吸入不同剂量糖皮质激素对咳嗽变异型哮喘的疗效观察

Curative effect observation of inhaled corticosteroids at different doses for the cough variant asthma

目的通过吸入不同剂量糖皮质激素对咳嗽变异型哮喘(CVA)的临床观察,以探讨其适宜的治疗和维持剂量。方法采用随机配对法将确诊的60例CVA并嗜酸细胞性支气管炎(EB)患者分为A、B、C 3组,A组吸入布地奈得200μg/d,B组吸入布地奈得400μg/d,C组吸入布地奈得800μg/d;治疗3个月后,观察治疗前及治疗后的咳嗽症状评分、诱导痰嗜酸细胞计数及症状消失时间。再随机配对法分为G、H 2组,G组吸入维持剂量布地奈得200μg/d,H组吸入维持剂量布地奈得400μg/d;治疗12个月观察复发率。结果治疗3个月后B组、C组与A组在症状评分、痰嗜酸细胞计数、症状消失时间均有显著性差异(P均<0.05),而B组与C组比较则无显著性差异(P>0.05);维持剂量治疗12个月G组与H组比较无显著性差异(P>0.05)。结论CVA患者吸入糖皮质激素(布地奈得)适宜的治疗剂量为400μg/d,而维持剂量为200μg/d。

Objective It is to approach the fitting treatment and maintenance doses through the clinical manifestation of cough variant asthma （CVA） in inhaling different doses of corticosteroids . Methods 60 patients were definite CVA with eosinophilic bronchitis （EB） were divided randomly into 3 groups named A, B, and C, A group inhaled 200 tLg/d of budesonide, B group inhaled 400 μg/d of budesonide, and C group inhaled 800 μg/d of budesonide. After 3 months treatment, we observed the cough symptoms scores, the counted number of induced sputum eosinophilia and the time of the symptoms disappeared. Then the patients were divided randomly into 2 groups named G and H. G group inhaled 200 μg/d of maintenance doses budesonide. H group inhaled 400 μg/d of maintenance doses budesonide. After 12 month treatment, observe the relapse rate. Results After 3 month treatment, there were significantly different （ all P 〈 0.05 ） between B group and A group in the cough symptoms scores, the counted number of induced sputum eosinophilia and the time of the symptoms disappeared, The situation was the same between C group and A group. However there weren not significantly different（ P 〉 0.05 ） between B group and C group. There weren not significantly different（ P 〉 0.05 ）between G group and H group after 12 month treatment of maintenance doses. Conclusions The fitting treatment doses for CVA patients who inhale the corticosteroids （budesonide） is 400 μ/d while the fitting maintenance doses is 200 μ/d.