增加维持和缓解治疗方案的维持剂量对中重度持续性支气管哮喘控制程度改善的临床研究

发布时间：2018-10-12 09:17

【摘要】：目的对中重度持续性哮喘采用布地耐德和福莫特罗复合制剂(布地耐德160μg,福莫特罗4.5μg)维持和缓解治疗(SMART)方案,其中的维持剂量分别采用每次2吸、每日2次与每次1吸、每日2次,对比两种方案的治疗效果及副反应。方法纳入符合入选标准的61例中重度持续性哮喘患者,按照维持剂量的不同分为2组。常规剂量组30例,每次1吸、每日2次;高维持剂量组31例,每次2吸、每日2次。两组患者均可根据自觉症状随时增加药物的吸入次数,每日总剂量≤6吸。观察时间为4个月,对比2组患者的以下指标:哮喘控制评分(ACT)、急性发作次数、肺功能指标第一秒用力呼气容积(FEV1),诱导痰中嗜酸粒细胞(EOS)比例以及药物的不良反应。结果所有患者治疗过程中均未发生严重药物不良反应。治疗4个月后,高维持剂量组患者ACT评分显著高于常规剂量组,急性发作次数较常规剂量组显著减少(均P0.05),但2组患者FEV1指标、诱导痰中EOS的比率差异均无统计学意义(均P0.05);2组患者每日药物的使用剂量差异无统计学意义(P=0.052)。2组患者肺功能FEV1改善率与ACT评分的改善率呈正相关。结论对于中重度持续性哮喘,以布地耐德和福莫特罗复合制剂SMART策略对进行治疗时,维持剂量采用每日2吸,每日2次能更有效改善患者的临床症状并减少急性发作次数,而无显著不良反应。
[Abstract]:Objective to maintain and relieve (SMART) regimen with budesonide and formoterol (160 渭 g, 4. 5 渭 g) for moderate and severe persistent asthma. Two times a day, the therapeutic effects and side effects of the two regimens were compared. Methods 61 patients with moderate and severe persistent asthma were divided into two groups according to the maintenance dose. The routine dose group (30 cases) was inhaled twice a day, and the high maintenance dose group (31 cases), 2 times a day (2 times a day). Patients in both groups could increase the number of inhaled drugs at any time according to their conscious symptoms, the daily total dose was less than 6. The observed time was 4 months. The following indexes were compared: asthma control score (ACT),) acute attack times, pulmonary function index forced expiratory volume (FEV1) in the first second, eosinophil (EOS) ratio in sputum and adverse drug reactions. Results there was no serious adverse drug reaction in all patients. After 4 months of treatment, the ACT score of the patients in the high maintenance dose group was significantly higher than that in the routine dose group, and the number of acute seizures was significantly lower than that in the conventional dose group (P0.05), but the FEV1 index of the two groups was significantly lower than that of the normal dose group. There was no significant difference in the ratio of EOS in induced sputum (P0.05), and there was no significant difference in daily dosage of drugs between the two groups (P0. 052). There was a positive correlation between the improvement rate of FEV1 and the improvement rate of ACT score in the two groups. Conclusion in the treatment of moderate and severe persistent asthma, the maintenance dose of budesonide and formoterol combined with SMART can improve the clinical symptoms and reduce the number of acute attacks more effectively. There was no significant adverse reaction.
【作者单位】：广州医科大学附属第一医院广州呼吸疾病研究所呼吸疾病国家重点实验室;
【分类号】：R562.25

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