哮喘患者使用吸入激素的依从性调查及对策

Causes and solutions of refusing to use inhaled corticosteroids in asthmatic patients

目的探讨哮喘患者未使用吸入糖皮质激素(ICS)的原因并提出对策。方法随访2007年3月至2008年10月门诊、住院的哮喘患者共138例,详细询问并记录患者使用ICS的情况及未使用原因,并予以哮喘健康知识教育。结果哮喘患者ICS使用率较低,仅为13%(18/138)。其未持续使用ICS的主要因素有:担心激素不良反应(82例,占68.3%);病重时或发作时才用(66例,占55%);使用有效,认为病情已控制或痊愈(62例,占51.6%),且还因患者年龄及文化程度不同而存在差异,45岁以上及文化程度较低者依从性较高。结论为提高患者使用ICS的依从性,应加强患者对哮喘和ICS作用的认识,提供有效而具个性化的ICS使用方案。

Objective To investigate the causes of unusing corticosteroids（ICS） in asthmatic patients and to provide solutions. Methods One hundred and thirty-eight asthmatic patients educated with basic knowledge of asthma were followed up the causes of unusing ICS from Mar. 2007 to Oct. 2008. Results The rate of using ICS treatment in asthma patients was 13%. The causes of un- using ICS were：afraid of side effects of ICS（68.3 % ） ;only useas in exacerbation or outbreak（55 % ） ;stop taking ICS after achieving satisfied effects from ICS（51.6%）. The compliance of using ICS was significantly different in different ages and education levels（P 〈0.05）. Conclusion To improve compliance of using ICS in asthma patients, available solutions include： enhancing patients knowledge of asthma and anti-inflammation mechanism of ICS, providing individual and effective projects.