雾化吸入布地奈德治疗慢性阻塞性肺疾病急性加重期的研究

Study of inhaling budesonide in the treatment of acute exacerbations of chronic obstructive pulmonary disease

目的观察吸入布地奈德混悬液在慢性阻塞性肺疾病急性加重期（acute exacerbation of COPD,AECOPD）的疗效及安全性。方法将92例AECOPD的住院患者分为布地奈德组、强的松组和安慰剂组进行随机单盲对比观察。观察三组在用药后2h、72h、疗程结束（10d）时的呼吸困难评分、肺功能改善情况及不良反应。结果布地奈德组在开始治疗后2h呼吸困难分级改善明显,与其它两组比较差异有统计学意义;布地奈德组与强的松组在治疗后10d呼吸困难症状及肺功能均有显著改善,与安慰剂组比较差异有统计学意义。强的松组有2例出现血糖增高,1例出现上消化道出血。结论吸入布地奈德及口服强的松对AECOPD的短期疗效肯定,但吸入布地奈德起效快,副作用少,可以作为治疗AECOPD口服强的松的替代药。

Objective To observe the curative effect and security when inhaling Budesonide to cure acute exacerbations of chronic obstructive pulmonary disease （AECOPD）. Methods Ninety-two patients hospitalized with AECOPD were enrolled and divided into three groups randomly predisolone, prednisolone and placebo groups, and carried out one-blind comparision and observation. The score of dyspnea, improvement status of pulmonary function and the adverse reaction of three groups were observed respectively when the time of 2 hours and 72 hours after administration of drugs and the period of treatment was over. Results There was the difference between Budesonide and Prednisolone or placebo in the score of dyspnea when the time of 2 hours after administration of drugs. There was the difference between Budesonide or Prednisolone and placebo in the score of dyspnea and status of FEV1 at the period of treatment was over. Two patients with Prednisolone were observed suffered hyperglycemia and 1 patient with Prednisolone had upper gastrointestinal hemorrhage. Conclusions Both Budesonide and Prednisolone took the short-term efficacy in patients with AECOPD. Budesonide took had early effect and less systemic activity. The study suggests that nebulized Budesonide may be an alternative to oral Prednisolone for the treatment of patients with AECOPD.