大剂量布地奈德混悬液治疗小儿哮喘急性发作的疗效观察

Effects of high-dose budesonide suspension inhalation on acute asthma attack in children

目的探讨大剂量布地奈德混悬液雾化吸入治疗小儿哮喘急性发作的疗效及不良反应。方法将84例哮喘急性发作的患儿随机分为两组,在常规治疗的基础上,治疗组给予布地奈德混悬液1 mg/次雾化吸入,每30分钟1次,共3次,之后2 mg,每12小时1次;对照组给予甲泼尼龙2 mg/(kg.d)静脉滴注,之后布地奈德混悬液0.5 mg每12小时1次雾化吸入。观察两组治疗前及治疗后1、24 h的临床症状、体征及最大呼气峰流速(PEFR)变化以及不良反应。结果治疗1 h后治疗组患儿临床控制率及PEFR与对照组比较差异无统计学意义,且两组较治疗前有显著改善。治疗24 h后治疗组患儿临床控制率及PEFR较控制组改善明显,且两组较治疗前有显著改善。两组均未见明显不良反应。结论大剂量布地奈德混悬液雾化吸入治疗哮喘急性发作起效快、疗效显著,可替代全身使用激素,不良反应少。

Objective To investigate the therapeutic effect and adverse reactions of high-dose budesonide suspension inhalation on acute asthma attack in children.Methods Eighty-four children with asthma acute attack under conventional treatments were randomly divided into two groups.The study group was treated with high-dose budesonide suspension inhalation（1 mg,q 0.5 h×3＇ then 2 mg,q 12 h）;the control group was treated with methylprednisolone 2 mg/（kg·d）,then low-dose budesonide suspension inhalation（0.5 mg,q 12 h）.The clinical symptoms,signs,peak expiratory flow rate（PEFR）and adverse reactions before and 1,24 h after treatment were observed.Results There was no significant difference between the indices of study group and those of the control group 1 hour after treatments.There was significant difference between the indices of study group and those of the control group 24 hours after traetments.There was significant difference between the indices before and after treatments in the two groups.No adverse reaction was observed.Conclusion High-dose budesonide suspension inhalation has fast and evident therapeutic effectiveness on acute asthma attack with less adverse reaction,which can be used as the substitution of glucocorticosteroid systemic administration.