不同剂量沙美特罗替卡松粉气雾剂治疗支气管哮喘急性发作的疗效比较研究
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摘要
目的比较不同剂量沙美特罗替卡松粉气雾剂治疗支气管哮喘急性发作的临床疗效。方法选取江油市人民医院2015—2017年收治的支气管哮喘急性发作患者120例,采取随机数字表法分为A、B、C组,各40例。3组均予以沙美特罗替卡松粉气雾剂治疗,A组应用50μg/100μg规格,B组应用50μg/250μg规格,C组应用50μg/500μg规格。比较3组患者临床疗效、症状缓解时间、治疗前后肺功能指标〔用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、最大呼气峰流速(PEF)〕、炎性因子〔肿瘤坏死因子α(TNF-α)、白介素12(IL-12)、白介素17(IL-17)〕,并观察3组患者不良反应发生情况。结果 3组患者临床疗效及咳嗽、喘息、肺部哮鸣音症状缓解时间比较,差异无统计学意义(P>0.05)。治疗前后,3组患者FVC、FEV1、PEF、TNF-α、IL-12、IL-17水平比较,差异无统计学意义(P>0.05);治疗后3组患者TNF-α、IL-17水平低于治疗前,FVC、FEV1、PEF、IL-12水平高于治疗前(P<0.05)。3组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论不同剂量沙美特罗替卡松粉气雾剂均可有效治疗支气管哮喘急性发作,但中低剂量安全性较高。
Objective To investigate clinical effect of different doses of salmeterol bicarbonate aerosol for acute attack of bronchial asthma.Methods A total of 120 cases of patients with acute attack of bronchial asthma were selected form2015 to 2017 year in Jiangyou People's Hospital,which were randomly divided into A,B and C groups according to the random number table method,40 cases in each group.All the three groups were treated with salmeterol bicarbonate aerosol,group A:50 μg/100 μg,group B:50 μg/250 μg,group C:50 μg/500 μg.Clinical effect,symptom relief time,lung function(FVC,FEV1,PEF)and inflammatory factor index(TNF-α,IL-12,IL-17)before and after treatment were compared among three groups,and the incidence of adverse reactions were observed.Results There was no significant differences in clinical effect,remission time of cough,wheezing or lung wheezing among the three groups(P>0.05).Before and after treatment,there was no significant differences in the levels of FVC,FEV1,PEF,TNF-α or IL-12,IL-17 among the three groups(P>0.05).After treatment,the levels of TNF-α and IL-17 in the three groups were lower than before treatment,and the level of FVC,FEV1,PEF,IL-12 were higher than before treatment(P<0.05).There was no significant difference in the incidence rate of adverse reactions among the three groups(P>0.05).Conclusion Different doses of salmeterol bicarbonate aerosol can effectively treat the acute attack of bronchial asthma,but the incidence of adverse reactions at middle and low doses with higher safety.
Objective To investigate clinical effect of different doses of salmeterol bicarbonate aerosol for acute attack of bronchial asthma.Methods A total of 120 cases of patients with acute attack of bronchial asthma were selected form2015 to 2017 year in Jiangyou People's Hospital,which were randomly divided into A,B and C groups according to the random number table method,40 cases in each group.All the three groups were treated with salmeterol bicarbonate aerosol,group A:50 μg/100 μg,group B:50 μg/250 μg,group C:50 μg/500 μg.Clinical effect,symptom relief time,lung function(FVC,FEV1,PEF)and inflammatory factor index(TNF-α,IL-12,IL-17)before and after treatment were compared among three groups,and the incidence of adverse reactions were observed.Results There was no significant differences in clinical effect,remission time of cough,wheezing or lung wheezing among the three groups(P>0.05).Before and after treatment,there was no significant differences in the levels of FVC,FEV1,PEF,TNF-α or IL-12,IL-17 among the three groups(P>0.05).After treatment,the levels of TNF-α and IL-17 in the three groups were lower than before treatment,and the level of FVC,FEV1,PEF,IL-12 were higher than before treatment(P<0.05).There was no significant difference in the incidence rate of adverse reactions among the three groups(P>0.05).Conclusion Different doses of salmeterol bicarbonate aerosol can effectively treat the acute attack of bronchial asthma,but the incidence of adverse reactions at middle and low doses with higher safety.
引文
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[9]宋艳,黄钦蓉.孟鲁司特与激素吸入治疗对支气管哮喘患者血清IL-12及microRNA-21表达的影响[J].内科急危重症杂志,2017,23(3):242-243.
[10]邓赶飞,宋智心,杨蟠储.血清IL-17、IL-4、IFN-γ和IL-33与支气管哮喘的相关性研究[J].国际呼吸杂志,2016,36(21):1627-1630.
[11]刘展池.不同剂量糖皮质激素对支气管哮喘急性发作的治疗效果及不良反应的影响[J].中国医学创新,2018,15(2):109-113.
[2]孙晓凤,张刚,孙兴珍.沙美特罗替卡松粉气雾剂治疗儿童哮喘的临床疗效及其对气道炎性反应的影响[J].实用心脑肺血管病杂志,2017,25(8):158-160.
[3]中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(2016年版)[J].中华结核和呼吸杂志,2016,39(9):675-697.
[4]姜水菊,沈水杰,尚云飞.小青龙颗粒联合沙美特罗氟替卡松治疗支气管哮喘急性发作的临床观察[J].现代中西医结合杂志,2016,25(5):499-500.
[5]余静.代谢组学在支气管哮喘发病机制中的研究进展[J].临床肺科杂志,2016,21(5):924-926.
[6]史玉婷,吴桢珍,费凡,等.支气管哮喘急性发作101例临床分析[J].江苏医药,2017,43(5):315-317.
[7]黄小龙.血清及痰液MMP、TIMP及TNF-α与支气管哮喘患者气道重塑的关系[J].实用临床医药杂志,2016,20(1):52-55.
[8]姜增凯,贾萍,叶晓歌.孟鲁司特钠联合沙美特罗替卡松粉吸入剂治疗支气管哮喘的临床疗效及其对炎性因子、肺功能、免疫功能的影响研究[J].实用心脑肺血管病杂志,2016,24(4):49-52.
[9]宋艳,黄钦蓉.孟鲁司特与激素吸入治疗对支气管哮喘患者血清IL-12及microRNA-21表达的影响[J].内科急危重症杂志,2017,23(3):242-243.
[10]邓赶飞,宋智心,杨蟠储.血清IL-17、IL-4、IFN-γ和IL-33与支气管哮喘的相关性研究[J].国际呼吸杂志,2016,36(21):1627-1630.
[11]刘展池.不同剂量糖皮质激素对支气管哮喘急性发作的治疗效果及不良反应的影响[J].中国医学创新,2018,15(2):109-113.