小剂量糖皮质激素联合茶碱治疗支气管哮喘的临床效果

Clinical effect of low dose Glucocorticoid combined with Theophylline in treating bronchial asthma

目的探讨小剂量糖皮质激素(GC)联合茶碱治疗支气管哮喘的临床效果。方法选择2018年4月~2019年4月大连大学附属中山医院收治的80例支气管哮喘患者作为研究对象,根据随机数字表法分为观察组与对照组,每组各40例。观察组采用吸入二丙酸倍氯米松250μg/次,2次/d,联合口服缓释茶碱治疗,对照组采用吸入二丙酸倍氯米松500μg/次,2/d治疗,治疗后1个疗程,比较两组的炎症指标变化情况,两组治疗中的哮喘控制测试结果为标准(ACT)评分情况,比较两组的复发和因哮喘急性发作而住院情况、治疗期间不良反应发生情况。结果观察组的炎症指标中肿瘤坏死因子-α(TNF-α)和超敏C-反应蛋白(hs-CRP)水平低于对照组,差异有统计学意义(P<0.05),治疗后1周和治疗后1个月,观察组的哮喘控制测试结果(ACT)评分高于同期对照组,差异有统计学意义(P<0.05),治疗期间观察组出现皮肤瘙痒、水钠潴留、血糖异常等总比例低于对照组,差异有统计学意义(P<0.05)。随访1年,观察组的复发和因哮喘急性发作而住院次数均低于对照组,差异有统计学意义(P<0.05)。结论对支气管哮喘使用茶碱联合小剂量GC,能有效降低炎症反应,改善临床症状,且不良反应少,对减少哮喘急性发作有重要意义。

Objective To explore the clinical effect of low-dose glucocorticoid(GC)combined with Theophylline in the treatment of bronchial asthma.Methods A total of 80 cases with bronchial asthma admitted in Zhongshan Hospital of Affiliated to Dalian University from April 2018 to April 2019 were selected and divided into observation group and control group,40 cases in each group.The observation group was treated with inhaled beclomethasone dipropionate 250μg/twice a day combined with oral sustained-release Theophylline,while the control group was treated with inhaled beclomethasone dipropionate 500μg/twice a day.After one course of treatment,the changes of inflammatory indicators were compared between the two groups.The results of asthma control test were the changes of standard(ACT)scores during treatment.The recurrence and hospitalization due to acute asthma attack,and the occurrence of adverse reactions during treatment was compared between the two groups.Results The levels of tumor necrosis factor-α(TNF-α)and high-sensitivity C-reactive protein(hs-CRP)in the inflammatory indexes of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).The ACT score of the observation group was higher than that of the control group at the same time,the difference was statistically significant(P<0.05).One week after treatment and one month after treatment.the total proportion of skin pruritus,water and sodium retention,abnormal blood glucose and so on in the observation group during treatment were lower than those of the control group,the differences were statistically significant(P<0.05).After one year of follow-up,the recurrence and hospitalization times due to acute asthma attack in the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion For bronchial asthma,theophylline combined with low-dose GC can effectively reduce inflammatory reaction and improve clinical symptoms with few adverse reactions,which is of great significance for reducing acute attack of asthma.