雾化吸入不同剂量布地奈德与静脉用泼尼松龙治疗支气管哮喘的对比观察

Comparative observation of aerosol inhalation of different doses of budesonide and intravenous drip of methylprednisolone in treating bronchial asthma

目的探讨雾化吸入不同剂量的布地奈德混悬液对比静脉用泼尼松龙治疗支气管哮喘急性发作期的临床疗效及安全性。方法将85例支气管哮喘急性发作期患者随机分为A、B、C、D四组。A组20例，B组21例，C组22例，D组22例。A、B、C组分别给予雾化吸入不同剂量布地奈德，D组给予静脉滴注泼尼松龙40mg／d。四组治疗前及治疗后24h、3d、10d进行临床评分、测定肺功能及动脉血气分析。治疗前及治疗后10d测空腹血糖及早晨8点血浆皮质醇浓度。结果①C组和D组治疗后24h临床评分明显下降，与A、B组比较差异有统计学意义（P〈0．05），c组和D组间、A组与B组比较差异无统计学意义（P〉0．05）。②治疗3d后，四组临床症状评分、肺功能、动脉血气分析均改善，B、C、D组比较差异无统计学意义（P〉0．05），与A组比较差异有统计学意义（P〈0．05）。③治疗10d后，四组临床症状评分、肺功能、动脉血气分析均改善，组间比较差异无统计学意义（P〉0．05）。④治疗10d后，D组空腹血糖升高，血浆皮质醇浓度下降，与治疗前比较差异有统计学意义（P〈0．05）。结论雾化吸入大剂量布地奈德（8mg／d）能明显改善支气管哮喘患者的肺功能、缓解临床症状，与静脉用泼尼松龙（40mg／d）疗效相同，但全身不良反应少。

Objective To evaluate the effects and safety of aerosol inhalation of different doses of budesonide suspension and intravenous drip of methylprednisolone on acute attacks of bronchial asthma. Methods Eighty -five patients suffered from acute attacks of bronchial asthma were randomly divided into 4 groups（ A, B, C, D） ： group A （ n = 20） , group B （ n = 21 ） and group C （ n = 22） received nebulized inhalation, group D （n = 22 ） received methylprednisolone 40 mg/d. The clinical score, tung function, and blood gas ananysis were detected to evaluate the therapentic effects at the time of 24 hours, 3 days, 10 days after treatment and before treatment. Blood glucose and plasma eortisol were recorded after 10 days and before treatment. Results Twenty -four hours after the treatment, compared with group A and B, the clinical score of group C and D descended obviously （P 〈 0.05）. There were similar improvements in the group A and B （P 〉 0.05）, C and D （P 〉 0.05）. Three days after the beginning of treatment, similar improvements in the clinical score and lung function and blood gas ananysis were observed in the group B, C and D （P 〉 0.05 ） and the difference of the group A （P 〈 0.05）. Ten days after the treatment, there were similar improvements in the 4 groups （P 〉 0.05）. The adverse effects were hige blood glucose and low plasma cortisol in the group D （P 〈 0.05 ）. Conclusions The large dosing of inhaled budesonide suspension can improve the lung function and the clinical score more significantly and quickly. Its curative effects are as effective as methylprednisolone and the adverse reactions are lighter.