摘要
目的 :研究糖皮质激素 (美卓乐 )联合缓释茶碱 (舒氟美 )序贯治疗中度哮喘急性发作的疗效与安全性。方法 :6 0例中度哮喘急发患者采用开放随机对照的方法分成两组。 (A组 ) 30例 :给予美卓乐 2 0mg口服 ,每日一次 ,加无水缓释茶碱 0 .2g ,每12h口服一次 ,加吸入布地奈德 4 0 0 μg每日 2次 ,7d后美卓乐逐渐减量 ,疗程 4周 ,第 4周完全停用口服美卓乐 ,而继续使用布地奈德吸入治疗。B组用无水茶碱 0 .2 g每 12h口服一次 ,加布地奈德 4 0 0 μg吸入 ,每日 2次 ,疗程 4周。结果 :根据治疗后症状及肺部哮鸣音消失时间及起效时间 ,及治疗前后的肺通气功能 (FEV1.0 )等显示 ,A组起效快 ,服药 1d症状开始缓解 ,肺部哮鸣音平均 4d消失 ,治疗 4周肺通气功能 (FEV1.0 )改善显著 ,而B组治疗 3d才开始症状缓解 ,肺部哮鸣音平均 7d才基本消失 ,治疗 4周肺通气功能 (FEV1.0 )改善没有A组显著。FVE1.0 A组比治疗前提高 1.2 7L/s,而B组提高 0 .36L/s。临床有效率分别A组 90 % ,B组 76 .6 % ,有显著差异 (P <0 .0 5 )。两组不良反应都少 ,A组胃痛 1例 ,失眠 2例。B组肌肉抽搐 1例 ,夜尿多1例。两组对血像及肝肾功能无不良影响。结论 :皮质激素、无不茶碱及布地奈德联合治疗中度哮喘发作比仅用后两者治疗更有效。
Objective: To investigate the efficacy and safety of steroid (Medral) and suspended releasing theophyline; (Shufumei) in the treatment on moderate asthmatics. Methods: 60 moderate asthmatics were randomly divided into two groups. Group A (n=30) were treated with Medral 20mg qd, long acting theophyline (Shufumei 0.2 q12h ) and budinide 400μg bid for four weeks, then stopped Medral and used budinide for the following treatment. Group B (n=30) were treated with theophyline 0.2 q12h and budinide 400ug bid for four weeks. Efficacy of the treatment were evaluated by symptoms release, disappearance of wheezing, time of the effectiveness and lung function improvement. Results: Symptom improvement in Group A was within one day compared with Group B (three days); Marked improvement for forced expiration volume in one second (FEV 1.0 ) was detected in Group A (mean improvement : 1.27L/S) than Group B (mean improvement 0.36 L/S); The average time for the disappearing of wheezing in Group A was 4 days compared with Group B (7 days); Effectiveness in Group A was 90% compared with Group B (76.6%). Both groups showed less side effects, with no apparent impairment on blood cells and liver, renal function. Conclusion:Combined steroid, theophyline and budinide was more effective in the treatment of the moderate asthmatics than theophyline and budinide only.
出处
《中国临床医学》
2004年第3期340-341,共2页
Chinese Journal of Clinical Medicine
