雾化吸入布地奈德对哮喘儿童肺功能的影响

Clinical observation of atomization inhalation of budesonide and formoterol plus salbutamol for asthma treatment in infants

目的:探讨雾化吸入布地奈德福莫特罗粉加沙丁胺醇治疗儿童哮喘急性发作的疗效.方法:2006-01/2007-12我院儿科门诊哮喘患儿130例,随机分为3组:①A组(n=60),用雾化器吸入布地奈德福莫特罗粉加沙丁胺醇混悬液;②B组(n=45),使用贮雾罐和面罩,吸入布地奈德福莫特罗粉加沙丁胺醇气雾剂;③对照组(n=25),不接受表面激素的吸入治疗.观察期为1a,在第4,12,24,48周随访,记录观察期的临床症状评分及哮喘急性发作时药物使用的情况.结果:与对照组相比,A组和B组明显降低了日间症状评分、夜间症状评分,有更多的无症状天数;显著减少了口服激素和吸入速效β2受体激动剂的需求,减少了哮喘的急性发作.而A组在观察期的第4,12周的治疗效果比B组更明显(P<0.05),两组在观察期的第24,48周的治疗指标的差异则无统计学意义.结论:雾化吸入布地奈德福莫特罗粉加沙丁胺醇治疗可以更好地减轻哮喘症状,更早地达到长期稳定,是婴幼儿哮喘的首选吸入方式.

AIM：To investigate the clinical efficacy of atomization inhalation of budesonide （BUD） and formoterol （FOM） plus salbutamol （SAB） in the treatment of asthma in infants. METHODS：From January 2006 to December 2007,130 infants diagnosed with mild to severe persistent asthma were randomly divided into 3 groups：Respules group （inhaling BUD and FOM plus SAB suspension by jet nebulizational machine with facial mask）,MDI group （inhaling BUD and FOM plus SAB metered dose inhaler by spacer with facial mask） and Control group （inhaling no corticosteroids）. Efficacy was assessed by receding nighttime and daytime symptom scores,the percentage of symptom-free days,the times of worsening asthma,requirement for oral corticosteroids and the daily beta2-receptor agonist used on a daily diary card. The data needed were recorded respectively on the 4th week,12th week,24th week and 48th week. RESULTS：Better effects were observed in both Resplues group and MDI group in reducing nighttime and daytime symptom scores,diminishing the exacerbations of asthma,decreasing the need for beta2-receptor agonists and oral corticosteroids,and increasing the percentage of symptom-free days,compared with those in control group （P〈0.01）. Significantly better effect was found by 4th week and 12th week in the Respules group compared with that in MDI group （P〈0.05）,while no significant difference was found between the two groups by 24th week and 48th week. CONCLUSION：The results of this study demonstrate that the inhalation of budesonide and formoterol plus salbutamol suspension by jet nebulization effectively alleviates the symptoms of asthma and achieves long-term stabilization,which is the first choice in the treatment of asthma in infants.