中国实用儿科杂志

中国实用儿科杂志

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布地耐德联合福莫特罗与双倍剂量布地耐德干粉吸入疗法对儿童轻度持续性哮喘的疗效观察

彭秋莹,陈爱欢   

  1. 广州医学院附属第一医院，广东广州510120
  • 收稿日期:2006-10-20 修回日期:2007-01-25 出版日期:2007-04-06 发布日期:2007-04-06

Efficacy and safety of low-dose Budesonide plus Formoterol versus double dose Budesonide in children with mild persistent asthma.

PENG Qiu-ying,CHEN Ai-huan.   

  1. Guangzhou Institute of Respiratory Disease,the First Affiliated Hospital of Guangzhou Medical College，Guangzhou 510120,China
  • Received:2006-10-20 Revised:2007-01-25 Online:2007-04-06 Published:2007-04-06

摘要： 目的观察布地耐德(BUD)联用福莫特罗(FOM)与单用双倍剂量BUD干粉吸入疗法对轻度持续性哮喘患儿的有效性和安全性，探讨儿童轻度持续性哮 喘的理想治疗方案。 方法选取2005-01—2005-06在广州医学院附属第一医院呼研所专科门诊就诊的轻度持续哮喘患儿50例，采取开放、随机、平行对照方法把50例 患儿分为两组，分别吸入BUD联用FOM(B+F组)或双倍剂量BUD(Double B组)8周，药物均用都保干粉吸入装置吸入。8周的观察期内由患儿或家长 记录哮喘日记，包括日间和夜间症状评分、无症状天数、其它平喘药物(包括应急用速效β2-受体激动剂、长效缓释茶碱、口服长效β2-受体激 动剂、全身用糖皮质激素)使用情况，同时以简易峰流速仪监测其呼气峰流速值(PEF)作为主要肺功能指标。 结果B+F组和Double B组在治疗8周后，日间症状及PEF均较治疗前明显改善，无症状天数明显增加，差异具有统计学意义(均P<0.05)；与治疗前 比较，B+F组在治疗8周后夜间症状评分明显下降(P<0.05)，而Double B组治疗前后比较差异无统计学意义(P>0.05)；两组间日间症状评分、夜 间症状评分、无症状天数及PEF治疗前及治疗后比较差异均无统计学意义(均P>0.05)。两组间病情反复发作次数、需联合应用速效β2-受体激动 剂次数及口服强的松、长效缓释茶碱或口服长效β2-受体激动剂的天数均无统计学意义(均P>0.05)。 结论低剂量吸入糖皮质激素(ICS)联用长效β2-受体激动剂(LABA)与单用双倍剂量ICS治疗儿童轻度持续性哮喘的疗效相当。但从减少或避免ICS 潜在的全身性副反应方面考虑，联用低剂量ICS＋LABA可能是更好的选择。

关键词: 吸入皮质激素, β2-受体激动剂, 儿童, 轻度持续性哮喘

Abstract: AbstractObjectiveTo evaluate the efficacy and safety of low-dose Budesonide(BUD) plus Formoterol(FOM) and double dose Budesonide in children with mild persistent asthma. MethodsFrom Jan. 2005 to Jun. 2005,50 children with mild persistent asthma were randomly divided into two groups,treated with BUD plus FOM (group B+F ) or double dose BUD (group double B) twice daily respectively.The outcomes included daytime symptom scores、nocturnal symptom scores、symptom free days、times of exacerbation、usages of other therapeutic medicines included short-acting β2-agonists、oral prednisone、slow-release theophylline、long-acting β2-agonists and PEF. ResultsDaytime symptom scores and symptoms free days were reduced and PEF was improved significantly in both groups after 8 weeks of treatment ( P<0.05,respectively).Nocturnal symptom scores were significantly reduced in group B+F(P<0.05)but not in group double B(P>0.05) when compared to pre-treatment.There were no differences in daytime symptom scores、nocturnal symptom scores、symptom free days、PEF and usages of other therapeutic medicines between two groups (all P>0.05). ConclusionNo difference is found between the combination therapy with inhaled corticosteroids and long-acting β2-agonist versus double dose inhaled corticosteroids in children with mild persistent asthma,and taking the potential systemic side effects into considerution,the combination therapy may be the better choice.

Key words: Mild persistent asthma , β2-agonist, Children