小剂量茶碱口服联合小剂量激素吸入对支气管哮喘的疗效评价

Evaluation of small dose of oral theophylline combined with low dose of inhaled corticosteroid for treatment of bronchial asthma

目的研究小剂量茶碱联合小剂量激素对哮喘患者的疗效。方法45例轻、中度哮喘患者随机分为两组,茶碱激素组(A组)23例,给予无水缓释茶碱每晚200 mg口服,二丙酸倍氯米松(BDP)每天250μg吸入。单纯激素组(B组)22例,仅给予二丙酸倍氯米松(BDP)每天500μg吸入及每晚口服安慰剂,疗程13周。结果治疗前、后的呼气峰流速值(PEF)及其变异率(PEFR):A组分别为(296±96)L/min、(452±149)L/min、(23±8)%、(8.9±3)%,B组分别为(314±123)L/min、(442±151)L/min、(24±8)%、(9±3)%,两组治疗前后比较差异有统计学意义(P<0.01),而两组间比较差异无统计学意义(P>0.05)。两组治疗前、后的气道反应性(BHR)比较差异有统计学意义(P<0.01),两组间比较差异无统计学意义(P>0.05)。治疗期间夜间使用β2受体激动剂的次数A组(1.3±0.8)次,B组(3.8±1.6)次,差异有统计学意义(P<0.01)。结论小剂量茶碱口服联合小剂量激素吸入同单纯大剂量激素吸入对哮喘具有相同的疗效,但减少了夜间β2受体激动剂的使用次数,且避免了因大量使用激素而产生的副作用。

Objective To investigate the effect of small dose of oral theophylline combined with low dose of inhaled beclomethasone dipropionate（BDP） on clinical symptoms and bronchial responsiveness. Methods 45 patients with mild-moderate bronchial asthma were randomly divided into A and B groups. 23 subjects in group A were treated with oral sustained - release theophylline （200 mg/ night） and inhaled BDP（250 μg/day） ;22 cases in group B received BDP（500 μg/day） and oral placebo. Results Before and 13 weeks after the treatment , peak flow （PEF） and peak flow rate （PEFR） in group. A were （ 296 ± 96 ） L/min and （ 452± 149 ） L/min, （ 23±8 ） % and （ 8.9±8 ） % respectively, and those in group B were （ 314 ±123 ） L/min and （ 442 ± 151 ） L/min, （ 24± 8 ） % and （ 9± 3 ） % respectively, which were remarkably improved in both groups （ P 〈 0.01 ） , and bronchial provocation responsiveness to histamine tests （BHR） in both groups were also improved significantly （ P. 〈 0.01 ） . There were no differences between two groups （ P 〉 0. 05 ）. Frequency of using inhaled β2 agonist to relieve nocturnal asthmatic attacks in group B （ 3.8 ± 1.6 ） was significantly greater than that in group A （ 1.3 ± 0. 8 ） （ P 〈0.01 ） . Conclusion It was suggested that small dose of oral theophylline combined with low dose of inhaled BDP might have the same effect in relief of clinical symptoms and bronchial responsiveness compared with relatively highter dose of inhaled BDP, and decrease of frequency of using inhaled β2 agonist using .