统计学意义,两组副作用相似。结论罗红霉素联用吸入类固醇能安全有效地控制哮喘,其治疗12周时疗效与小剂量茶碱联用吸入小剂量类固醇相似。

Objective To evaluate the therapeutic effect of roxithromycin combined with inhaled corticosteroids （ICS） on ashma ,compareing with the effect of low dose theophylline combined with ICS. Methods Forty asthmatics subjects were randomly treated with either roxithromycin combined with budesonide （BUD） dry powder inhalation （group A） or low dose theophylline combined with BUD dry powder inhalation （group B） for 12 weeks. Forced expiratory volume in 1 second （FEV1） ,peak expiratory flow rate （PEFR） in the early morning and the late afternoon,and diurnal variations in PEFR were measured before and after treatment. Results FEV1 was significantly improved in both groups after treatment;however,the improvement in FEV1 was significantly lower in group A than that in group B after 8 weeks treatment;No difference between two groups were found after 12 weeks treatment in FEV1, PEFR and diurnal variations in PEFR;the side effect in both groups are also similar. Conclusions Roxithromycin combined with ICS is a highly effective and safe therapy for asthma,and the therapeutic effect is similar to that of low dose theophylline combined with ICS after 12 weeks treatment.