氨茶碱联合糖皮质激素吸入治疗轻中度支气管哮喘临床疗效分析

Clinical Effectiveness of Aminophylline Combined with Glucocorticoids in Inhaled Treatment of Mild-moderate Bronchial Asthma

目的了解氨茶碱联合糖皮质激素吸入治疗轻中度支气管哮喘患者的临床疗效。方法回顾性分析2013年6月—2015年6月期间收治的118例轻中度支气管哮喘患者的临床特征及治疗资料,按治疗方法分为3组,A组为氨茶碱口服和糖皮质激素吸入联合使用,B组单纯口服氨茶碱,C组单纯吸入糖皮质激素。疗程为3个月。观察3组治疗前后呼出气一氧化氮(Fe NO)、最大呼气流速峰值(PEF)、第一秒用力呼气容积占预测值的百分比(FEV1%)和哮喘控制测试评分表(ACT)评分变化情况,临床疗效及不良反应发生情况。结果 3组治疗后PEF、FEV1%和ACT评分均高于治疗前(P<0.05);A和C组治疗后Fe NO水平低于治疗前(P<0.05)。治疗后3组Fe NO、FEV1%预计值和ACT评分比较差异有统计学意义(P均<0.001)。3组治疗总有效率比较差异无统计学意义(P>0.05)。3组临床疗效程度分布和不良反应发生率差异均有统计学意义(P<0.001,P<0.05)。结论氨茶碱与糖皮质吸入联合治疗支气管哮喘安全有效。

Objective To investigate therapeutic effect of Aminophylline combined with glucocorticoids in inhaled treatment of mild-moderate bronchial asthma. Methods Clinical features and treatment data of 118 patients with mild-moderate bronchial asthma between June 2013 and June 2015 were retrospectively analyzed. The patients were divided into 3 groups according to different treatments. Group A was treated with inhaled Aminophylline combined with glucocorticoids; group B was treated with oral theophylline only; group C was treated with inhaled corticosteroids only. The course of treatment was 3 months. Changes of fraction of expired nitric oxide（ Fe NO）,peak expiratory flow（ PEF）,percentage of forced expiratory volume in the first second（ FEV1%） and asthma control test（ ACT） score,clinical efficacy and incidence rate of adverse reactions before and after the treatment in three groups were observed. Results After treatment,values of PEF and FEV1% and ACT score were higher than those before treatment in 3 groups（ P〈0. 05）. Fe NO levels after treatment were lower than those before treatment in A and C group（ P〈0. 05）. There were significant differences in estimated values of Fe NO and FEV1% and ACT scores after treatment among the 3 groups（ P〈 0. 001）. There were no significant differences in the total effective rates among the 3 groups（ P〉0. 05）. There were significant differences in degree distribution of curative effect and incidence rate of adverse reaction among the 3 groups（ P〈 0. 001,P〈0. 05）. Conclusion Aminophylline combined with glucocorticoids in inhaled treatment of mild-moderate bronchial asthma is safe and effective.