单剂量沙美特罗替卡松与双倍剂量替卡松吸入治疗支气管哮喘临床疗效的比较研究

Comparative Study for Clinical Effect on Bronchial Asthma between Single-dose Inhalation of Salmeterol and Fluticas and Double-dose Inhalation of Flonase

目的比较单剂量沙美特罗替卡松与双倍剂量替卡松吸入治疗支气管哮喘的临床疗效。方法选取2014年6月—2015年4月重庆北部新区第一人民医院呼吸科收治的支气管哮喘患者78例,按照住院单双号分为单剂量组36例和双倍剂量组42例。单剂量组患者给予沙美特罗替卡松粉吸入剂(规格:50μg/250μg)吸入治疗,1吸/次,2次/d;双倍剂量组患者给予丙酸氟替卡松吸入气雾剂(规格:125μg/揿)吸入治疗,4揿/次,2次/d。比较两组患者治疗前及治疗2个月日间症状评分和夜间症状评分、肺功能指标〔第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、呼气峰流速(PEF)〕,痰中嗜酸粒细胞分数(EOS)、中性粒细胞分数(NEU)、淋巴细胞分数(LYM)、巨噬细胞分数(MAC)、上皮细胞分数(EE)及白介素5(IL-5)水平,血浆皮质醇水平。结果两组患者治疗前及治疗2个月日间症状评分和夜间症状评分及FEV1、FVC、PEF比较,差异无统计学意义(P>0.05);两组患者治疗2个月日间症状评分和夜间症状评分均低于治疗前,FEV1、PEF均高于治疗前(P<0.05)。两组患者治疗前及治疗2个月痰中EOS、NEU、LYM、MAC、EE及IL-5水平比较,差异无统计学意义(P>0.05);两组患者治疗2个月痰中EOS及IL-5水平低于治疗前(P<0.05)。两组患者治疗前及治疗2个月血浆皮质醇水平比较,差异无统计学意义(P>0.05)。结论单剂量沙美特罗替卡松吸入治疗支气管哮喘的临床疗效及对气道炎症的控制效果与双倍剂量替卡松相似,但激素用量更小,不良反应发生风险更低。

Objective To compare the clinical effect on bronchial asthma between single-dose inhalation of salmeterol and fluticas and double-dose inhalation of flonase.Methods A total of 78 patients with bronchial asthma were selected in the First People＇s Hospital of Chongqing Northern New District from June 2014 to April 2015,and they were divided into A group（n = 36）and B group（n = 42）according to odd or even number of hospital sequences.Patients of A group received inhalation of salmeterol and fluticas（50 μg /250 μg）,1 absorption per time,2 times per day; patients of B group received inhalation of flonase（125 μg / press）,4 presses per time,2 times per day.Before treatment and after 2 months of treatment,daytime symptom score,nighttime symptom score,lung function index（including FEV1,FVC and PEF）,EOS,NEU,LYM,MAC,EE and IL-5 level in sputum,plasma cortisol level were compared between the two groups.Results No statistically significant differences of daytime symptom score,nighttime symptom score,FEV1,FVC or PEF was found between the two groups before treatment or after 2 months of treatment（P〉0.05）; daytime symptom score and nighttime symptom score of both groups after 2 months of treatment were statistically significantly lower than those before treatment,while FEV1,FVC and PEF of both groups after 2 months of treatment were statistically significantly higher than those before treatment（P〈0.05）.No statistically significant differences of EOS,NEU,LYM,MAC,EE or IL-5 level in sputum was found between the two groups before treatment or after 2 months of treatment（P〉0.05）; EOS and IL-5 level in sputum of both groups after 2 months of treatment were statistically significantly lower than those before treatment（P〈0.05）.No statistically significant differences of plasma cortisol level was found between the two groups before treatment or after 2 months of treatment（P〉0.05）.Conclusion Single-dose inhalation of salmeterol and fluticas has similar clinical effect and airway inflammation control effect with double-dose inhalation of flonase in treating bronchial asthma,but the hormone dosage is less,and the occurrence risk of adverse reactions is lower.