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哮喘是由多种细胞包括气道的炎性细胞和结构细胞(如嗜酸粒细胞、肥大细胞、T淋巴细胞、中性粒细胞、平滑肌细胞、气道上皮细胞等)和细胞组分(cellular elements)参与的气道慢性炎症性疾病。治疗哮喘的药物可以分为控制药物和缓解药物。(1)控制药物:指需要长期每天使用的药物。这些药物主要通过抗炎作用使哮喘维持临床控制,包括吸入糖皮质激素(ICS)全身用激素、白三烯调节剂、长效肾上腺素β_2受体(β_2受体)激动剂(LABA,须与ICS联合应用)、缓释茶碱、色苷酸钠、抗IgE抗体及其他有助于减少全身激素剂量的药物等;(2)缓解药物:指按需使用的药物。这些药物通过迅速解除支气管痉挛从而缓解哮喘症状,包括速效吸入β_2受体激动剂(SABA)、全身用激素、吸入性抗胆碱能药物、短效茶碱及短效口服SABA等。激素是最有效的控制气道炎症药物,吸入为首选途径,局部抗炎作用强,药物直接作用于呼吸道,所需剂量较小。ICS是长期治疗哮喘的首选药物,常用ICS见表1。
Asthma is caused by a variety of cells, including inflammatory cells and structural cells of the airways (such as eosinophils, mast cells, T lymphocytes, neutrophils, smooth muscle cells, airway epithelial cells, etc.) and cellular components Inflammatory diseases of the airways involved. Medications for asthma can be divided into controlled and relieved medications. (1) Control drugs: refers to the need for long-term daily use of drugs. These drugs maintain clinical control of asthma primarily through antiinflammatory effects, including inhalation of glucocorticosteroids (ICS) systemic hormones, leukotriene regulators, long-acting adrenergic beta 2 receptor (beta 2 receptor) agonists (LABA, ICS combination), sustained release theophylline, sodium edetate, anti-IgE antibodies and other drugs to help reduce the dose of systemic hormones, etc .; (2) remission drugs: refers to the use of drugs on demand. These drugs relieve asthma symptoms by rapidly relieving bronchospasm, including rapid inhaled beta-2 receptor agonists (SABA), systemic hormones, inhaled anticholinergic drugs, short-acting theophylline and short-acting oral SABA. Hormone is the most effective control of airway inflammation drugs, inhalation is the preferred route, local anti-inflammatory effect, the drug directly on the respiratory tract, the required dose is small. ICS long-term treatment of asthma drug of choice, ICS commonly used in Table 1.