Guérin J C, Pappo M
Service de Pneumologie, Hôpital de la Croix-Rousse, Lyon.
Presse Med. 1992 Oct 3;21(32):1526-31.
Beclomethasone dipropionate has now been used for more than 10 years during which our knowledge of how to use inhaled corticosteroids has gradually improved: high dose initial treatment followed by progressive reduction down to the minimum effective dosage; administration in 2 daily doses when the asthma is stable and 4 daily doses in case of instability; mild and transient undesirable effects, often minimized by a correct use of the inhaler; effectiveness assessed from bronchial hyper-reactivity and respiratory function tests, reduction or avoidance of oral corticosteroid therapy, or results of association with other treatments, and in particular bronchodilators. When exactly should inhaled corticosteroid therapy should be started and how long should it be pursued are controversial points, but an early and prolonged treatment must probably be recommended.
丙酸倍氯米松现已使用超过10年,在此期间我们对如何使用吸入性皮质类固醇的认识逐渐提高:初始采用高剂量治疗,随后逐渐减至最低有效剂量;哮喘稳定时每日给药2次,不稳定时每日给药4次;不良反应轻微且短暂,正确使用吸入器通常可将其降至最低;疗效通过支气管高反应性和呼吸功能测试、减少或避免口服皮质类固醇治疗或与其他治疗(尤其是支气管扩张剂)联合使用的结果来评估。吸入性皮质类固醇治疗究竟应何时开始以及应持续多长时间是有争议的问题,但可能必须推荐早期且长期的治疗。