Igarashi T, Maeda K, Komuta K
Second Department of Internal Medicine, Osaka Teishin Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Sep;30(9):1638-42.
Oral beta-stimulants, theophylline and oral antiallergic drugs are frequently used for asthma treatment in Japan. However, inhaled beta-stimulants and inhaled steroids are becoming the first and second choice of drugs in asthma treatment in European countries, and these three categories of drugs are becoming third or fourth-line therapeutic choices. Accordingly, we investigated the effectiveness of these drugs, which is limited by their pharmacological actions and effects. As found in this study many cases of bronchial asthma cannot be well controlled by their agents, either alone or in combination. The necessity of these drugs for the treatment of chronic bronchial asthma was investigated. Substitution of inhaled beta-stimulant for oral beta-stimulant was possible in 8 of 15 cases. However, in 7 cases, substitution was impossible because of the patient's complaints, and it could not be concluded that oral beta-stimulants are necessary for asthma treatment. Theophylline was substituted by inhaled corticosteroids in 6 of 8 cases. Oral antiallergic drugs were substituted by inhaled corticosteroids in 5 of 6 cases. These results do not conclusively indicate that theophylline and oral antiallergic drugs are not necessary for asthma treatment.
在日本，口服β-兴奋剂、茶碱和口服抗过敏药物常用于哮喘治疗。然而，在欧洲国家，吸入性β-兴奋剂和吸入性类固醇正成为哮喘治疗的首选和次选药物，而这三类药物在欧洲正成为第三或第四线治疗选择。因此，我们研究了这些药物的有效性，其有效性受到其药理作用和效果的限制。如本研究所示，许多支气管哮喘病例单独使用或联合使用这些药物均无法得到良好控制。我们研究了这些药物治疗慢性支气管哮喘的必要性。15例患者中有8例可以用吸入性β-兴奋剂替代口服β-兴奋剂。然而，有7例患者因自身主诉而无法替代，因此不能得出口服β-兴奋剂对哮喘治疗是必要的结论。8例患者中有6例用吸入性皮质类固醇替代了茶碱。6例患者中有5例用吸入性皮质类固醇替代了口服抗过敏药物。这些结果并不能确凿地表明茶碱和口服抗过敏药物对哮喘治疗不必要。
