长效β_2-受体激动气雾剂加激素气雾剂治疗哮喘的临床观察

Effect of Long Acting β_2-Receptor Agonist on Bronchia Asthma Patients with Tolerance to Glucocorticoid Aerosol

目的观察吸入糖皮质激素(激素)症状控制不佳的支气管哮喘患者加用长效β2-受体激动气雾剂氟莫特罗的疗效。方法37例哮喘患者随机分为氟莫特罗组19例,在原吸入激素剂量的基础上加吸入氟莫特罗;对照组18例原吸入激素的剂量增加。观察2组患者肺功能变化、症状的改善情况,共4周。结果第4周末,两组患者的FEV1和PEF均较改变治疗前明显增加(P<0.01和P<0.05),但氟莫特罗组增加值较对照组更加显著(P<0.05);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哮喘症状被唤醒的次数皆明显减少(P<0.05),氟莫特罗组夜间因哮喘症状被唤醒次数的减少比对照组更为明显(P<0.05)。结论吸入激素症状控制不满意的哮喘患者,每天2次吸入氟莫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未控制的哮喘患者,加用氟莫特罗吸入为一种可选择的治疗方案。

Objective To investigate the effect of long acting β2-receptor agonist on bronchia asthma patients with tolerance to glucocorticoid aerosol Methods 37 patients were divided into fomloterol group （n = 19） and control group （n = 18） randomly. The patients of fomloterol group received glucocorticoid associated with fomloterol aerosol. Oppositely, the control group＇s patients inhaled doubled dosage of corticc,steroid only. The changes of pulmonary function and symptoms in the patients were followed up for 4 weeks. Results During 4 weeks after reatment, the levels of FEV1 and PEF of all treated patients were higher than that in pretherapy （P〈0.01 or 0.05）, moreover, comparing with control group, the increased degree in experimint group was more obviously （ P 〈 0.05）. The required dosage of short acting β2-receptor agonist and the frequency of waking up at night because of asthmaticattack in all treated patients were decreased significantly （P〈0. 05）, furthermore, that in fomloterol group was more markedly（ P 〈 0.05）. Conclusions Inhaling formoterol twice daily combined with could improve the pulmonary function and symptom of the asthma patients who did not respond to glucocorticoid aerosol.