布地奈德福莫特罗吸入剂联合尘螨变应原脱敏疗法治疗中—重度支气管哮喘的临床研究

发布时间：2018-05-17 10:59

本文选题：支气管哮喘 + 布地奈德福莫特罗吸入剂　；参考：《大连医科大学》2017年硕士论文

【摘要】：【目的】研究布地奈德福莫特罗吸入剂联合尘螨变应原脱敏疗法治疗中-重度支气管哮喘的临床疗效。【方法】选取80例尘螨为变应原的中-重度支气管哮喘患者,分为对照组与治疗组,40例患者作为对照组给予布地奈德福莫特罗吸入剂治疗12个月(160/4.5μg剂量,每天2喷,早晚各1次,间隔约12小时),另40例患者作为治疗组除了给予上述布地奈德福莫特罗吸入剂治疗12个月外,还联合尘螨变应原脱敏疗法治疗。对于治疗组的脱敏治疗,脱敏疫苗在患者上臂三角肌部位皮下注射,最初治疗剂量从1/100000开始,每周1次,按照0.1,0.2,0.4,0.6,0.8 ml剂量递增。当达到最大剂量(1/5000)0.8ml时维持治疗,每4周注射1次,直到12个月。分别在治疗前后3个月、6个月、12个月时观察哮喘症状、肺功能及患者生活质量(AQLQ)评分等指标变化。【结果】两组患者治疗3个月、6个月、12个月时日间及夜间哮喘症状评分较治疗前明显下降(P0.05);治疗3个月、6个月、12个月时第一秒用力呼气容量(FEVl)及峰呼气流速(PEF)较治疗前明显升P0.05);AQLQ评分治疗12个月时活动受限、哮喘症状、心理状况、对刺激原反应、对自身健康的关心评分较治疗前明显升高(P0.05)。与对照组相比,治疗12个月后日间及夜间哮喘症状评分明显下降(P0.05),AQLQ评分明显升高(P0.05),FEV1与PEF明显升高P0.05)。患者哮喘控制时间、哮喘急性发作次数、急救药物使用次数比较治疗组明显低于对照组(P0.05),治疗期间脱敏疗法相关不良反应发生率为15.98%,未发生严重不良反应。【结论】布地奈德福莫特罗吸入剂联合尘螨变应原脱敏疗法治疗中-重度支气管哮喘能短期内改善哮喘症状及肺功能,脱敏疗法有利于长期哮喘症状控制及生活质量的改善,无严重不良反应,安全性好。
[Abstract]:[objective] to study the clinical effect of budesonide formoterol inhalation combined with desensitization of dust mite allergen in the treatment of moderate to severe bronchial asthma. [methods] 80 cases of moderate to severe bronchial asthma with dust mite as allergen were selected. 40 patients in the control group and the treatment group were treated with budesonide formoterol inhalation for 12 months at a dose of 160 / 4.5 渭 g, twice a day and once in the morning and evening. The other 40 patients in the treatment group were treated with budesonide formoterol inhalation for 12 months, and the other 40 patients were treated with dust mite allergen desensitization therapy. For the desensitization treatment of the treatment group, the desensitized vaccine was injected subcutaneously into the deltoid muscle of the upper arm of the patients. The initial treatment dose was 1 / 100 000, once a week, and the dose was increased according to the dose of 0.41 ~ 0.42 ~ 0.40 ~ (0.6) ~ (0.8) ml. The treatment was maintained at a maximum dose of 1 / 5000v / 0.8ml, once every 4 weeks until 12 months. The symptoms of asthma were observed at 3 months, 6 months and 12 months before and after treatment, respectively. Pulmonary function and quality of life (QOL) scores were significantly lower in the two groups than before treatment for 3 months, 6 months, 12 months and night, 3 months, 6 months and 12 months after treatment (P 0.05), 3 months, 6 months and 12 months respectively. Forced expiratory volume (FEVl) and peak expiratory flow (PEF) in the first second were significantly higher than those before treatment (P0.05 / AQLQ score). The scores of asthma symptoms, psychological status, stimulus response and care for self health were significantly higher than those before treatment (P 0.05). Compared with the control group, after 12 months of treatment, the symptom scores of asthma decreased significantly (P 0.05) and the scores of AQLQ increased significantly (P 0.05), FEV1 and PEF increased significantly (P 0.05). The control time of asthma, the frequency of acute attack of asthma, The frequency of first-aid drug use in the treatment group was significantly lower than that in the control group (P 0.05). The incidence of adverse reactions associated with desensitization therapy was 15.98, and there was no serious adverse reaction. [conclusion] budesonide formoterol inhalation combined with dust mite degeneration was not found. Treatment of moderate to severe bronchial asthma with proto-desensitization therapy can improve asthma symptoms and pulmonary function in a short period of time. Desensitization therapy is beneficial to long-term asthma symptom control and quality of life improvement, no serious adverse reactions, good safety.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R562.25

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