门诊支气管哮喘患者治疗及控制现状的再调查

Re-survey on current status of treatment and control in asthmatic outpatients

目的了解第三军医大学新桥医院呼吸内科门诊支气管哮喘（简称哮喘）患者治疗及控制现状。方法以面对面问卷形式对我院2010年4月至2010年7月呼吸内科门诊哮喘患者进行调查，同类调查结果与我们1999年的报道相比较。结果患者过去一年内急性发作时口服或使用气雾剂后缓解的比例明显增加（P〈O．01）；在哮喘发作间期，Et常生活完全不受限的比例明显增加（P〈O．01）；在用药种类上，64．2％的患者使用含ICS类药物，其中的53．2％患者使用ICS＋LABA，规律使用ICS患者为37．2％，使用全身激素、β2受体激动剂、茶碱或其他治疗的患者均有所减少；在用药方式上，单纯吸人治疗患者由0．0％增加至24．8％（P〈0．01），同时主要口服治疗患者明显减少（P〈0．01）。哮喘急性发作需要住院的患者为20．0％，需要院外输液治疗或急诊的患者为33．9％，与我们既往的情况比较无显著改善（P〉O．05）；在急性发作期，85．2％的患者活动受限；39．1％的患者因哮喘误工误学。哮喘控制测试评分显示完全控制为4．4oA，良好控制为30．7％，平均值（16．9±5．2）分。结论我院门诊哮喘患者治疗及控制情况较前有所改善，但如何实现科学的长期管理模式，进一步提高规范化治疗患者的比例，提高哮喘控制水平，仍然是哮喘防治工作者的重要任务。

Objective To investigate the current status of treatment and control of asthmatic patients in out-patient respiratory department, Xinqiao Hospital, the Third Military Medical University. Methods We investigated the patients visiting our out patient department from April 2010 to July 2010 by face to face questionnaire survey. The results were then compared with that we reported in 1999. Results The percentage of the patients with relief after oral or areosol usage when suffering from exacerbation was significantly increased during last year （ P 〈0.01）. The percentage of patients without any activity limitation during free of asthma attack was significantly increased （ P〈0.01）. Regarding the types of drugs usage, 64.2% of patients used ICS, 53.2% of patients used ICS plus LABA, 37.2% of patients regularly used ICS. The patients using systemic glucocorticoid, β2-receptor agonist, aminophylline and other medication were decreased. Regarding the mode of medication, the patients with single areosol usage were increased from 0.0% to 24.8% （ P 〈0.01）, while the patients with oral usage were significantly decreased （ P〈0.01）. Regarding acute attack, the percentage of patients with hospital admission were 20.0~%0, with emergency visit or transfusion treatment were 33.9%, and there was no significant improvement compared to previous results （ P 〉 0.05 ）. During exacerbation, 85.2% of patients suffered from activity limitation, 39.1% of patients missed work or school. The ACT score showed that the percentage of complete control was 4.4%, well control was 30.7%, the average scorewas （16.9±5.2） scores. Conclusions The status of asthma treatment and control in our outpatient department was improved. However, how to achieve scientific and long administration mode, farther improving the percentage of patients with standardization treatment and improving asthma control, was still important mission for us.