Eriksson N E, Lindgren S, Lindholm N
Allergol Immunopathol (Madr). 1975 Mar-Apr;3(2):77-86.
In the efforts to avoid the side-effects of the peroral cortisone drugs in the treatment of asthma, trials have been made since the early fifties with the administration of steroids in aerosol form applied direct on the bronchial mucosa. Hydrocortisone as well as prednisolone and dexamethasone have been used with a documented effect on the obstruction. However, the drugs were found to be resorbed and thus resulted in suppression of adrenal function and appearance of Cushing syndrome and other well-known steroid side-effects (12). More recently, beclomethasone dipropionate -- a steroid with potent topical activity -- has been used as a pressurised aerosol. In 1972 Morrow Brown et al. (1) as well as Lal et al. (10) reported a good therapeutic effect with this drug and at the same time found evidence for the opinion that its systemic effect, if any, was insignificant. Less ositive results were reported by Choo-Kang et al. (4) and also by Herxheimer (8), who considered beclomethasone spray not to possess any advantages as compared with the earlier steroids. The purpose of the present study was to assess the clinical value of beclomethasone in the treatment of adult patients previously on long-term oral steroids.
为避免口服皮质类固醇药物治疗哮喘时产生的副作用,自五十年代初以来,人们进行了多项试验,采用气雾剂形式将类固醇直接应用于支气管黏膜。氢化可的松、泼尼松龙和地塞米松都已被使用,并且证实对气道阻塞有疗效。然而,这些药物被发现会被吸收,从而导致肾上腺功能受到抑制,并出现库欣综合征和其他众所周知的类固醇副作用(12)。最近,倍氯米松二丙酸酯——一种具有强大局部活性的类固醇——已被用作加压气雾剂。1972年,莫罗·布朗等人(1)以及拉尔等人(10)报道了该药物具有良好的治疗效果,同时发现有证据支持这样一种观点,即其全身作用(如果有的话)微不足道。朱康等人(4)以及赫克斯海默(8)报道的结果不太理想,他们认为倍氯米松喷雾剂与早期的类固醇相比没有任何优势。本研究的目的是评估倍氯米松在治疗此前长期口服类固醇的成年患者中的临床价值。