布地奈德雾化治疗咳嗽变异性哮喘临床疗效研究
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摘要
应用布地奈德雾化吸入治疗咳嗽变异性哮喘(CVA)可取得较好的临床疗效。CVA是临床门急诊常见疾病,该病多以夜间咳嗽为主要症状,多影响患者休息,若长期不予治疗易导致哮喘发作,预后不良。糖皮质激素是最有效的控制气道炎症的药物。布地奈德有口服和雾化吸入剂型。该药口服需较大剂量,对于全身各脏器存在一定的副作用。而吸入型糖皮质激素布地奈德,通过雾化吸入的方式可直接作用于炎症部位,可起到稳定内皮细胞以及溶酶体膜的作用,抑制炎性细胞因子反应,减少支气管收缩物质的产生,有效缓解支气管痉挛状态,故布地奈德雾化吸入治疗CVA可更好改善患者症状,缩短病程,减少复发及进一步演变成哮喘的风险,值得推广应用。
The application of Budesonide aerosol inhalation in the treatment of cough variant asthma(CVA)can achieve better clinical efficacy. CVA is a common disease in clinical outpatient and emergency department.The main symptoms of CVA are cough at night, which affects the rest of patients. If long-term treatment is not given, asthma attack will easily lead to poor prognosis. Glucocorticoid is the most effective drug to control airway inflammation. Budesonide has oral and aerosol inhalation formulations. Oral administration of the drug requires a large dose and has certain side effects on all organs of the body. The inhaled glucocorticoid budesonide can directly act on the inflammation site by atomizing inhalation, which can stabilize endothelial cells and lysosome membrane, inhibit inflammatory cytokine response, reduce the production of bronchial contractile substances, and effectively alleviate bronchial spasm. Therefore, Budesonide aerosol inhalation therapy for CVA can better improve the symptoms of patients, shorten the course of disease, reduce the risk of recurrence and further development of asthma, which is worthy of promotion and application.
The application of Budesonide aerosol inhalation in the treatment of cough variant asthma(CVA)can achieve better clinical efficacy. CVA is a common disease in clinical outpatient and emergency department.The main symptoms of CVA are cough at night, which affects the rest of patients. If long-term treatment is not given, asthma attack will easily lead to poor prognosis. Glucocorticoid is the most effective drug to control airway inflammation. Budesonide has oral and aerosol inhalation formulations. Oral administration of the drug requires a large dose and has certain side effects on all organs of the body. The inhaled glucocorticoid budesonide can directly act on the inflammation site by atomizing inhalation, which can stabilize endothelial cells and lysosome membrane, inhibit inflammatory cytokine response, reduce the production of bronchial contractile substances, and effectively alleviate bronchial spasm. Therefore, Budesonide aerosol inhalation therapy for CVA can better improve the symptoms of patients, shorten the course of disease, reduce the risk of recurrence and further development of asthma, which is worthy of promotion and application.
引文
[1]李海燕.丙酸倍氯米松联合孟鲁司特钠治疗老年咳嗽变异性哮喘及对Eotaxin表达水平影响[J].河北医学,2017,23(12):2029-2031.
[2]Zou YX,Zhang J,Ma C,et al.Clinical efficacy of montelukast sodium in treatin g infantile wheezing[J].European Review for Medical&Pharmacological Sciences,2014,18(6):775.
[3]许琴.孟鲁司特钠联合布地奈德福莫特罗治疗支气管哮喘急性发作的效果研究[J].中国基层医药,2017,24(11):1677-1680.
[4]Tagaya E,Kondo M,Kirishi S,et al.Effects of regular treatment with combination of salmeterol/fluticasone propionate and salmeterol alone in cough variant asthma[J].Journal of Asthma Official Journal of the Association for the Care of Asthma,2015,52(5):512.
[5]Niimi A,Brightling CE,Dicpinigaitis PV.Cough in Asthma Is due to Eosinophilic Airway Inflammation:A Pro/Con Debate[J].Lung,2014,192(1):33-38.
[6]李倩,李立维,刘君,等.孟鲁司特钠对咳嗽变异性哮喘患者IL-4、IL-10及肺功能的影响[J].临床肺科杂志,2018,21(8):1423-1425.
[7]Obase Y,Shimoda T,Kishikawa R,et al.Trigger of bronchial hyperresponsiveness development may not always need eosinophilic airway inflammation in very early stage of asthma[J].Allergy&Rhinology,2016,7(1):1-7.
[8]Zhang YX,Liu Y,Xue Y,et al.Correlational study on atmospheric concentrations of fine particulate matter and children cough variant asthma[J].Eur Rev Med Pharmacol Sci,2016,20(12):2650-2654.
[9]Ohta K,Yamaguchi M,Akiyama K,et al.Japanese guideline for adult asthma[J].Allergol Int,2011,60(2):115-145.
[10]刘军艳,刘晓娟.咳嗽变异性哮喘与支气管哮喘的关系[J].吉林医学,2014,35(2):255-256.
[11]Fujimura M.Pathophysiology,diagnosis and treatment of cough variant[J].Rinsho Byori,2014,62(5):464-470.
[12]中华医学会呼吸病学分会呼吸治疗学组.雾化治疗专家共识(草案)[J].中华结核和呼吸杂志,2015,38(6):478-479.
[13]张灵芳,凌杰.儿童咳嗽变异性哮喘治疗前后血清超敏C应蛋白白细胞介素-10和肿瘤坏死因子-α水平的变化[J].中国药物与临床,2014,14(5):642-643.
[14]梁伟烽,于海建,王灿良,等.布地奈德对哮喘大鼠免疫功能、细胞炎症因子水平的影响[J].中国老年学杂志,2016,36(15):3644-3646.
[15]陈庆群.孟鲁司特联合布地奈德混悬剂治疗咳嗽变异哮喘的疗效及对炎性因子水平的影响[J].中国基层医药,2018,25(2):244-248.
[16]容令新,莫火弟,陈智锋.孟鲁司特钠辅助治疗咳嗽变异性哮喘的疗效及对血清炎性因子水平的影响[J].中国医院用药评价与分析,2018,18(5):630-633.
[17]马媛媛,艾合提热木·塔力甫,崔彦杰.布地奈德福莫特罗吸人剂联合苏黄止咳胶囊治疗咳嗽变异性哮喘的临床效果[J].中国医药,2018,13(6):842-845.
[18]刘晓波,钟海潮,盛碧婵,等.老年咳嗽变异性哮喘患者炎症细胞因子变化及中西医结合干预的疗效[J].中国老年学杂志,2018,38(11):2628-2630.
[19]李志莹,徐健,陈济明,等.呼出气冷凝液中8-异前列腺素水平检测对咳嗽变异性哮喘的临床意义[J].临床肺科杂志,2015,20(9):1633-1635.
[2]Zou YX,Zhang J,Ma C,et al.Clinical efficacy of montelukast sodium in treatin g infantile wheezing[J].European Review for Medical&Pharmacological Sciences,2014,18(6):775.
[3]许琴.孟鲁司特钠联合布地奈德福莫特罗治疗支气管哮喘急性发作的效果研究[J].中国基层医药,2017,24(11):1677-1680.
[4]Tagaya E,Kondo M,Kirishi S,et al.Effects of regular treatment with combination of salmeterol/fluticasone propionate and salmeterol alone in cough variant asthma[J].Journal of Asthma Official Journal of the Association for the Care of Asthma,2015,52(5):512.
[5]Niimi A,Brightling CE,Dicpinigaitis PV.Cough in Asthma Is due to Eosinophilic Airway Inflammation:A Pro/Con Debate[J].Lung,2014,192(1):33-38.
[6]李倩,李立维,刘君,等.孟鲁司特钠对咳嗽变异性哮喘患者IL-4、IL-10及肺功能的影响[J].临床肺科杂志,2018,21(8):1423-1425.
[7]Obase Y,Shimoda T,Kishikawa R,et al.Trigger of bronchial hyperresponsiveness development may not always need eosinophilic airway inflammation in very early stage of asthma[J].Allergy&Rhinology,2016,7(1):1-7.
[8]Zhang YX,Liu Y,Xue Y,et al.Correlational study on atmospheric concentrations of fine particulate matter and children cough variant asthma[J].Eur Rev Med Pharmacol Sci,2016,20(12):2650-2654.
[9]Ohta K,Yamaguchi M,Akiyama K,et al.Japanese guideline for adult asthma[J].Allergol Int,2011,60(2):115-145.
[10]刘军艳,刘晓娟.咳嗽变异性哮喘与支气管哮喘的关系[J].吉林医学,2014,35(2):255-256.
[11]Fujimura M.Pathophysiology,diagnosis and treatment of cough variant[J].Rinsho Byori,2014,62(5):464-470.
[12]中华医学会呼吸病学分会呼吸治疗学组.雾化治疗专家共识(草案)[J].中华结核和呼吸杂志,2015,38(6):478-479.
[13]张灵芳,凌杰.儿童咳嗽变异性哮喘治疗前后血清超敏C应蛋白白细胞介素-10和肿瘤坏死因子-α水平的变化[J].中国药物与临床,2014,14(5):642-643.
[14]梁伟烽,于海建,王灿良,等.布地奈德对哮喘大鼠免疫功能、细胞炎症因子水平的影响[J].中国老年学杂志,2016,36(15):3644-3646.
[15]陈庆群.孟鲁司特联合布地奈德混悬剂治疗咳嗽变异哮喘的疗效及对炎性因子水平的影响[J].中国基层医药,2018,25(2):244-248.
[16]容令新,莫火弟,陈智锋.孟鲁司特钠辅助治疗咳嗽变异性哮喘的疗效及对血清炎性因子水平的影响[J].中国医院用药评价与分析,2018,18(5):630-633.
[17]马媛媛,艾合提热木·塔力甫,崔彦杰.布地奈德福莫特罗吸人剂联合苏黄止咳胶囊治疗咳嗽变异性哮喘的临床效果[J].中国医药,2018,13(6):842-845.
[18]刘晓波,钟海潮,盛碧婵,等.老年咳嗽变异性哮喘患者炎症细胞因子变化及中西医结合干预的疗效[J].中国老年学杂志,2018,38(11):2628-2630.
[19]李志莹,徐健,陈济明,等.呼出气冷凝液中8-异前列腺素水平检测对咳嗽变异性哮喘的临床意义[J].临床肺科杂志,2015,20(9):1633-1635.