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为比较皮质激素吸入加用小剂量的茶碱联合应用治疗哮喘与单纯激素吸入,能否减低激素的用量并维持疗效,减少两药副作用。采用随机分组方法,将40例哮喘患者分为:A组为激素(布地奈德200μg,一日两次)加缓释放茶碱(葆乐辉,0.2g,一日一次);B组为单纯激素吸入(布地奈德200μg,一日3～4次),观察18周,(定期检测肺功能、呼气峰流速率、临床症状体征平分、β2激动剂的使用情况及内源性的皮质醇的水平等)。结果两组肺功能持续性的改善,FEV1及PEF随治疗后比治疗前有显著的提高(P<0.05),PEF的改善率>25%的占75%～80%,两组之间无差异;临床综合疗效两组均有明显的好转,两组之间无差异。单纯激素吸入组的内源性的皮质醇经18周的治疗后与治疗前比有所下降(P<0.05),而激素加茶碱组则无变化。表明小剂量茶碱加小剂量激素吸入,在治疗轻、中度的慢性症状性哮喘的临床疗效与单纯吸入较高剂量的激素相当,观察期间未见两药的明显副作用。认为小剂量的茶碱可作为轻、中度持续性哮喘常规抗炎药物来应用。
For the comparison of corticosteroid inhalation plus a small dose of theophylline combination therapy for asthma and simple hormone inhalation, can reduce the amount of hormones and maintain efficacy, reduce the side effects of both drugs. Forty patients with asthma were divided into two groups according to randomization: group A was hormone (budesonide 200μg, twice a day) plus slow release of theophylline (Bao Lehui, 0.2g once a day); group B was simple Hormone inhalation (budesonide 200μg, 3 to 4 times a day), observed for 18 weeks, (regular detection of lung function, peak expiratory flow rate, clinical symptoms and signs of bispectral, β2 agonist use and endogenous cortisol Level, etc.). Results The improvement of pulmonary function in both groups showed that FEV1 and PEF increased significantly with the increase of FEV1 and PEF before treatment (P <0.05), while those with PEF improvement> 25% and 75% ~ 80%, respectively. There was no difference between the two groups ; Clinical efficacy of two groups have significantly improved, no difference between the two groups. Endogenous cortisol in the group treated with steroid alone decreased after treatment for 18 weeks compared with that before treatment (P <0.05), while there was no change in the hormone plus theophylline group. That the small dose of theophylline plus a small dose of hormone inhalation, in the treatment of mild to moderate chronic symptomatic asthma clinical efficacy and high intake of only a simple dose of hormone, no significant side effects observed during the two drugs. Small doses of theophylline are considered as routine anti-inflammatory drugs for mild-to-moderate persistent asthma.