雾化吸入利多卡因治疗顽固性哮喘的临床疗效探讨

CLININAL OBSERVATION OF SPRAY LIDOCAINE INHALATION ON SEVERE ASTHMA

目的 :探讨雾化吸入利多卡因治疗顽固性支气管哮喘的临床疗效 ,为临床治疗顽固性哮喘提供一种新方法 ;方法 :将近年来收治入院的对常规应用茶碱类、胆碱能受体阻滞剂、β受体激动剂及皮质激素等治疗无效的所谓顽固性哮喘 1 3 6例患者随机分成两组 ,每组6 8例 ,对照组仍继续原方案治疗 ,其中包括雾化吸入 :喘乐宁原液 1ml +爱喘乐原液 1ml+生理盐水 2ml ,每 4小时一次 ;治疗组在原方案基础上将上述雾化次数改为每 8小时一次 ,中间插入 2 %利多卡因 4ml雾化吸入 ,每 8小时一次。 72小时后比较两组的临床 :显效率、总有效率 ;结果 :治疗组和对照组按上述方案治疗后评定疗效∶显效分别为 2 3例和 7例 ,显效率分别为 3 3 .82 %和 1 0 .2 9% (P <0 .0 1 ) ;总有效例数分别为 3 8例和 1 7例 ,总有效率分别为 55.88%和 2 5.0 0 % (P <0 .0 1 ) ;两组的临床疗效差异具有显著性 ;结论 :雾化吸入利多卡因后在气道内慢性吸收 ,能持续发挥作用 ,不但能减轻气道慢性炎症 ,而且可抑制哮喘患者的气道高反应性 ,还可抑制支气管P物质激发的FEV1下降 ,对联合应用过多种平喘药物治疗无效的所谓顽固性哮喘具有一定的效果 ,且能明显减少喘乐宁、爱喘乐引起的肌颤、心悸甚至心律失常 ,为临床治疗顽固性哮喘提供一种新的、安全、

Objective:To observe the therapeutic effects of spray lidocaine inhalation on severe asthma.Methods:136 patients with severe asthma were assigned in the test and the control group of 68 cases each. The patients in test group received across spray treatment with salbutamol 1ml+aichuanle 2ml+normal saline 2ml and 2% lidocaine 4ml on the basis of general support, one time/4 hours for 2 days. The controls received the similar spray inhalation as test group but lidocaine. The clinical symptoms, signs and lung function were observed after treatment 48 hours.Results:The effective rate of therapy in test and control group was 26.47% and 17.64% respectively (P<0.05); the total effective rate was up to 94.12% and 72.06% (P<0.01) respectively.Conclusion: There is a better efficacy in spray inhalation treatment for severe asthma with lidocaine + other anti-asthma drugs than that with anti-asthma drugs only.