Masoli Matthew, Holt Shaun, Weatherall Mark, Beasley Richard
Medical Research Institute of New Zealand, PO Box 10055, Wellington, New Zealand.
Curr Allergy Asthma Rep. 2004 Mar;4(2):144-8. doi: 10.1007/s11882-004-0060-y.
Inhaled corticosteroids are the only class of asthma medication that can reduce symptoms, improve lung function, reduce the frequency of severe exacerbations, including hospital and ICU admissions, and decrease the risk of mortality. The therapeutic dose range for all clinical outcome measures in adults is 100 to 1000 mg/d of beclomethasone dipropionate or budesonide, or 50 to 500 mg/d of fluticasone propionate. Doses in excess of this range are not recommended for routine use because they are likely to increase the risk of systemic side-effects without further major improvement in efficacy. The recommendations are qualified by the recognition that there is considerable individual variability in the response to inhaled corticosteroids in asthma, which would suggest that some patients might obtain greater benefit at higher doses, just as some might obtain maximum benefit at lower doses.
吸入性糖皮质激素是唯一一类能够减轻症状、改善肺功能、减少严重加重发作（包括住院和入住重症监护病房）频率并降低死亡风险的哮喘药物。在成人中，所有临床疗效指标的治疗剂量范围为丙酸倍氯米松或布地奈德100至1000毫克/天，或丙酸氟替卡松50至500毫克/天。不建议常规使用超过此范围的剂量，因为这可能会增加全身副作用的风险，而疗效不会进一步显著改善。这些建议有一定条件限制，因为人们认识到哮喘患者对吸入性糖皮质激素的反应存在相当大的个体差异，这表明一些患者可能在较高剂量下获得更大益处，就像一些患者可能在较低剂量下获得最大益处一样。
