羧甲司坦联合布地奈德治疗哮喘的临床研究

Effects of Carbocisteine combined with low dose of inhaled corticosteroid on asthma

目的:观察羧甲司坦联合小剂量吸入性糖皮质激素治疗轻中度哮喘的临床效果。方法:将30例哮喘患者随机分为2组,实验组给与羧甲司坦联合小剂量二丙酸倍氯米松气雾剂,对照组给予大剂量二丙酸倍氯米松气雾剂联合安慰剂。治疗前后评价PEFRv、哮喘症状评分及不良反应。同时检测治疗前后诱导痰上清中IL-17及IL-8含量的变化。结果:羧甲司坦联合小剂量吸入性激素治疗轻、中度哮喘可显著降低PEFRv及改善症状评分(包括每日用沙丁胺醇气雾剂的喷数),两组间PEFRv改善百分比无明显统计学差异(P>0.05)。两组均可明显降低哮喘患者的诱导痰上清中IL-17及IL-8的水平,其中实验组治疗前后水平分别为:(168±43.2)vs(99±56.2)pg/mL,(542±121.4)vs(285±89.5)pg/mL。两组间毒副反应无明显差异。结论:小剂量吸入性激素联合羧甲司坦和大剂量吸入性激素对治疗轻中度哮喘的疗效相当,且安全性好。

Objective：To investigate the effects of Carbocisteine combined with low dose of inhaled beclomethasone dipropionate （BDP） on patients with mild-moderate bronchial asthma. Methods. Thirty patients with mild-moderate asthma were randomly divided into treatment group and control group. The patients in control group were given inhaled BDP（500 μg/d）, while treatment group were treated with Carbocisteine and low dose of inhaled BDP（250μg/d）. Before and after the treatment, the peak expiratory flow rate variation （PEFRv）, asthma symptom score and adverse reactions were compared between the two groups. Additionally, the levels of IL-17 and IL-8 in sputum supernatant were also detected before and after the treatment. Result. After treatment, PEFRv decreased significantly and asthma symptom score increased significantly in both groups （P〈0. 05） ,but there was no significant difference in impmvement rate of PEFRv between two groups（P;0.05）. The levels of IL-17 F（168.0±43.2） pg/mL vs （99.0 ±56.2） pg/mL] and IL-8 [（542.0±121.4） vs （285.0±89.5） pg/mL] in sputum supernatant decreased greatly in both group after treatments. Conclusions： Carbocisteine combined with low dose of inhaled BDP, which shows good security, might have better effects on asthma comparing with relatively higher dose of inhaled BDP.