儿童哮喘急性发作糖皮质激素序贯治疗观察

Observation on the effects of glucocorticoid sequential treatment on acute episode of childern asthma

目的 观察儿童哮喘急性发作糖皮质激素 (GCS)序贯治疗的效果。方法 观察对象分为两组 ,治疗组 32例与不接受吸入组 30例均常规抗哮喘治疗 ,同时给予地塞米松 0 1～ 0 2 5mg·kg-1·d-1静脉滴注 3～ 5d后 ,治疗组序贯吸入氟替卡松 2 5 0 μg/d ,分 2次吸入。不接受吸入组停用GCS 均随访 3个月。结果 治疗组临床控制 33% (10 /30 ) ,显效 4 7% (15 /32 ) ,好转 2 2 % (7/32 ) ,总有效率 10 0 %。不接受吸入组临床控制 10 % (3/30 ) ,显效 17% (5 /30 ) ,好转 33% (10 /30 ) ,无效 4 0 % (12 /30 )。总有效率 6 0 % ,t检验 ,P <0 0 5 ,差异有显著性。结论 儿童哮喘急性发作GCS序贯治疗安全有效 ,副作用少 。

Objective To observe the effects of sequential treatment with glucocorticoids (GCS) on acute episode in children with asthma.Methods Observance subjects were divided randomly into two groups:32 patients in treatment group;30 patients without accepting inhalation treatment,they were treated with routine antiasthmatic methods at the same time given dexamethasone 0 1～0 25 mg·kg -1 ·d -1 intravenous drip for 3～5 days.After these,inhaled fluticasone 250 μg/d sequentially in treatment group,dividing 2 times inhaled.Stopping using GCS in control group.Results There were clinical controls 33%(10/30),obvious effects 47%(15/32),and changing well 22%(7/32);with a total effective rate 100% in the treatment group.Clinical controls 10%(3/30),obvious effects 17%(5/30),changing well 33%(10/30),and no effects 40%(12/30);a total effective rate 60% in the control group.A significant difference existed between the two groups via t test ( P <0 05).Conclusion Sequential glucocorticoid treatment on acute episode of childhood asthma is safe and effective,with few side effects but a good longterm follow up result.