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目的 探讨小剂量布地奈德粉吸入剂(商品名:普米克都保)长期吸入治疗轻度支气管哮喘(简称哮喘)的远期疗效和不良反应。方法 将52例轻度哮喘患者分为3组。吸入糖皮质激素组(A组)22例:每晚吸入布地奈德粉吸入剂200μg。口服糖皮质激素组(B组)15例:在哮喘发作期给予泼尼松5mg每天1次口服,茶碱控释片(商品名:舒弗美)02g每天2次口服;沙丁胺醇(商品名:喘乐宁)气雾剂2揿(每揿100μg)每天3次吸入。非糖皮质激素组(C组)15例:发作期只给茶碱控释片02g每天2次口服,沙丁胺醇气雾剂2揿每天3次吸入。全部病例连续治疗3年,停药后随访1年。在此4年间,检测各组患者治疗前、后一秒钟用力呼气容积(FEV1)、气道阻力(Raw)、气道传导率(Gaw)、气道高反应性(BHR)、临床疗效、血浆皮质醇浓度以及促肾上腺皮质激素(ACTH)刺激后的反应等。结果 (1)治疗前A、B、C3组绝大多数病例的BHR均在3~4级,分别为91%(20/22)、100%(15/15)、93%(14/15)。治疗后A组18例(82%)转为1~2级;B组13例(87%)仍为3~4级;C组15例(100%)病例为3~5级。A、B、C3组间比较差异有统计学意义(P均<001)。(2)A、B、C3组Raw治疗前分别为(623±103)%、(605±90)%、(638±108)%,治疗后分别为(158±24)%、(340±61)%、(420±81)%,3组间比较差异有统计学意义(P均<001)。(3
Objective To investigate the long-term efficacy and side effects of long-term inhalation of low-dose budesonide inhalation (brand name: Pulmicort) for the treatment of mild bronchial asthma (asthma). Methods 52 mild asthma patients were divided into 3 groups. Inhaled glucocorticoid group (group A), 22 patients: inhaled budesonide powder inhaler 200μg every night. Oral glucocorticoid group (group B) 15 cases: during the asthma attack prednisone 5mg once daily oral administration, theophylline controlled release tablets (trade name: Shu Weimei) 02g orally twice daily; salbutamol (trade name: Salbutamol) Aerosol 2 吸 (100 揿 per)) Inhaled 3 times a day. In the non-glucocorticoid group (group C), 15 cases were given oral administration of 2 g of theophylline controlled-release tablets orally twice daily and salbutamol aerosol 2 揿 3 times daily. All cases of continuous treatment for 3 years, followed up for 1 year after stopping. During these 4 years, FEV1, Raw, Gaw, BHR were measured before and after treatment, clinical efficacy , Plasma cortisol concentration and response to ACTH stimulation. Results (1) Before the treatment, the BHR of the most cases in groups A, B and C3 were all from 3 to 4, which were 91% (20/22), 100% (15/15) and 93% . After treatment, 18 cases (82%) in group A turned to grade 1 to 2; in group B, 13 cases (87%) remained in grade 3 to 4; and in group C, 15 cases (100%) were grade 3 to 5. There was significant difference between A, B and C3 groups (P <0.001). (62.3 ± 103)%, (605 ± 90)%, (638 ± 108)% respectively in Raw A, B and C groups, and were (158 ± 24)% and )%, (420 ± 81)% respectively. The difference between the three groups was statistically significant (P <0.001). (3