摘要:
目的: 研究小剂量皮质类固醇合并复方甲氧那明对哮喘患者的疗效及对下丘脑-垂体-肾上腺轴的影响。 方法: 96例轻、中度的哮喘患者随机分成两纽。CA组(Corticosteroid/Asmeton组)49例:给予复方甲氧那明(阿斯美)2#tid口服,加二丙酸倍氯米松(BDP)每天300μg吸入;C组(Corticosteroid组)47例:仅给予BDP每天600μg吸入。疗程12周。 结果: 治疗前、后的症状计分:CA组分别为(1．8±0．7)和(0．13±0．16),C组分别为(1．9±0．9)和(0．13±0．15),两组治疗前、后比较差异均有显著性(P＜0．01);12周使用速效β2受体激动剂的次数CA组(2．3±1．3)与C组(5．9±1．4)比较差异有显著性(P＜0．05);C组治疗前后的血浆促肾上腺皮质激素(ACTH)水平为(31±11)ng/L和(20±9)ng/L、基础血浆皮质醇浓度为(97±53)μg/L和(84±43)μg/L以及ACTH激发后血浆皮质醇的变化率为(156±78)%和(75±44)%,前后比较差异有显著性(P＜0．05),而CA组则无统计学差异。 结论: 低剂量皮质类固醇的吸入合并复方甲氧那明(阿斯美)可降低较高剂量皮质类固醇对下丘脑-垂体-肾上腺的抑制作用且具相同的疗效。
Abstract:
Objective: To investigate the effect of low dose of inhaled beclomethasone dipropionate(BDP)combined with asmeton on clinical symptoms,bronchial responsiveness and hypothalamic-pituitary-adrenal axis(HPAA). Methods: 96 patients with mild-mod-erate bronchial asthma were randomly divided into CA and C groups.49 subjects in group CA were treated with asmeton(2# tid)and inhaled BDP(300μg/day),47 cases in group C received inhaled BDP(600μg/day), Results: Before and 12 weeks after the treat-ment,symptom scores for group CA were(1.8±0.7)and(0.13±0.16),and those for group C were(1.9±0.9)and(0.13±0.15),which were remarkably improved in both groups(P＜0.01).Frequency of using inhaledβ2 agonist to relieve nocturnal asthmat-ic attacks in group C(5.9±1.4).was significantly greater than that in group CA(2.3±1.3),(P＜0.05).Plasma ACTH concentra-tions,basic cortisol levels and cortisol responses to ACTH before and 12 weeks after the treatment in group C were(31±11)ng/L and (20±9)ng/L,(97±53)μg/L and(84±43)μg/L,(156±78)% and(75±44)% respectively,which were decreased significant-ly after the treatment(P＜0.05).There were no such changes in group A. Conclusion: It was suggested that asmeton combined with low dose of inhaled BDP might have the same effect on relief of clinical symptoms and bronchial responsiveness,without suppression on HPAA function,comparing with relatively higher dose of inhaled BDP.
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