氨茶碱联合特布他林与沙丁胺醇对老年支气管哮喘的治疗作用

Therapeutic effects of aminophylline combined with terbutaline and salbutamol in the elderly patients with bronchial asthma

目的探讨氨茶碱静脉滴注联合特布他林与沙丁胺醇吸入对老年支气管哮喘(BA)患者的影响。方法将86例老年BA患者随机分为两组,每组43例。常规组采用特布他林、沙丁胺醇吸入治疗,联合组在常规组基础上加用氨茶碱静脉治疗。比较两组治疗的总有效率、临床症状消失时间、肺功能、哮喘控制情况、气道炎症因子水平、免疫功能、不良反应及复发情况。结果治疗后,联合组治疗总有效率93.02%,高于常规组76.74%,差异有统计学意义(P<0.05);联合组气喘、哮鸣音、咳嗽等症状消失时间均短于常规组(P<0.05)。治疗后,联合组FEV1、FEV1/FVC、PEF、ACT评分、免疫球蛋白(IgA、IgG和IgM)水平高于常规组(P<0.05);痰嗜酸性粒细胞(eosinophil,EOS)和外周血EOS计数,以及IL-17、TGF-β和IgE水平低于常规组(P<0.05)。两组不良反应比较,差异无统计学意义(P>0.05)。随访6个月,联合组复发率低于常规组(P<0.05)。结论氨茶碱联合特布他林与沙丁胺醇治疗老年BA可有效控制哮喘病情,改善肺功能与免疫功能,提高治疗效果。

Objective To investigate the effects of aminophylline injection combined with terbutaline and salbutamol in the elderly patients with bronchial asthma(BA).Methods 86 elderly patients with BA were randomly divided into the conventional group and combined group,with 43 cases in each group.The patients in the conventional group were treated with terbutaline and salbutamol inhalation,and the patients in the combined group were treated with aminophylline on the basis of the conventional group.The clinical efficacy,disappearance time of clinical symptoms,lung function,asthma control,airway inflammatory factors,immune function,adverse reactions and recurrence were compared the between conventional group and combined group.Results After treatment,the total effective rate in combined group was 93.02%,which was higher than 76.74%in conventional group,showing a statistically significant difference(P<0.05).The disappearance time of asthma,wheezing sound and cough in combined group were shorter than those in conventional group(P<0.05).FEV1,PEF,FEV1/FVC,ACT scores,IgA,IgG and IgM in combined group were obviously higher than those in conventional group,and the levels of phlegm and peripheral blood eosinophil(EOS),IL-17,TGF-0 and IgE in sputum in combined group were obviously lower than those in conventional group(P<0.05).During treatment,the overall incidence of adverse reactions was not different between the conventional group and combined group(P>0.05).After 6 months of follow-up,the recurrence rate in the combined group was obviously lower than that in conventional group(P<0.05).Conclusion Aminophylline combined with salbutamol and terbutaline has definite clinical efficacy in the elderly patients with BA,which controls effectively the progression of asthma,improves lung function,reduces the degree of airway inflammation,corrects immune dysfunction,and reduces the recurrence rate.